Private provision does not mean efficient use of funds

By Dr Mary Church, GP and member of BMA Council.

As a Lanarkshire GP, I am used to hearing from colleagues south of the border how much better we have it - we have not had to put up with the imposition of polyclinics, and our policy-makers generally do not share their English counterparts' zeal for market forces.

But Scotland has had its own negative experiences of the commercialisation agenda, and as a recent BMJ paper argued, they can shed light on the situation in the rest of the UK.

Allyson Pollock's research looked at Scotland's only independent sector treatment centre (ISTC), unearthing the alarming fact that in its first year of operation it performed only 18 per cent of its total annual contract value - Scottish health boards may have overpaid up to £3 million in the contract's first year.

Pollock et al found that if the same findings apply in England, as much as £927 million of the total first-wave contracts might have been overpaid to ISTCs. That is money that could and should have been invested in NHS general practice, and on better hospital services for our patients.

The BMA believes now is the time to finally put to bed the notions that competition is self-evidently good, and that private provision means efficient use of public funds.

The aim of our new 'Look After Our NHS' initiative is to show that a publicly provided, publicly funded health service is the best option for patients and taxpayers alike - particularly in a time of global economic crisis.

We are gathering examples from front-line doctors of the true cost of market-driven reforms, the waste of public money, and the negative impact they have had on patient care.

You can tell us about your experiences by emailing us at or going to You will also find a set of principles on the website that set out our vision for a publicly funded, publicly provided, publicly accountable NHS.

So tell us about your concerns, share your experiences with us, and let us stand up for an NHS led by healthcare professionals putting patients before profits.

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