Political

Polly Toynbee: in praise of the private sector in the NHS

Polly Toynbee wrote in 2009 (with my emphasis):

There is no doubt that putting some services out to tender has vastly improved certain standards over the years, broken the power of vested interests and brought in competition that has sharpened up results. Just look at how hospital consultants’ waiting lists plummeted when a few Independent Treatment Centres were set up nearby. Suddenly, long waiting lists for hip and cataract operations fell because patients had a choice. The wholescale mass privatisation of a service is rarely needed, but a little gingering up round the edges has an electrifying effect on sleepy outfits. Often, private provision makes sense where small units need to buy in some expertise or back-office work they can’t develop themselves.

Some things have always been private – GPs, for example, the most-loved part of the National Health Service

The answer is flexibility and practicality; see what works best and keep ideology at bay as far as possible.

Hat tips: Nick Thornsby and Martin Shapland.

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9 responses to “Polly Toynbee: in praise of the private sector in the NHS”

  1. She also said: Coalition government: Like a flat-pack with screws missing, this deal will wobble.
    The Tory partner, five times the size, will trample the Liberal Democrats like a rhino without even noticing.

    • John McReynolds Yup – the link to the full comments is there in the first line of my post. As you say, the overall piece is fairly balanced – but that also makes it rather different from some of her recent writing which has had a very different tone about private suppliers.

    • Mark – I don't think she says anything different in the piece to what she believes now. If you had placed the emphasis on the line:
      "The wholescale mass privatisation of a service is rarely needed, but a little gingering up round the edges has an electrifying effect on sleepy outfits."
      then her ongoing view becomes clear.

  2. She also said: Coalition government: Like a flat-pack with screws missing, this deal will wobble.
    The Tory partner, five times the size, will trample the Liberal Democrats like a rhino without even noticing.

  3. Mark, your focus on this particular piece of output from Toynbee (in which she quite clearly uses the words 'a little') implies that the question of the QUANTITY of private provision as a proportion of overall provision is irrelevant. It is absolutely not a simple question of either/or, and your adoption of such a stance only undermines any suggestion that you and your party understand the nature of these changes or the impact they will have. Bravo.

    • Beth – I think the quote highlights something different, which is that some of the simplistic statements being made (private provision in the NHS = disaster! etc.) are way off, especially given that almost everyone making such comments isn't calling for GPs to be nationalised.

      Where Polly Toynbee's recent writings fall down (at least those I've read) is that they rather glide over her own support for some private provision in the NHS and indeed the existing very popular role of private provision in the form of GPs.

  4. Thanks for your reply, Mark. I think it is a specious argument to focus on acceptance of limited existing private provision as somehow contradictory to opposition to the far-reaching reforms of the bill, not least since there is overwhelming evidence that the service you are reorganising was, as left by the previous government, a high-performing organisation compared to the services available in other countries, cheaper than a great many of them, and with record levels of public satisfaction:
    http://www.kingsfund.org.uk/current_projects/the_health_and_social_care_bill/mythbusters/nhs_performance.html
    And indeed Polly herself is explicit in the article from which you have taken the extract in stating that what is required is to 'see what works best'. This is a clear case for evidenced-based policymaking in which careful and detailed consideration of the implications of any change is paramount. She is merely a journalist doing her best to make intelligible a very complex landscape to her to readership. It speaks volumes that your party chooses to direct its most vocal defence at her rather than to the vast array of healthcare professionals and their representative bodies who are lined up against you, as shown here:
    http://www.bbc.co.uk/news/uk-16954223
    So I reiterate, there is a world of difference between the nature and level of current private provision within the NHS, and that which this bill will usher in. You think large-scale private provision as an alternative to the NHS will improve (an already very good) healthcare system? Take a look at this.
    http://t1ber1us.wordpress.com/2012/02/10/the-problem-of-the-private-sector-in-nhs-reform/
    How is competition (perfect competition, not the day-to-day reality we face!) deemed to work to drive up the quality of the 'customer' experience? It requires real consumer power along the lines of the 'loyalty, voice, exit' model famously laid out by US economist Albert Hirschman in the '60s. But this will not work for a public service such as the NHS, as this piece clearly explains.
    Instead what it will create is precisely the 'two-tier system' which the Royal College of GPs is so concerned about. You want US levels of health inequality? This is the road you take. It will be cold comfort for those of us on the outside of your party to see the political suicide which ensues from you so wedding yourself to Tory doctrine. This issue is a so much bigger than party politics and 'She said'/'She said'. Those of us opposing this bill do not, for the most part, oppose all reform. But these reforms do not and will not address the health challenges facing our ageing, financially squeezed, population in the years to come- quite the opposite.

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