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BAD reaction to BMJ report on privatisation of the NHS

A statement from Dr. David Eedy, President of the BAD, in regards to the research released by Professor Oliver in the British Medical Journal regarding NHS contracts and management salaries:: 

The news today that a third of NHS contracts in England have been awarded to private sector providers since the service was reorganised in 2013 is a fact that dermatologists and their patients are all too aware of. In fact, some estimates put the figure at 70 per cent of NHS contracts going to private providers in just the first year.

Dermatology is a prime example of how government meddling is decimating the NHS, despite the fact that each year, 54 per cent of the population is affected by skin disease, and 23 to 33 per cent of the population at any one time has a skin disease that would benefit from medical care. Skin cancer is by far our most common cancer. That means thousands of patients let down because of spurious health service reforms.

Dermatology has been seen as an easy service for hard-pressed commissioners to shift ‘into the community’ with private providers, due to the widely held but mistaken view that skin diseases are minor ailments and can be easily identified and treated locally, reducing the burden on hospitals. However, the drive to shift treatment into the community leads to decommissioning of Dermatology hospital services, and has not achieved its intended aim of improving patient care. It makes no sense economically either, as in the majority of cases the cost of care remains the same per head of patients as the hospital service. 

Another concern is the practice of ‘cherry-picking’ by private healthcare providers who are more likely to take on relatively easy, high volume, lucrative work in the interests of profit. The upshot of this is that the local NHS hospital department is left to pick up the more difficult and expensive work while saddled with increased financial pressures. 

There have been cases of independent providers tendering for dermatology services without even having dermatologists or other appropriately trained staff in post.

To maintain a high standard of healthcare for patients it is necessary to retain a large degree of public accountability, from the very beginning of the tendering process all the way through to the treatment of patients, and beyond. However, commercial confidentiality clauses, which do not apply to the public sector, can stifle transparency when private companies are involved in bidding to provide healthcare services. This makes it hard for external bodies to scrutinize whether the new service is compliant with national guidelines.

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