The cost of private healthcare to the NHS

I was interested, but not surprised, to read an article in the Times about the cost to the NHS of complications encountered in the private healthcare sector; according to the Times the cost over the last three years to the NHS of treating patients who have suffered complications whilst undergoing treatment in the private sector is more than £250 million.

A research report; ‘No Safety Without Liability’ by the Centre for Health and the Public Interest (CHPI) has highlighted a number of fundamental safety flaws within in the independent healthcare sector, not least that they are not subject to the same reporting requirements as the NHS when serious untoward incidents occur in which patients have been harmed or subjected to a ‘near miss’.  The report also points out that a single junior doctor is often responsible for up to 96 patients with no consultant on site.

The CHPI reports makes five recommendations:-

1. Private hospitals should directly employ the surgeons, anaesthetists and physicians who work at their hospitals and should take responsibility for monitoring their activities and appraising their performance.
2. Private hospitals should have adequate facilities and personnel to deal with situations where a patient’s life becomes endangered following an operation.  This will reduce the number of high risk patient transfers to NHS facilities.
3. Private hospitals should end the reliance on a single junior doctor; a ‘Resident Medical Officer’ working alone on extreme shift patterns, to provide post-operative care for patients.
4. Private hospitals should be required to adhere to the same reporting requirements as NHS hospitals in order to improve the chance of harm to patients being detected.
5. The legislation governing private hospitals should be amended to make clear that all those who are registered with the CQC should be fully liable for all the services which are provided within them, including the actions of surgeons and other healthcare professionals.

The report makes interesting reading and I’m sure many of the issues highlighted by the CHPI will come as news to some. I think a lot of people assume that treatment in a private hospital means better care, in a comfortable, almost hotel-like, environment under a highly qualified specialist.  This may well be true in an ideal situation when things go to plan however when things go wrong, either due to recognised complications of surgery or through sub-standard treatment or care, many will be surprised to learn; particularly overnight or at weekends, that the specialist facilities required to deal with the situation, including intensive care units and resident medical staff, may not be available or fit for purpose.

As a nurse who has worked in the NHS in emergency medicine and critical care I have first-hand experience of receiving patients from the local private hospital whose surgery has not gone to plan, or their post operative course has been complicated by infection or a pre-existing condition that the private facility is just not set up to deal with.  With the best will in the world, in situations such as these, it is always the patient who has the most to lose.

The recent Ian Paterson scandal illustrates some of the problems highlighted by the CHPI report.  Whilst I do believe that private healthcare has its place, I completely support the recommendations made by CHPI.  In order to ensure patient safety as far as possible, I believe that medical professionals working in the private sector should do so under the same regulatory conditions as they do in the NHS and that private healthcare institutions should be subject to the same mandatory reporting regime and standards as the NHS.