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What are the arguments for privatising the National Health Service in the UK?

Bounty Note: The answer should include official statements from MPs (current or previous) and credible sources (such as think tanks, interest groups, influential scholars).

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    Are you asking for the stated arguments or credible arguments? They are not necessarily the same thing. – Venture2099 May 6 '17 at 19:11
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    Because they are so inefficient people die in lines. theguardian.com/society/2014/sep/18/… – Chloe May 7 '17 at 0:39
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    @Peter Privatizing only works with competition. If you don't have competition, you still have a monopoly - just a private monopoly vs. a public monopoly. Healthcare can have competition more easily compared to railways. – Chloe May 7 '17 at 0:40
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    @Chloe some might argue that inefficiency is caused by underfunding from the government. – Bradley Wilson May 7 '17 at 7:10
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    While it's your right to scope the question as you wish, i'm curious why only MPs' opinions hold validity in your views? (as opposed to think tanks, or interest groups, or influential scholars or other figures) – user4012 May 7 '17 at 13:23
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+50

In a BBC debate, Thomas Cawston (then with the think tank Reform) states:

Competition is a "bogey" word in the NHS. Yet this hostility to competition and private providers is a uniquely British obsession. [...] The reason for competition is that [it] can drive real improvements in care.

Cawston was an author on several reports for Reform. One from 2010 provides evidence of the "ability of competition to drive up health standards and productivity". For example:

The Office for National Statistics’ analysis of productivity has shown that public sector productivity declined on average by 0.3 per cent a year between 1997 and 2007. Private sector productivity, in contrast, rose by 2.3 per cent on average each year. These statistics hide the relative performance of spending in different areas – and in this respect health spending has performed particularly poorly. The NHS has lagged behind the rest of the public sector on delivering value for money.

A 2014 report further makes this point about competition. Quoting from the executive summary:

This report presents ten case studies of successful health reform. Each case study shows how a radical change in the delivery of healthcare can result in improved quality and productivity.

The case studies show that successful health reform leads to:

Reduced costs through integration and competition

In Rhode Island, a private company, Beacon Health Strategies, has created an integrated care pathway for mental healthcare services, which were previously highly fragmented. In one year the cost of mental healthcare hospitalisations for children was cut by 20 per cent.

In Massachusetts any willing providers were invited to organise community services for low income elderly patients. Patient-centred care management replaced uncoordinated services reducing the number of nursing home admissions by up to 42 per cent.

Reduced costs through standardisation of clinical practice

In the United States MinuteClinic has developed strict protocols for a range of routine services. This has allowed the clinics to use nurses instead of more expensive doctors, enabling them to provide consultations 30 to 50 per cent cheaper than a visit to a GP.

The Indian specialist maternity hospital LifeSprings has focused on providing a limited number of procedures and used standardised clinical protocols. Doctors’ productivity is four times higher than non-specialist providers and prices are up to 50 per cent lower than of market rates.

Greater patient safety through service reconfiguration

In Finland, the Pirkanmaa region closed joint replacement departments in five hospitals and concentrated care at one specialist hospital. The new hospital delivered complication rates below 1 per cent compared to an average of up to 12 per cent for general hospitals.

The NHS in London moved emergency stroke care from 34 general hospitals to 8 specialist units with dedicated staff. London now has the highest standards of stroke care of any major international city.

Greater patient safety through better data

Birmingham University Hospitals took the initiative to develop its own IT infrastructure to track medical errors and provide decision support to front line clinicians. Medication errors were cut by 66 per cent and contributed to a 17 per cent drop in 30-day mortality.

The Cleveland Clinic in Ohio has published its clinical outcomes and data used by the hospital leaders to manage productivity, benchmark clinicians and improve quality. The hospital is one of the highest ranked in the United States for quality but costs are half those of equivalent providers.


(In the spirit of the Ideological Turing Test, I've done my best to pretend there are credible arguments for NHS privatisation. But I don't think I passed, because there are no such arguments. As mentioned in the comments to the original question, this isn't a position that any sane politician in the UK would take. Crawson is now with a PR company, and represents the economic interests of private insurers and health care providers.)


EDIT: Here is a pretty extensive report by the Institute of Economic Affairs that argues for abolition of the NHS. It relies on a lot of international comparisons to make that case that lack of competition and private delivery are producing bad outcomes. It even claims that:

In terms of outcomes, quality and efficiency, social health insurance systems [with delivery of care by the private sector] are consistently ahead of the NHS on almost every available measure.

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I believe that this question can be answered by discussing the arguments in favor of privitization of any public service. Put simply, those that support privatization believe that a privately owned firm that is subject to the forces of a free market (competition, supply-and-demand, etc.), can supply a service more effectively and efficiently than a state-owned firm. According to Wikipedia, this tends to lead to:

lower prices, improved quality, more choices, less corruption, less red tape, and/or quicker delivery.

Furthermore:

Literature reviews find that in competitive industries with well-informed consumers, privatization consistently improves efficiency. The more competitive the industry, the greater the improvement in output, profitability, and efficiency.

This article does a more in-depth, qualitative (and quantitative) comparison between private and public healthcare, using the Australian system as an example.

  • I wasn't asking for privatized healthcare in general nor for the pro arguments for that, I was asking for arguments for privatizing the NHS in the UK specifically backed up by statements from UK representatives/mediums whom are specifically talking about the NHS and any pros of current NHS contracts where applicable (of course that article is against). I would ask a totally different question if that was the case. – Bradley Wilson May 9 '17 at 9:29
  • sorry for the misunderstanding of the question, but you did specify in the comments that you wanted credible arguments rather than arguments stated by UK officials. If that's not the case, please edit your question. But you're right, my answer may have been too generalized. – NDR May 9 '17 at 9:39
  • I assumed official statements from MPs and the United-Kingdom tag would have sufficed. But i'll make another note. – Bradley Wilson May 9 '17 at 9:41
  • Ah right! Didn't realise there was additional information in the bounty text box, my mistake. – NDR May 9 '17 at 9:44
  • A common misunderstanding, I'll reiterate in the question too. (I removed it previously to be a placeholder for the bounty box) – Bradley Wilson May 9 '17 at 9:46
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It's about profits for the private sector

A senior adviser to David Cameron says the NHS could be improved by charging patients and will be transformed into a "state insurance provider, not a state deliverer" of care.

Mark Britnell, who was appointed to a "kitchen cabinet" advising the prime minister on reforming the NHS, told a conference of executives from the private sector that future reforms would show "no mercy" to the NHS and offer a "big opportunity" to the for-profit sector.

https://www.theguardian.com/politics/2011/may/14/david-cameron-adviser-health-reform

Most often is proposed as a response to a funding crisis:

Ministers will have to consider charging patients for seeing a GP, attending A&E, and using the food, power and water of hospitals, unless better long-term solutions for funding the NHS can be found, public finance experts have warned.

Contributions towards the cost of treatments and patients taking out health insurance are among other options that must be on the table if the comprehensive spending review in November fails to address the issue, the Chartered Institute of Public Finance (Cipfa) says in a briefing.

https://www.theguardian.com/society/2015/aug/05/nhs-patients-may-face-widescale-charges-warns-financial-thinktank

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