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Monday, September 12, 2011

Mixed messages

This morning's headlines on the BBC that the Welsh Health Minister has "completely rejected the privatisation of NHS services" is bizarre to say the least. It flies in the face of what is happening on the ground and smacks of political posturing.

I think though that the key lies in her choice of words. 'Privatisation' implies allowing the NHS to be run by the private sector, whereas what is actually happening, especially with orthopaedic services is that health boards are buying in operating capacity from the private sector to supplement their own. In fact the use of private facilities in the Welsh NHS is starting to increase.

Five days ago a Welsh Government spokesperson said of the Government's investment in orthopaedic services that “there may still be a shortfall in capacity, and it is prudent for health boards to explore all possible avenues to ensure our targets are met by March." In that regard the Welsh Government's position is not dissimilar to that of the UK Coalition. The big difference is that in England they are planning provision so as to get value for money. Here in Wales they are going about using the private sector in an ad hoc, almost surreptitious way and it is costing us more than it should.

Now the Minister is saying that she does "not want to see private companies making money out of our NHS." The two positions are not compatible and some clarification is needed, especially given the actual way the Welsh NHS is operating.

This is a bit more than mixed messages. It is a Minister trying to maintain an unsustainable public position whilst allowing Health Boards to act pragmatically in contradiction to her policy. It is little wonder that there are calls for greater transparency. Perhaps if the Welsh Government came off its ideological perch and recognised what is really going under its management we could get a better deal, including agreed tariffs across the board for surgical procedures and a proper framework for the delivery of care, regardless of sector.

At the moment the Health Minister is fooling nobody but herself.
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