There has been condemnation over the last 24 hours or so of the instruction by BMI Meriden Hospital’s chief executive Bernie Creaven to the hospital’s consultants to deliberately delay treatment of NHS patients to increase profit. The hospital treats NHS patients at NHS costs if it has empty beds, but makes more profit if those patients get sick of waiting for their operations and opt to pay more for immediate, private treatment. So Ms Creaven ordered consultants to immediately instigate an automatic and growing delay in treatment of NHS patients in the hope of forcing more of those patients to pay extra to be treated faster.
Her letter ran: ‘
“Over the past few months I have had numerous discussions with consultants regarding the lack of differentiation between NHS and private patients and there is significant anecdotal evidence to suggest that the lack of differentiation has had a negative effect on our private patient referrals.
I now wish to implement with immediate effect a new rule which will mean that operations on NHS Choose and Book patients will not be able to take place until at least four weeks following their outpatient consultation. Also, in each subsequent month, I will extend this by another week until September and the time will be eight weeks from initial consultation. I believe that this time to access the system is probably the most critical factor for some private patients converting to NHS patients.”
Quite rightly, this action has been condemned – forcing patients to endure unnecessarily prolonged suffering for the sake of increasing profit is abhorrent, and for it to be done by one of the country’s major private healthcare providers who operates close to 70 hospitals in the UK is appalling.
However, for Andrew Lansley’s Department of Health to pretend outrage over the action is purest hypocrisy – and carefully phrased to leave plenty of room for more profit-based apartheid. DH issued the following statement:
“Minimum waiting times that do not take account of healthcare needs of patients are unacceptable. Decisions on treatments, including suitability for surgery, should be made by clinicians based on what is best for the patient. This applies regardless of whether a hospital is run by the NHS or the independent sector.
“We will therefore be contacting BMI to ensure that NHS patients are not disadvantaged“
The hypocrisy is clear. If it walks like a duck, swims like a duck and quacks like a duck, it’s a duck – but you can’t really condemn the duck for being a duck. Especially if you put it in the pond in the first place. Commercial companies are in the business of making money – providing healthcare just happens to be how BMI does it. When profit is your imperative, there is always going to be pressure to do whatever it takes to cut cost and increase profit – and in a healthcare company, the wellbeing of patients is only really as important as its contribution to the bottom line. Getting a reputation for bad outcomes, or getting sued by dissatisfied patients, is bad for the bottom line, so private hospitals will take every precaution to avoid these things – but that’s not always good for patients. It can easily mean turning away risky or difficult cases. And when a private hospital can increase profits through (usually) hidden measures like extending waiting times, it’s probably going to do so.
Lansley has put the duck in the pond, and is now making a big and very hypocritical deal of criticising the duck for acting like a duck, and vowing to stop it doing so. But you can never really prevent a beast from acting on its instincts – and he knew perfectly well that introducing the profit motive into healthcare was always going to lead to companies making decisions like BMI Meriden;s. It’s what they do – and it’s why they shouldn’t be allowed within light-years of the NHS.
And note the careful phrasing:
“Minimum waiting times that do not take account of healthcare needs of patients are unacceptable”
Not ‘minimum waiting times are unacceptable’. For a private healthcare provider to impose minimum waiting times is – according to Lansley & co – perfectly acceptable. For such a company to operate such a policy, all it has to do is manufacture some kind of story that it’s taken patients’ healthcare needs into account before making its decision to impose the MWT, and it’s in the clear. The DH has said so!
It’s clearly not only profit-making companies that should never have been allowed near the NHS. For all their protestations that ‘the NHS is safe in our hands‘ and that they want to ensure better healthcare for our ill and infirm, Cameron and Lansley are a deadly infection in our NHS – and in our society generally. They need to be isolated – and removed at the earliest electoral opportunity, and limited as much as humanly possible in the damage they can do between now and then.