Private medicine’s real manifesto…

BMJ 01 July 2013    Cite this as: BMJ 2013;347:f41

Historians may one day look back at the NHS and say that there was a time, in the 20th century, when people actually gave a fuck about each other. That once the world was more than just a jungle—full of monsters rising on all sides to smite us, where the strong prosper and the weak are devoured.

But that time is passing, as our health minister perfects the trick of throwing up his hands in horror while simultaneously washing them, like a little Tory Pontius Pilate. And as the NHS is slowly eroded, private medicine is blossoming. It even has a conference now: Private Practice 2013 is “for clinicians looking to launch or expand their private practice” and who “want to start a private practice and offer a higher quality service.” So it’s timely to present the real manifesto for private medicine.

  • 1) Always remember that you are a client, not a patient. Your main purpose is for us to generate income. Our doctors will be professional, I’m sure, but if you do happen to get better, that’s just a bonus.

  • 2) Health is a commodity, disease the product line, and doctors the sales force. We’ll obfuscate with weasel words like “providing a better service,” but remember point 1.

  • 3) We do things to you; that’s what we do. There is money in procedures and high-tech investigations. Sitting you in a bed and watching you for a few days is not a big earner. Masterly inactivity will not launch us into the million dollar club.

  • 4) Old, chronically ill, or mentally ill people are unsuitable for our services.

  • 5) Private health screens are the whores of medicine. They make even us a bit ashamed.

  • 6) “Robes and furred gowns hide all / Plate sin with gold, / And the strong lance of justice hurtless breaks.” We disguise our mendacity with a veneer of luxury. The waiting room has carpet and ferns; the whorehouse parlour look is quite deliberate, and you won’t have to share it with the riff raff. In contrast, the NHS has always been the Ryanair health service—austere, without frills, it doesn’t aim to give you what you want but what you need.

  • 7) Of course, if the worst happens and you get really sick (or unprofitable) you will be turfed back to the NHS. Looking after sick people: that’s what it’s for, isn’t it?


2 thoughts on “Private medicine’s real manifesto…

  1. Privatising NHS is not an answer at all. But when we waste £20 Billion a year and when potential medico-legal bill for the NHS is 15 to 20 Billion a year (If duty of candour really works) then somewhere someone has to do something and that includes privatising NHS which I strongly oppose. With 45% of doctors and 25% of staff from BME (Black and Minorith Ethnic – I am one of these doctors) sadly Snowy White Peaks says a lot about NHS leadership and NHS culture!

    Culture of bullying, naming, shaming, discipline, regulation, inspection and so on rather than help, support, guidance, just culture, fair and open culture and learning culture! Unless we get NHS culture, leadership, accountability for leaders and managers, IT use, stop working in silos and get good governance from top to bottom and get Work Force Race Equality right, there is no choice but to privatise part of the NHS so that efficiency can increase, savings can be done and that money can be re-invested. Most important for NHS is to get leadership right and to address health and social care together and to stop wastage by using IT and digital health, Vanguard, Devomanc and 5 years plan and Work Force Race Equality are all supposed to transform NHS. We can and we will do it if we get leadership and accountability for all leaders, managers and to all staff right! The we need not privatise NHS!


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