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A hospital consultant writes...

From: Hospital Consultant
Sent: 20 April 2015 10:04
To: Rob Marris
Subject: Re: NHS privatisation

Dear Rob

Many thanks for this (= http://www.independent.co.uk/life-style/health-and-families/health-news/nhs-struggling-to-monitor-the-safety-and-efficacy-of-its-services-outsourced-to-private-providers-10187339.html), which I had not read or come across.  While I knew of the high profile scandals e.g. Winterbourne, West Country GP services etc., the data on the lack of monitoring and inspection are new, even to me.  It does not surprise me however.

Clinical Commissioning Groups each consist of 12 GPs doing commissioning part time, plus 1 lay person, plus 1 nurse; plus 1 Consultant from outside the area doing commissioning as an add-on.  That's it!

Whilst Monitor has over 300 staff, in 2014 a Public Accounts Committee report found that only 7 of them are healthcare professionals

Meanwhile, the Care Quality Commission has had to halve its inspections this year – because of lack of human and financial resources.

Outsourcing is required as a last resort, if local or adjacent NHS providers can't deliver.  However it brings massive extra risks for patients and loved ones – and taxpayers.

Having been a General Medical Council specialist Assessor for several years until 2013, I am well aware of the considerable limitations of the regulators (e.g. GMC, HCPC, NMC, etc.) which are due to lack of human and financial resources.   Healthcare professionals who are able to regulate must still be in active practice, and their NHS employer, colleagues, and patients can't spare them much time; ditto for lay assessors, who often still actively work in other sectors

Therefore, much of the "regulation" is done voluntarily, unpaid, at night and weekends, with such healthcare professionals and lay assessors reading the papers sent to them by GMC, NMC, HCPC, about a doctor/nurse/midwife about whom concerns have been raised.

Conversely, NHS providers have a whole lattice of governance, monitoring and, most importantly, peer feedback and scrutiny which the private providers may well lack.

Some private providers do offer excellent service for patients.  However, as someone who now is more worried about my own future healthcare, and that of my loved ones, than anything else, my view is that NHS providers should be the providers of first choice when commissioning healthcare

Very best wishes



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