NHS is very good value

[teamsaint]

Your breath has always appeared to me to be almost uniquely un-bated, ahinton ...

To answer Mr Barrett's query any profits generated by private industry in the NHS will deservedly go to the those who bravely invested the money. Where would one expect them to go to? The Socialist Workers' Party?

My bank made a nice little profit on the mortgage for my house ... but I was a most grateful beneficiary as well!

with apparently limitlss demand, ( so we are told) and ring fenced budgets, they may not be the bravest investments ever made.

[ahinton]

Your breath has always appeared to me to be almost uniquely un-bated, ahinton ...

Appearances can deceive - as indeed they might well have done in this particular instance...

[P. G. Tipps]

That doesn't answer my question at all! I asked how the profits would be generated in the first place, if health provision is free at the point of delivery.

Apologies. I did read your question several times not quite sure what it actually meant and decided it must mean the "beneficiaries of profit". Clearly this was not the case.

Of course the word 'free' when we talk about the NHS is a misnomer, which is precisely why I put it in inverted commas here and in an earlier post. We all know that "we" pay for it.

Now if private industry can help to run parts of the service more efficiently than is the case at present and make a profit for their shareholders at the same time what on earth is wrong with that? Few of us work or invest money without expecting some reward/profit at the end of it all.

We already know that the NHS sometimes has to use private hospitals for patients in certain circumstances and 'contracts out' in auxiliary service areas. We also know that administrators and managers and of course many GPs and consultants themselves do very well out indeed of the current system and make big personal profits out of our hard-earned taxes.

Of course a certain level of quality of service must be achieved and maintained (and indeed improved if possible) whether parts of the system are provided by public or private service workers. Wages for ground-floor staff must be held at a decent level which, apart from the economic justice of that, will help to aid recruitment. And I repeat the principle of 'free' health care at the point of delivery must never be compromised. So again we are back to the real topic of 'value for money'.

I know any private involvement in public services is pure anathema to some, but others don't have such political hang-ups, and are simply looking for the best deal for the customer/patient, which I suggest should take priority over all others.

Our quality of healthcare and the principle of 'no charge at the point of delivery', without allowing excessive public waste in its wake, are the only things that really matter in the end, not how we achieve it.

[Richard Barrett]

if private industry can help to run parts of the service more efficiently than is the case at present and make a profit for their shareholders at the same time what on earth is wrong with that? Few of us work or invest money without expecting some reward/profit at the end of it all.

Indeed. But (a) there's no rule that says a profitmaking company necessarily does things "more efficiently" than a state-run one (look at the railways for example!) - anything a business can do, a nonprofit concern can also do; (b) giving public services to private industry basically means that some of your taxes are effectively being paid directly to the shareholders, and I don't know about you but I don't really see the point of that, and (c) as we see from the water industry, privatised services can easily end up back in the hands of nationalised concerns, but of another country, which would seem to me to defeat the object of doing it.

It's not that private involvement is "anathema" in itself or that opposing it is the result of what you call a "hang-up" - it's just that its priorities are different, ie. maximising profit and paying dividends to shareholders, and these priorities are fundamentally in conflict with providing a free and committed service to patients which doesn't concentrate on more obviously profit-making parts of the service at the expense of less obviously money-making areas like mental health. Look at the American system and you see what that leads to: enormously increased expenditure and a decling in life expectancy. As for "value for money" I think it might be at least as appropriate to ask if bank bailouts and "defence" spending are providing "value for money" and then see how that compares with the NHS.

[ahinton]

Indeed. But (a) there's no rule that says a profitmaking company necessarily does things "more efficiently" than a state-run one (look at the railways for example!) - anything a business can do, a nonprofit concern can also do; (b) giving public services to private industry basically means that some of your taxes are effectively being paid directly to the shareholders, and I don't know about you but I don't really see the point of that, and (c) as we see from the water industry, privatised services can easily end up back in the hands of nationalised concerns, but of another country, which would seem to me to defeat the object of doing it.

Aye, there's the rub, indeed; (a) what matters is how efficiently the service is run, whoever runs it and (b) in the case of privatising any parts of NHS, the taxpayer is still funding the service and the only equitable way to address this anomalous situation is to chager the taxpayer less in recognition of those parts of the service no longer provided by the state from his/her taxes - were that to happen, private industry would have to "got it alone" in proving the serices required of it and this would not be so attractive an idea! Taxes should never be paid to private company shareholders; they should only be paid to governments for the services that they provide. If I ran a large scale healthcare company and the government offered me the contract to provide all of its A&E services but at my company's expense, I'd obviously tell it where to go!

It's not that private involvement is "anathema" in itself or that opposing it is the result of what you call a "hang-up" - it's just that its priorities are different, ie. maximising profit and paying dividends to shareholders, and these priorities are fundamentally in conflict with providing a free and committed service to patients which doesn't concentrate on more obviously profit-making parts of the service at the expense of less obviously money-making areas like mental health. Look at the American system and you see what that leads to: enormously increased expenditure and a decling in life expectancy. As for "value for money" I think it might be at least as appropriate to ask if bank bailouts and "defence" spending are providing "value for money" and then see how that compares with the NHS.

That's right; there are several ares of healthcare provision that by nature simply cannot be run for profit and so any private company taking them on would be acting irresponsibly towards its shareholders and would likely go bust in no time.

[Beef Oven!]

That's right; there are several ares of healthcare provision that by nature simply cannot be run for profit and so any private company taking them on would be acting irresponsibly towards its shareholders and would likely go bust in no time.

I don't understand the rationale for that belief. IMV, there is no theoretical basis for your view.

And in practice, Circle Healthcare, a stock market listed private firm, provides the full full range of clinical services at Hinchingbrooke Hospital and appointed a practicing doctor as the chief executive, there.

The bottom line (NPI), is that there are good returns to shareholders to be had in this sector of the economy.

[MrGongGong]

I don't understand the rationale for that belief. IMV, there is no theoretical basis for your view.

Said the man who thinks we can have a 40 mile exclusion Zone around the UK without invading France ?

:JOKE:

Why do we have to have a market model for EVERYTHING ?

WE don't
and it doesn't mean that things have to be badly or incompetently run

[Beef Oven!]

Said the man who thinks we can have a 40 mile exclusion Zone around the UK without invading France ?

:JOKE:

Why do we have to have a market model for EVERYTHING ?

WE don't
and it doesn't mean that things have to be badly or incompetently run

Seems it is, anathema to the faux-left, despite protests to the contrary.

[Richard Barrett]

it doesn't mean that things have to be badly or incompetently run

... just look at the railways in the UK, which most British people agree ought to be renationalised - 66% according to a recent poll. Interestingly 78% of kippers were in favour of renationalisation. As usual it's difficult to know what the head kipper's actual policy is on this question.

[ahinton]

I don't understand the rationale for that belief. IMV, there is no theoretical basis for your view.

The issue here is that A&E provision, mental healthcare and certain other areas of healthcare provision are simply not amenable to profit-making and so private companies have shown no interest in taking them on; where and how could a healthy (sorry?) profit be generated from A&E? Whilst proving the non-existence of something is by definition harder than proving its existence, it's still clear that there's no appetite among private healthcare service providers to enter such markets and accordingly none that any of them has done so; it's not that dissimilar in principle from the specific exclusions that almost all insurers set out in PMI policy terms & conditions.

[Beef Oven!]

... just look at the railways in the UK, which most British people agree ought to be renationalised

The railways is a long story of government disinvestment, foreign ownership and historical incompetent public sector management.

Look at utilities. Expensive and poor value due to historical public sector vertical integration of source, distribution and retail. Either separate the sourcing side of the industry from the retail and distribution, or put it back into state ownership with private sector management (my preference).

[Richard Barrett]

state ownership with private sector management

That sounds hideous to me. You mean like the relationship of ATOS and the DWP? That's been a roaring success has it not.

[Beef Oven!]

That sounds hideous to me. You mean like the relationship of ATOS and the DWP? That's been a roaring success has it not.

No like this, for example.

[amateur51]

The railways is a long story of government disinvestment, foreign ownership and historical incompetent public sector management.

Look at utilities. Expensive and poor value due to historical public sector vertical integration of source, distribution and retail. Either separate the sourcing side of the industry from the retail and distribution, or put it back into state ownership with private sector management (my preference).

When in doubt, resort to impenetrable financeconojargon.

BO would benefit from listening to the Money Talk conversation on Start The Week last Monday (ref'd to several times).

If a profit is available then how can it be 'value for money' at the same time?

Many years ago Sir Christopher Benson with vast private sector experiencetook over as Chairman of The Housing Corporation, the quango which at that tiome funded Housing Associations. His heart was in the right place and hios 'big idea' was that with all the HAs building home there must be a cost savings to be made when buying windows, doors, screws, glue, paint etc in bulk. Of course in practice none of the architects wanted to use the same materials as everone else, no housing director wanted to be seen to be developing to a standard model and so it couldn't be done.

Footnote: The Housing Corporation was eventually abolished.

[amateur51]

No like this, for example.

CHKS, who runs this award scheme, is part of Capita PLC.

I almost hate myself for pointing this out but could there not be a cultural link between the award donor and the winners?