David Rowland writes that clearing the NHS backlog of consultations and procedures cannot be achieved through private work because it’s the same doctors who offer private healthcare and NHS care (Private hospitals coming to the NHS’s rescue? Labour should know better, 12 December). However, he is missing one crucial detail. The reason those NHS doctors are willing to work additional hours to cover private work is that it pays them more.
Under the current system, you cannot incentivise NHS doctors to provide additional NHS work. Therefore it is left to the private industry to do so, while enjoying a healthy profit out of the bargain. Allow the NHS to incentivise NHS doctors to provide a service beyond their regular rostered hours for supply-and-demand-based financial gain. That way, the public will get the extra consultant hours it needs, at a fair price, without private enterprise interposing and doubling the cost.
Jack Pickard
Paediatric intensive care doctor, London
• David Rowland’s analysis of the perils of private healthcare is accurate. There is an ingrained tendency among the public to assume “private” – being more expensive – means superior. Having worked in both systems for a long time, I can categorically say that the opposite is the case. Private companies – legitimately – prioritise profits and returns for shareholders, often at odds with the best interests of patients.
But Mr Rowland left out the link between NHS pay and private staffing. Nurses in particular – the largest group by numbers – seek employment with private providers not because they prefer it, but because a decade of shrinking NHS wages means that we are forced to increase our income by other means.
For a government that wants to replace the NHS with a private system, keeping NHS wages low is helpful with regard to that aim. If pay is not improved significantly, more NHS-trained professionals will be available to the private sector, at less expense.
Martin Giebner
Whitsome, Scottish Borders
• David Rowland’s portrayal of the private healthcare sector is not one I recognise. Spire Healthcare has one of the largest nurse apprenticeship programmes in the sector and we hope that many graduates from the scheme go on to work in the NHS.
During the pandemic, as well as caring for more than 350,000 NHS patients whose diagnosis or treatment would otherwise have been cancelled, we provided placements for many doctors in training; we continue to offer these and stand ready to do more. Furthermore, 98% of our hospitals are rated good or outstanding by regulators, well above the national average, demonstrating a safe and well-governed environment for patients. And we repaid all of the money back to the government that we had received in furlough. The challenges facing healthcare can only be tackled by a strong NHS and independent sector. We at Spire Healthcare are determined to play our part.
Justin Ash
CEO, Spire Healthcare
