NHS: 49% cap is a threat to us all
Today the Commons is debating the Government’s plans to increase the cap on NHS hospitals ability to raise private income to 49%. It currently varies from hospital to hospital but is, on average, 1.1% so this represents a massive increase.
Now some commentators have said that this is better than the original proposal to remove the cap entirely and that, in any case, almost no hospitals will get anywhere near that as there is not a market for a wholesale increase in private health provision in the current economic climate.
That misses the point however. The government is not trying to meet a market demand, it is trying to create one.
Cash-strapped NHS hospitals will try to help solve their financial difficulties by boosting the private sector. This creates a conflict of interest as it creates an incentive to try to get as many patients as they can to go private. It is also likely that the private patients will be those with “straightforward” procedures” that will be the most profitable, rather than those that are more complex and less profitable. This will certainly mean than there will be less resources available for NHS patients who are on waiting lists for these routine procedures.
In addition, because the cap is a cap on income rather than patients, individual NHS hospitals will gain a financial interest in benefiting from any medical developments and research. At present there are rules that govern how NHS intellectual property is used to ensure that the whole NHS benefits from new treatments developed in one trust. This common good of both the NHS and the patients will be undermined if hospitals can patent and licence any new procedures or treatments.
Let’s not forget the difference between the NHS and the private sector. The NHS was set up so that access to health care would be based on need rather than ability to pay. The private sector is there to make a profit. Creeping privatisation undermines the whole ethos of the NHS and universal healthcare free for all becomes secondary to making money for a few.