Thursday, 8 September 2011

Dispelling not-for-profit

I can understand arguments that proposed NHS changes may make the service less efficient. I can understand suggestions they won’t, as claimed, put the patient - or his/her GP - in the ‘driving seat’. I disagree, but I can understand, and in truth can imagine failure. I am less impressed with warnings of impending privatisation; what arrant nonsense. Nor do I care for the consternation apparent at the notion of a private company making a profit. That so many decry the idea of an NHS-run hospital closing - as a result of being open to competition and unable to compete - suggests either wilful obfuscation or an inability to understand the basics.

When the running of the national lottery was open for bids, Richard Branson made much of his group’s tender being not-for-profit; however, the relevant detail is revenue generated. Branson was courting public opinion, that he felt able to throw in this red herring is indicative of how easily confused we are. For example, should we accept a bid that will generate £800 million for the country and £100 million profit for the organisers, or should we accept a not-for-profit bid generating £750 million?

Understanding ‘commission versus provision’ is equally simple. When the NHS spends money on our behalf, would we for instance rather spend £3000 on an ‘in-house’ operation, or out-source to a private hospital charging £2800 for the same service, of which £300 might be profit? Of course these numbers are made up, I use them merely to illustrate that profit should have no bearing on the decision made. Accusations of cherry-picking by private consortia should, if we procure sensibly and ensure multiple providers, also prove irrelevant. An informed choice, one that allows for profit, will result in an NHS that costs less and/or one that can do more.

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