Abstract
By the time this article has been published, the Health & Social Care Act should have passed through Parliament. The Act has been most noted for the introduction of the new ‘super regulator’, the Care Quality Commission, and for the changes it makes to health professional regulation. Another new body, the Office of the Health Professions Regulator, is established by the Act and will take over the adjudication function of the GMC and eventually other regulators. However, debates about one relatively low profile clause which opens up membership of the NHS Litigation Authority's (NHSLA) indemnity scheme to private healthcare providers, who treat NHS patients under contract, did not get the attention they deserved.
On the face of it this is a very good move. AvMA has had experience of NHS patients treated negligently in Independent Sector Treatment Centres and other private settings, having insult added to injury when faced with arguments about who is liable. Allowing private providers into the NHS scheme makes sense. However, in the debates, in spite of reasoned arguments by the opposition, Ministers insisted that the arrangement must be voluntary. While some private providers will find it commercially beneficial to join the NHS scheme rather than make their own arrangements, some will prefer to stick with their own arrangements.
Why should this matter? Ministers have consistently said that NHS patients treated in the private sector will enjoy the same rights as any NHS patient. However in making this decision the Government is effectively saying that if an NHS patient is injured as a result of negligent treatment in a private facility, they are prepared to disown them and leave them to pursue their case against a commercial organization and their insurer/indemnifier.
While most would acknowledge that the way the NHSLA handles claims is far from perfect, and the organization providing insurance/indemnity to private providers can claim to do a respectable job, isn't there something fundamentally wrong in the NHS being prepared to abdicate responsibility for its patients in this way? It seems that the Government feels that it is so politically incorrect to regulate the private sector that it is prepared to dilute the NHS's traditional relationship with its patients. If it feels that private insurers/indemnity providers do just as good a job as the NHSLA, why do we have an NHSLA at all?
Imagine yourself being told by the NHS that you remain their patient but for its own reasons the NHS decides to send you to a private provider for your operation. You are badly injured through negligent treatment. Then you find that the NHS does not want anything to do with it and you have to take on the private provider and its defence organization.
In the year we celebrate the many achievements of the NHS over 60 years, this is a worrying sign of how key principles of the NHS are being eroded.
Forthcoming Events
9 October 2008, Woburn House, London
13 November 2008, Woburn House, London
26 November 2008, Woburn House, London
10 December 2008, London Aquarium