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Don’t commercialise the NHS, warn US doctors

The NHS is becoming more like the American health care system, and faces higher costs, increasing administrative overheads and inequitable access to services unless current market-oriented policies are reversed, says the Health Policy Network.

The network—a loose affiliation of the NHS Consultants’ Association, the NHS Support Federation and the Public Health Alliance—argues in its latest report that the NHS internal market could be abolished virtually overnight without any ill effects on patient care, saving money and increasing equity at the same time.

The report includes views from a number of eminent US physicians who are campaigning for a ‘national health program’—a form of non-profitmaking national health insurance—in America.

Writing in the foreword, Harvard doctors David Himmelstein and Steffie Woolhandler reveal how the standard contracts of many US health maintenance organisations include gagging clauses which prevent doctors from revealing anything about the the way the organisation runs.

The reason for such clauses becomes clearer in the light of the example of insurance company US Healthcare, which offers physicians ‘steep incentives to tailor care to increase company profits’. A primary care doctor working for the company loses 50 cents pay for each dollar of emergency care that patients receive under the plan, write Himmelstein and Woolhandler.

Professor Harry Keen, chair of the Health Policy Network, said: ‘When financial profitability becomes the primary goal, the prime purpose of medicine becomes perverted.’

The Americanisation of the NHS. Health Policy

Network: Hill House, Great Bourton, Banbury OX17 1QH. £10.00.