Quality of care in independent sector treatment centres
BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d6936 (Published 04 November 2011) Cite this as: BMJ 2011;343:d6936- Martin Bardsley, head of research,
- Jennifer Dixon, director
- 1Nuffield Trust, London W1G 7LP, UK
- martin.bardsley{at}nuffieldtrust.org.uk
In the linked study (doi:10.1136/bmj.d6404), Chard and colleagues compare patient characteristics and outcomes after elective surgery in independent sector treatment centres (ISTCs) and NHS providers.1
The NHS has always bought a wide range of services from private suppliers—for example, to provide drugs, construction, information technology, and primary care. The extension of this arrangement into hospital care has been deeply controversial. Some are concerned that independent ownership focuses unduly on making private profit rather than on investing surpluses in better care, and that this contaminates the altruism of the professionals working in the facilities. Others are worried that there may be unfair advantages to independent over NHS providers, in that they may not need to bear the costs of training clinical staff or research, may be paid higher prices for care, may be given more favourable contracts, may unfairly poach clinical staff, or may cherry pick healthier cases to treat (which are lower cost) or “dump” complex cases back into the NHS. Still more are concerned about the quality and safety of the routine care provided, in part because of a lack of information about the quality of care and the reliance of some independent facilities on clinical staff …
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