Can general practitioners compete with big business?: NHS privatisation was piloted in prisons

doi:10.1136/bmj.332.7553.1336

BMJ 2006;332:1336 (3 June), doi:10.1136/bmj.332.7553.1336

Letter

Can general practitioners compete with big business?

NHS privatisation was piloted in prisons

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

EDITOR—It is no surprise to see NHS general practice beingeroded by big business.¹ Doctors advocate for all their patients;politicians (the "owners" of the NHS) have pressures that areoften at odds with those of patients and therefore their doctors.

By seeking a system that reduces doctors' responsibility forpatients to an employment contract (with minimum and maximumstandards set by managers), politicians can have less hassle,perhaps at the expense of reduced patient care but without theelectoral risk of providing for free an increasingly expensiveproduct to an increasing number of clients within a limitedbudget.

In Scotland some years ago, a group of senior prison doctorsattempted to bid for the contract to provide health servicesto Scottish prisoners but were thwarted by a tender processthat seemed biased towards a single service provider with acommercial track record. During the run up to . . . [Full text of this article]

Andrew J Ashworth, general practitioner

Davidson's Mains Medical Centre, Edinburgh EH4 5BP Andrew.ashworth@lothian.scot.nhs.uk