NHS Privatisation Debate: Arguments & Impacts

This assignment delves into the contentious issue of privatising the National Health Service (NHS). Students are tasked with examining both sides of the argument, weighing potential benefits such as increased efficiency and innovation against concerns about reduced accessibility and compromised patient care. The analysis should encompass various perspectives, including economic, social, and ethical considerations, drawing upon relevant research and scholarly sources.

Running head: HEALTHCARE MANAGEMENT
Name of the student
University name
Author’s note

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Table of Contents
Introduction............................................................................................................................2
Impact of privatisation of NHS on the UK healthcare...........................................................2
Benefits of NHS privatisation on other industries.....................................................................4
Argument for and against privatisation of NHS....................................................................6
Reflection on the research......................................................................................................7
Conclusion..............................................................................................................................8
References..............................................................................................................................9

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Introduction
The current assignment focuses on the concept of healthcare management. In the
current assignment England based National Health Service (NHS) has been taken into
consideration. The term is collectively used for a number of sister concerns of the NHS such
as – NHS England, NHS Scotland, Health and social care in North Ireland , NHS Wales. The
goal behind the establishment of the organization was to develop universal, comprehensive
and free healthcare services for the needy and the poor. However, the privatisation of
healthcare has become a huge threat in the pathway of establishment of the NHS objectives.
The assignment explores the effect of Privatisation of NHS on various healthcare services.
This in accordance with the Health and Social Care Act, 2012, by which increased number of
staffs are transferred from the NHS to private sectors hospitals for imparting sophisticated
care at higher prices. The process of privatisation is transforming NHS into a money making
trust, which radically limits the quality and quantity of care delivered by the NHS trust.
Impact of privatisation of NHS on the UK healthcare
The inception of the health and social care act has promoted the prospects of the
privatisation of NHS. Though the plan provides a larger role to the general practitioners, the
plan has been nullified by most of the medical care units. In order to analyse the changing
dimensions we need to focus upon the present scenario within the NHS. It could be
highlighted that the NHS already has a significant amount of privatisation in the form of
contributions from commercial businesses. There are mixed reactions within the economy
regarding making the health and social care act into a legal act. As commented by Kirkwood
and Pollock (2016), most healthcare providers under the NHS umbrella, act through
competitive contracts. Under this they are competing with the NHS and public sector
healthcare services for getting sufficient number of patients (Burton 2014). Though the

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Independent Sector Treatment Centres (ISTCs) supplement for the range of healthcare
services provided by NHS, there are inequalities within the range of healthcare services
provided. As argued by Maynard (2017), increased commercialization would shift the
balance from NHS to an increasingly privatised service. Thus, commercialization of the
healthcare industry can generate huge amount of international revenues. Therefore, the
government has to solely depend upon the frequency of illness within the population to help
pay the taxes. As mentioned by Burton (2014), the power play can do more harm to the
population than good. The privatization will disturb the balance between the intrinsic and
extrinsic motivators for the NHS trust as a whole (Goffey et al. 2014). The intrinsic factors
here refer to compassion, generosity whereas the extrinsic motivators refer to money, power
and prestige. The NHS operates from intrinsic motivation which could be significantly
hampered by the thirst for power (Maynard 2017).
The privatisation of NHS would make the healthcare services turn into a commodity.
The industrialisation of healthcare can work well in conceptually simple and well
circumscribed illnesses such as cataract and arthritis. On the other hand, it is not so effective
in redressing complex, multiple problems observed in old age and mental healthcare.
Therefore, the industrialisation creates an imbalance by the oversupply of commoditised care
versus catering to the health requisites of the old and the mentally ill. The privatisation can
make NHS focus upon the short term health goals more as a means of making money rather
than focus upon the deep rooted health problems of the patients. This is because as long as
illness is prevalent within the population, the health industry would keep on making money
(Kahungu 2016).The root cause of healthcare problems are much more deep rooted and often
needs a psycho-social mirror for analysis and retrospection. However as mentioned by
Kirkwood and Pollock (2016), the privatisation would disturb the holistic approach of
healthcare. The health and social care act, 2012, has been manifested by the government in

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making consumerist choices in healthcare. The choices will decide the kind and quality of the
healthcare services received. For example rich client is supposed to receive improved quality
of care services whereas the poor and the needy will suffer.
Benefits of NHS privatisation on other industries
The privatisation can impact upon the patient population and the staff in a number of
ways. The commercialization of NHS would result in huge transaction costs which can upset
the healthcare budget of the general public. As commented by Kahungu (2016), the unequal
distribution of services also resulted in a sharp increase in the cost of healthcare. The private
agencies have been seen to compromise the quality of care by attempting to cut down upon
the additional health care cost. As reported by the guardian, six people were feared to suffer
from sight loss due to failure of a privately run health care provider to provide adequate
services (McKee 2014). Additionally, the doctors are seen to arrive late at their own
privatised set ups which often kills significant amount of the time of the patients.
The commercial confidentiality compromises the accountability of the private firms in
providing superior quality of care. As commented by Goffey et al. (2014), the strict
confidentiality norms of the private healthcare agencies makes estimation of the public
spending difficult in health care. The private health agencies are accountable to their
shareholders for obtaining maximum profit. An instance could be related over here where in
Southern Cross the profit making perspective led to the closing of the old age care homes.
Additionally, commercialization of the services has led to less focus upon implementation of
holistic care approaches. This particularly degrades the quality of care and support services
offered to the mentally challenged and ill. The privatisation has also led to the fragmentation
of the support and care services. As commented by Naguleswaran et al. (2015), the cherry
picking attitude of the insurance agencies have resulted in a massive paradigm within

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healthcare. The investment of money as well as human resources in the short term and
lucrative healthcare objectives affect the quality of the support services.
The commercialisation of the NHS also affects the staffs working in the healthcare
setup in a considerable manner. The privatisation objectives means that the healthcare staffs
would no longer be governed as per the national negotiating arrangements stated in the NHS
directives (Burton 2014). This also means that any future pay uplifts would also not be
applicable to the staffs under the new directives. The change of power from public sector to
private sector undertaking will bring about significant changes within the pension scheme and
policies of the NHS. Under this an employee who have moved out of NHS and joined a
private sector healthcare firm would no longer be entitled to the NHS pension scheme and
would be treated as a new employee on re-joining (Naguleswaran et al. 2015).Under the
previous healthcare system of the NHS, 80% of the health related costs were settled by the
government subsidies (Kahungu 2016). However, under the new scheme the patient party
actually might have to pay more prices for availing the basic healthcare services. This means
more investment in health care policies or cut out from employee pension schemes, which
will in turn benefit the insurance companies.
The requirements and the guidelines for the new staff are drastically different from
the current staff. The staffs joining afresh under the privatisations rules and directives would
not be entitled to the NHS pension scheme or agenda for change terms and conditions
(Greener 2016). Previously, the issues faced by the healthcare staffs working in NHS were
handled by the trade unions. The trade unions have been seen to help the employee settle
disputes in matters related to workload, disputable conditions at work and incidences of
discrimination. However, under the new directives separate permission to recognise the trade
unions need to be sought by every new employee entering the NHS firm (Krachler and Greer
2015). The professional standards also deteriorate owing to increased workload, cutting of

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staff and change in the skills sets due to mixing of the less trained staff with the well trained
ones. The private healthcare agencies are under no obligations for contributing towards the
training of the NHS staffs. Therefore, the quality of the healthcare services is also
compromised.
Argument for and against privatisation of NHS
View of doctors
The concept of privatisation varies considerably with individual perception as well as
from the perception of a healthcare professional. As mentioned by Simonet (2015),
privatisation is the provision of healthcare services to NHS patients by independent sectors.
The views of the doctors or the medical professionals have been taken into consideration
regarding the pros and cons associated with the privatisation of the health care services
provided by NHS. More than two- thirds of the doctors were not convinced with the idea of
privatisation of NHS. This could be attributed to a number of causes such as destabilisation
of the NHS services, fragmentation of the services, deteriorating standards of clinical care,
less trained staff, worse patient experience. A number of healthcare professionals have gone
up to the extent of putting the blame on the government for deliberately underfunding NHS in
order to speed up the privatisation plans (Exworthy et al. 2016).
View of healthcare department
However, the statement has been contradicted by the department of health, Great
Britain which states that the recent plan proposed by the government will save up to £70 m a
year (England, 2018). Though, the general physicians working across the country have raised
their voice against the issues by notably mentioning that the NHS supplies healthcare staffs
much more cheaply than private firms. The senior practicing professionals have emphasised
that the privatisation would reduce the power of NHS and make the medical services more

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profit-oriented than patient centred. However, 93% of the junior doctors have supported the
privatisation move out of a desire of getting higher pay (England, 2018).
View of consumers
The availability of improved and sophisticated healthcare technologies has further
encouraged a certain section of the society to pay more. This further supports the move for
privatisation of the NHS based upon individual patient preferences. As supported by Crouch
(2015), some of the health care and support seeking individuals just want to pay more with a
wish of availing better care services. The private sector encourages the aspect of cherry
picking whereby they are seen making money in lucrative deals leaving the rest to NHS
(Peckham et al. 2015). As argued by Mossialos et al. (2016), the rise in healthcare costs is
justified by the consumerist choices promoted by the government through rampant
privatisation. This increases the financial debts of the agency considerably. This also reduces
the ample opportunities of training and learning for the junior doctors, as large amount of
routine surgeries and medical processes are shifted from the NHS into the private hands. For
example some of the healthcare services have been dropped such as sexual health care.
Reflection on the research
The NHS works under the directive which states that-“any public body which caters
to the health services and requirements of people across the country must be in accordance
to information standards as published under the Health and Social Care Act, 2012 (section
250)”. In my opinion, the privatisation can hamper the quality and maintenance of NHS
standards. One such important criterion as mentioned in the NHS standards are pertaining to
the sharing of healthcare information. The information standards consist of a pre-determined
set of rules of capturing, processing, sharing and managing information and data. However,
as argued by Mossialos et al. (2016), the privatisation would result in fragmented services

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which will hamper the overall quality of healthcare. Therefore, working as a health care
professional in UK and after undertaking the research I think that privatisation would make
health care a matter of choice for the population and not a basic right.
Conclusion
The current study focuses on the aspect of privatisation of NHS trust England. The
commercialisation of the NHS can increase the price of the healthcare services. Additionally,
the quality of the healthcare services can be significantly compromised. This is because the
mixing of the staff puts more power on the less trained staffs for the delivery of the
healthcare services. Additionally, the aspect of commercialisation puts more emphasis upon
making money out of lucrative deals rather than providing a more holistic support care.
Additionally, the privatisation aspects would result in the development of health inequalities
within the different social classes. Moreover, increased amount of work pressure and less pay
can also reduce the motivation in the healthcare staffs. However, differences between
different power plays could led to disparity within the present health scenario where some of
would prefer the move of privatisation and the others would strongly oppose it. Additionally,
the increased demand of consumerist choices can suitably favour the move for
commercialisation.

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References
Burton, J., (2014). Partnership or privatisation? An NHS Trust's experience of
sponsorship. Gastrointestinal Nursing, 12(2), pp. 202-325.
Crouch, C., (2015). The Paradoxes of Privatisation and Public Service Outsourcing. The
Political Quarterly, 86(S1), pp.156-171.
England, N. (2018). NHS England » Search Results » nhs privatisation. [online]
England.nhs.uk. Available at: https://www.england.nhs.uk/?s=nhs++privatisation+ [Accessed
21 Jan. 2018].
Exworthy, M., Mannion, R. and Powell, M. eds., (2016). Dismantling the NHS?: Evaluating
the Impact of Health Reforms. London: Policy Press, pp. 55-85.
Goffey, A., Pettinger, L. and Speed, E., (2014). Politics, policy and privatisation in the
everyday experience of big data in the NHS. In Big Data? Qualitative Approaches to Digital
Research(pp. 31-50). London: Emerald Group Publishing Limited.
Greener, I., (2016). An argument lost by both sides? The Parliamentary debate over the 2010
NHS White Paper. Dismantling the NHS?: Evaluating the Impact of Health Reforms, p.105.
Kahungu, L., (2016). Should the NHS be privatised? Potential merits and demerits of
privatisation of the National Health Service. New York: GRIN Publishing, pp.125-165.
Kirkwood, G. and Pollock, A., (2016). Awarding NHS contracts to private providers
decreased local NHS provision and increased inequalities: Scottish case study of elective hip
arthroplasty. Journal of Public Health, pp. 142-175.

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Krachler, N. and Greer, I., (2015). When does marketisation lead to privatisation? Profit-
making in English health services after the 2012 Health and Social Care Act. Social Science
& Medicine, 124, pp.215-223.
Krachler, N. and Greer, I., (2015). When does marketisation lead to privatisation? Profit-
making in English health services after the 2012 Health and Social Care Act. Social Science
& Medicine, 124, pp.215-223.
Maynard, A., (2017). Shrinking the state: the fate of the NHS and social care. Journal of the
Royal Society of Medicine, 110(2), pp.49-51.
McKee, M., (2014). Mutual ownership: privatisation under a different name?. BMJ: British
Medical Journal, 349.
Mossialos, E., Simpkin, V.L., Keown, O. and Darzi, A., (2016). Staff, drugs, research, TTIP,
patients: how would Brexit affect the NHS?. LSE Brexit, pp. 205-315.
Naguleswaran, K., Tribedi, T., Fenn, J. and Patel, S.B., (2015). This house believes the NHS
should be privatised—1st southwest medical debate. Philosophy, Ethics, and Humanities in
Medicine, 10(1), p.11.
Naguleswaran, K., Tribedi, T., Fenn, J. and Patel, S.B., (2015). This house believes the NHS
should be privatised—1st southwest medical debate. Philosophy, Ethics, and Humanities in
Medicine, 10(1), p.11.
Peckham, S., Falconer, J., Gillam, S., Hann, A., Kendall, S., Nanchahal, K., Ritchie, B.,
Rogers, R. and Wallace, A., (2015). Impact of changes in the Health and Social Care Act
2012 and Public Health White Paper, pp. 14-45.

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Simonet, D., (2015). The new public management theory in the British health care system: a
critical review. Administration & Society, 47(7), pp.802-826.