advance to your article “NHS paying private sector to carry out more medical operations” (Report, December 3), a key factor wasn’t mentioned, that being patient choice. The reason why so many NHS-funded hip and knee replacements and cataracts are being done in the independent sector is that patients, rather than languish for months or years on a waiting list, are choosing it.
Patient choice, which is enshrined in the NHS constitution, was introduced in 2006 by the last Labour government. It was combined with the independent sector treatment programme, which increased independent sector involvement in the provision of NHS care and ushered in a dramatic fall in waiting times for surgery. The lowest in my 40-year career as a surgeon.
It is true that the more complex cases are quite rightly treated in the larger NHS hospitals where they have the multidisciplinary teams to better deal with these more difficult cases. This is in the best interests of the patient and good clinical practice. This should be reflected in the tariff payments the hospital receives so that they are not in financial hardship. Rather than an antagonistic approach, expecting the independent sector to replicate all the facilities that are available in major NHS hospitals, the NHS and independent sector should adopt a collaborative approach and work in harmony to better serve our population. That was the approach adopted by the last Labour government.
We would then have a blended approach to the use of public and private hospitals, such as seen elsewhere in Europe, to furnish NHS-funded healthcare which, critically, remains free at the point of delivery. NHS England would set the tariff payment, define the conditions and monitor the outcome of treatment, but otherwise let the citizen select.
Derek Bickerstaff
Consultant Orthopaedic Surgeon,
Chairman, One Health Group,
Sheffield, UK
