iandriver wrote:It's the back door privatisation that worries me, at layers where you can't see it. You might go to a hospital for a blood test. This might appear to be done in a non privatised environment. But what about the testing itself once the sample has gone off?
What does it matter who does it as long as it gets done efficiently and effectively? You don't expect the NHS to manufacture its own beds and surgical equipment. It buys them in. So why do they need to do their own blood tests if someone can do it more efficiently and cost effectively? It saves the NHS spending money on building a lab and kitting it out with equipment and people - a big investment that is difficult to make within its annual budgetting one year payback model. So let someone else spend all the money and go for a pay as you go model instead.
I don't, in priciple, object to privatising some services, if it make things more efficient. As you correctly point out, the NHS is not going to manufacture it's own equipment. Blood tests are an exellent example. The majority of blood tests are relatively simple. Someone goes to their surgery, or the local hospital, has a couple of vials of blood collected, and off they go for analysis. The private lab can do them efficiently and cost effectively.
But what about at A&E when the medical staff may need analysis more quickly than the private laboratory (or the private laboratory, plus transport time) can do them? Should the hospital with an A&E department still have the equipment and staff to do the analysis? If no, how do we solve the problem of requiring results more quickly? If yes, what if the equipment and staff are underutilised? Should they sell their services elsewhere? And should they do so at actual cost? Or at a cost that will allow them to be utilised at something reasonable like 80%, so they can still serve the A&E department that caused them to exist in the first place?
And what about a blood test that requires specialised equipment, and the private companies that bid on blood testing analysis neither have the equipment, not want to invest in it? Should we find another company to do just that test? What if there are very few companies that do that test? Should the NHS pay excessive amounts for the test due to the near monopoly situation? Buy the equipment and train the staff? Send the blood samples to the continent and risk other problems (such as poor handling)?
I'm not suggesting that these are necessarily a reason not to privatise, but these are questions that are not always adequately addressed. Consequently, privatisation of something apparently simple, like blood tests, can result in inefficiencies that make up for the savings.
Furthermore, in some cases, the issues should be addressed for the whole system. Not just for the Mid Whatever NHS Trust.
“In some ways, it is easier to be a dissident, for then one is without responsibility.”
― Nelson Mandela, Long Walk to Freedom