I have recently retired after more than 30 years of NHS service. The NHS is indeed broken (Editorial, 3 March), but it’s not quite in critical care, and there are signs that Wes Streeting is addressing some of the problems, including the use of the “private sector”. While this may sit comfortably with parts of the Labour party and patient groups, it’s important to understand three things about the use of the private sector. First, it’s NHS staff who perform the surgery, second, the private sector is paid the same price per procedure as an NHS trust and, finally, using the private sector creates additional capacity in the NHS.
There are a number of things that Mr Streeting should look at to expedite his plans. He should address the payment system, as payment by results needs an urgent overhaul. It’s fine for low-cost, high-volume activity (like that undertaken in the private sector) but needs drastic reform for urgent and more complex care. He should also reform the consultant contract – for example, ensuring that consultants have to work a number of years as an NHS consultant before they can work privately. Next, move community services back to general practice. GPs can’t prevent people going into hospital if they have no support in the community to look after people. Finally, GPs (and employers) must be more proactive with the public and staff about the importance of being active.
Malcolm Cunningham
Sale, Cheshire
