The Labour Party’s promise to “end and reverse privatisation in the NHS in the next Parliament” has triggered a tetchy response from the private hospital chains, which have been doing good business and filling their otherwise empty beds with NHS-funded patients.
The Independent Healthcare Providers Network (IHPN) claimed (perhaps having just listened to Boris Johnson’s inflated promises) that “over 40” new NHS hospitals would be needed if a Labour government prevented private hospitals from delivering care for NHS patients, and warned that waiting lists for specialist care could treble in three years.
They went on to claim the private sector performed 11.2% of all non-urgent care, which they say was 436,000 operations a year. The IHPN’s chief executive David Hare argued that this proved the “vital role” private providers play.
NHS trained staff
However the boot is on the other foot. Without the medical, nursing and professional staff trained and largely employed by the NHS when not doing shifts in private hospitals, and the availability of NHS emergency and intensive care facilities for the cases that go wrong, the private hospital sector would collapse.
Indeed the more the private sector expands, the more they tend to poach further scarce NHS staff, and put greater pressure on NHS hospitals which are responsible for the full range of health services.
However their calculations seem wide of the mark in almost every respect.
According to the main market analysts Laing & Buisson, there are 197 private hospitals licensed to take acute patients, with 9872 beds between them, averaging just 50 beds per hospital: this underlines how limited is the range of services the private sector is set up to deal with, with no emergencies to deal with.
9872 beds is the equivalent of around 20 district general hospitals with 500 beds – not 40. But since many of the private sector hospital beds are under-occupied and providing only a limited range of elective procedures it’s not at all obvious they would all need to be replaced.
By contrast the NHS has just over 100,000 general and acute beds, mostly in full service general hospitals.
The situation is very different in mental health, where the private sector expansion has been the greatest.
Laing & Buisson estimate there are 8942 private beds funded by the NHS, but give an inflated figure of 23,596 public sector beds: in fact the latest NHS figures show just 18,179 mental health beds after a decade of cutbacks, so the private sector is currently providing around a third of mental health in-patient capacity, much of this through companies that are now owned by US corporations.
However the IHPN is not concerned with mental health: its focus is on acute care, and here too their numbers are questionable, and the basis on which they have made their calculations is not explained.
The NHS in England delivered 8.8 million elective admissions in 2018-19: so 436,000 operations is not equivalent to 11.2% of all non-urgent care, but just under 5%.
Some commentators argue that private hospitals are only paid the standard NHS tariff for the publicly-funded patients they treat – but they don’t do the standard type of NHS work. They take a very different, more restricted caseload, accepting only the least complex or risky cases, while the NHS has to accept all comers.
It’s high time there was a real audit of the costs – overt and hidden – of the private sector: if there was, the IHPN would have to come up with some more plausible figures.
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