Intended for healthcare professionals

Head To Head Maudsley Debate

Should NHS mental health services fear the private sector? No

BMJ 2010; 341 doi: (Published 04 October 2010) Cite this as: BMJ 2010;341:c5385
  1. Elaine Murphy, secretary1,
  2. Philip Sugarman, chief executive and medical director2
  1. 1All Party Parliamentary Group on Mental Health, House of Lords, London SW1A 0PW, UK
  2. 2St Andrew’s Healthcare, Northampton, UK
  1. Correspondence to: E Murphy murphyel{at}

The coalition government wants to open up the market in the NHS. Allyson Pollock (doi:10.1136/bmj.c5382) thinks this will result in an impoverished and inequitable service but Elaine Murphy and Philip Sugarman believe mental health services have much to gain

This is a fascinating time for the NHS, when funding may finally have peaked and there is a realisation that we can’t improve health outcomes further through using even more taxpayers’ money, we must do it through healthy competition. Although the marketisation of the NHS has been in progress for 20 years, the policy has meandered rather chaotically in the general direction of competition, for political reasons. The coalition government looks set to speed things up, and we welcome this in mental health services.

There is nothing in the founding principles of the NHS that says “national” means “nationalised” or care has to be delivered by one state owned monopoly provider employing staff on identical terms and conditions across the country. Indeed, there is plenty of evidence of inefficiencies, low productivity, high staff costs, and a shortfall in outcomes in the NHS. Despite unprecedented investment in mental health these past 10 years, improvement has been only modest. Many services, …

View Full Text

Log in

Log in through your institution


* For online subscription