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File on 4: The Private World of the NHS

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The Private World of the NHS

03/07/2018

BBC Radio 4 - File on 4, The Private World of the NHS

Why is 'private' the word that dare not speak its name in the National Health Service?

The private sector has worked with the NHS over the last 70 years delivering health care in the UK. So why does no-one seem to want to talk about it? Adrian Goldberg investigates.

As the NHS reaches its 70th anniversary, Adrian Goldberg investigates why the very mention of the word "private" - or, even more, privatisation - in UK health care provokes fierce opposition. 

No party dare publicly claim anything less than unswerving support for the NHS and its supporting mantra that health care should be "free at the point of delivery." 

Yet millions of people are treated by a private dentist. Millions more think nothing of having to pay for eye tests and the spectacles prescribed by opticians who work for "for-profit" businesses. GP practices are independent-run businesses. Routine operations are often outsourced to private hospitals. Yet NHS contracts are increasingly fulfilled by private health providers. While campaigners protest, most people continue having treatment. 

So what is at the root of opposition to private health care? Is it the fear of replicating the US system where ability to pay is often a condition of receiving health care? If good health care is the last standing public good is that because it's the last vestige of socialism, clung to by the left? Is there a fear that the nature of health care changes when a commercial transaction lies behind it? Do nostalgia and a notion of "fairness" play a part? And does the fear of opposition encourage a policy of reform by stealth which in turn fuels suspicion and more opposition?

Adrian's mother was a domestic at the Royal Orthopaedic Hospital in Birmingham for more than 20 years; his first job was working for the West Midlands Regional Health Authority, while his sister is a nurse. The programme takes Adrian on a personal journey to discover the true nature of opposition to private provision. On the way he talks to patients, practitioners and experts on health provision.

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