Public is urged to help exclude private companies from NHS

BMJ 2010; 340 doi: (Published 12 February 2010) Cite this as: BMJ 2010;340:c884
  1. Oona Mashta
  1. 1London

    The BMA is urging the public to support its campaign against private companies providing NHS care in England, which it says is adversely affecting many parts of the health service.

    The BMA’s “Look After our NHS” campaign (, which was launched to emphasise the problem among doctors in June 2009, is now being extended to highlight the issue to the general public. Successive governmental policies have allowed commercially run firms to compete against existing NHS trusts and GP practices to provide NHS care, to the detriment of the health service, says the BMA.

    The BMA’s campaign website has been revamped so that members of the public can add their support.

    As part of the protest the BMA will be sending “Look After our NHS” campaign packs to each of its members in England, over 100 000 doctors and medical students. The packs contain posters picturing businessmen taking money out of the NHS and call on the public to “help us put patients before profits.”

    Leaflets warning patients that “your local GP practice, hospital or community health service could be run by a commercial, profit driven company in the future” will also be distributed via GP practices and BMA representatives in hospitals.

    Hamish Meldrum, chairman of the BMA, said, “We want an NHS with patients, not profits, at its heart. The public values the NHS as a publicly provided, publicly funded service. Like doctors, they do not want vital public money to be diverted to shareholders.

    “Doctors have already backed the campaign. Now members of the public can show politicians the extent of opposition to commercialisation of their NHS.”

    The campaign packs for doctors also contain a brochure with several warnings of the effects on the NHS of market based reforms. It states that the creation of a market in the NHS has meant an increase in bureaucracy; the number of senior managers in the NHS rose by 91% between 1995 and 2008—more than double the increase in numbers of doctors and nurses.

    It also says that many private NHS providers have received millions in guaranteed payments for contracts, despite treating fewer patients than planned; on average, the first wave of independent sector treatment centres delivered just 85% of activity paid for—suggesting a shortfall of £220m (€251m; $343m) on the £1.47bn contracts.

    New GP led health centres have been costly, says the BMA brochure, enjoying on average three times the funding per patient of regular GP practices, despite in some cases few patients registering with them. Every eight cases diverted to an independent sector treatment centre costs the taxpayer the equivalent of almost 10 cases dealt with by the NHS, the BMA states.

    The health minister Mike O’Brien said, “Independent and third sector organisations were used successfully to get down waiting lists for operations and can make a contribution to this by helping to add capacity and increase patient choice.”

    The independent social policy think tank Civitas criticised the BMA’s campaign for being out of touch with the public and trying to protect its members “from radical changes that will be required.”

    James Gubb, director of the Health Unit at Civitas, said: “The BMA’s stance goes to the heart of the debate in the NHS at present: whether the financial challenges facing the NHS meant taxpayers’ money should be spent supporting NHS providers or spent on the provider—NHS or non-NHS—that can offer the best deal on quality and cost.

    “I suspect most of the public would side with the latter. Affinity lies with the values underlying the NHS: universal, comprehensive health care, free at the point of use, rather than who provides the service.”


    Cite this as: BMJ 2010;340:c884