An online map compiled by doctors to chart the extent of privatisation and outsourcing in the NHS has been updated to include all of the UK.
The interactive tool, developed by EveryDoctor, flags thousands of instances where non-NHS independent providers deliver publicly funded healthcare services. Launched with data from England in April this year, the digital map has now been extended to Scotland, Wales, and Northern Ireland using research carried out by EveryDoctor, as well as contributions from members of the public.
The doctor-led campaign organisation says it is part of an effort to raise public awareness of the degree to which external providers are already responsible for many NHS services. Dr Julia Patterson, the group's chief executive, told Medscape UK that "there isn't one source across the UK that shows all of the examples of outsourcing and so we've had to put it together, piecemeal, and we'll continue to do so as our information strengthens".
'Current Threat, Not Future Reality'
She explained: "When we think about privatisation, we're talking about any private company who are running an NHS service and taking public funds to do so. It's more complicated than that because some of the organisations who are providing outsourced care are not for profit companies. And yet we – and many people – believe that any outsourced care is bad for patients because it causes fragmentation of services as the short-term contracts change hands regularly."
The updated map contains 2531 records of instances where NHS services have been outsourced or where private companies have a role in their delivery. "A lot of people are very concerned about NHS privatisation, but it's often framed as a future threat rather than a current reality within the NHS," Dr Patterson said.
Outsourcing 'Creates Postcode Lottery' for Healthcare
EveryDoctor argues that not only does outsourcing affect long-term care relationships, it also creates a postcode lottery for health care and diverts public money into the hands of shareholders. Dr Patterson says people may not be aware that a service is outsourced if it remains free at the point they need it. Also, "one of the reasons public awareness is quite low is because companies providing outsourced NHS services will use the NHS logo on their facilities".
Map users can also click on parliamentary constituencies to see how MPs voted on the controversial Health and Care Bill which became law earlier this year, stoking fears by some campaigners that it would make it less onerous for private companies wanting to compete for health service contracts. Dr Patterson believes if those numbers "accelerate", it could have a negative impact on staff and patients. She told us: "We hear from doctors who work for some of these private providers and working conditions have changed. It's pulling away from the original premise of the NHS, which is to be a fully funded, fully publicly run service."
Her concern about private companies absorbing an increasing share of the health market is that "if a private company is running a public service, then they have an additional priority to create profit, and that is going to clash with the priority of putting the patient at the centre of all care".
EveryDoctor has begun work on a future update of the map to include details of debt and interest payments carried by NHS Trusts from historic contracts involving private finance initiatives, where money was borrowed to fund hospital buildings and other capital projects. "There's been various campaigns over the last 20 years for governments to pay off that debt, and there's been a lot of resistance to do so because the upfront costs would be sizable," said Dr Patterson. "And yet, if that was done, then in the long term, we would save a lot of money as a nation."
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