Intended for healthcare professionals

Head To Head Maudsley Debate

Should NHS mental health services fear the private sector? Yes

BMJ 2010; 341 doi: (Published 04 October 2010) Cite this as: BMJ 2010;341:c5382
  1. Allyson M Pollock, professor of international public health policy
  1. 1Edinburgh University, Edinburgh EH8 9AG, UK
  1. allyson.pollock{at}

The coalition government wants to open up the market in the NHS. Allyson Pollock thinks this will result in an impoverished and inequitable service but Elaine Murphy and Philip Sugarman (doi:10.1136/bmj.c5385) believe mental health services have much to gain

Soon multinational corporations will control the distribution and supply of mental health provision in England. US healthcare corporations have long been targeting mental health services in the NHS; first by substituting for NHS hospitals and then introducing niche markets in drug and alcohol addiction and other services. A whole swathe of NHS mental health services has been closed or transferred to the for profit private sector from the NHS.1 We know too little about cost, quality, or value for money as the sector has largely escaped public scrutiny in the UK. But we know enough to question claims of value for money and improved quality.2

The English white paper marks the end of market incrementalism and a switch to US style managed care and health maintenance organisations. Under these proposals the NHS will be reduced to government payers funding the private sector to commission and provide care.3 In the UK, general practice consortiums (many of which are already run by private companies) are at the heart of the new …

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