BMJ 2002;325:349-350 ( 17 August )

Editorials

The NHS, the private sector, and the virtual asylum

Proper systems are needed to develop, manage, and monitor cooperation between public and private sectors

The first 150 words of the full text of this article appear below.

The British government is promoting close cooperation between the NHS and the private sector.1 In mental health care, an outcry over conditions in private "madhouses" led to legislation and the establishment of county asylums in the early 19th century, almost eliminating private care.2 The number of beds for people with mental illness in the NHS dropped from a peak of 148 000 in 1954 to 35 740 in 2000. 3 4 As this decline accelerated, a thriving private market in the provision of beds for long stay patients emerged.5 It is time to consider the consequences.

One of the successes of community care has been the ability of non-statutory organisations to provide a diversity of supported housing. The private provision of long term inpatient care is more problematic. The lack of NHS facilities for patients whose behaviours are intractably difficult to manage or who have unusual psychiatric needs has been exploited as a market opportunity . . . [Full text of this article]
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Relevant Article

The NHS, the private sector, and the virtual asylum
Philip A Sugarman, Lorna Duggan, Geoff Dickens, John C Hughes, Leila B Cooke, Peter Carpenter, Rob Poole, Tony Ryan, and Alison Pearsall
BMJ 2002 325: 1300. [Extract] [Full Text]

This article has been cited by other articles:

  • Raleigh, V. S, Polato, G. M, Bremner, S. A, Dhillon, S., Deery, A. (2008). Inpatient mental healthcare in England and Wales: patterns in NHS and independent healthcare providers. JRSM 101: 544-551 [Abstract] [Full text]  
  • Yacoub, E., Hall, I., Bernall, J. (2008). Secure in-patient services for people with learning disability: is the market serving the user well?. Psychiatr. Bull. 32: 205-207 [Full text]  
  • Killaspy, H. (2007). From the asylum to community care: learning from experience. Br Med Bull 0: ldl017v1-14 [Abstract] [Full text]  
  • Sugarman, P. A, Duggan, L., Dickens, G., Hughes, J. C, Cooke, L. B, Carpenter, P., Poole, R., Ryan, T., Pearsall, A. (2002). The NHS, the private sector, and the virtual asylum. BMJ 325: 1300-1300 [Full text]  

Rapid Responses:

Read all Rapid Responses

Misleading English
John B Peniket
bmj.com, 18 Aug 2002 [Full text]
The virtual asylum: a destructive editorial.
Philip A Sugarman, et al.
bmj.com, 21 Aug 2002 [Full text]
No Lessons Learned
Leila B Cooke, et al.
bmj.com, 23 Aug 2002 [Full text]
Re: Editorial 17 August 2002 “The NHS, the Private Sector, and the Virtual Asylum”
John C Hughes
bmj.com, 30 Aug 2002 [Full text]
Commercial oversensitivity
Rob Poole, et al.
bmj.com, 2 Oct 2002 [Full text]
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