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World at OneTuesday, 4 December, 2001, 13:56 GMT
What price our NHS?
Nurse and patient
Treating patients or wasting money?
A new public-private NHS deal, but will it cost us more than it delivers? And who is driving government policy - the Treasury, the Department of Health or Number 10?

The Health Secretary, Alan Milburn, announced this morning that the Redwood Hospital, at Redhill in Surrey - owned and operated by BUPA - will soon be catering exclusively for National Health patients.

The deal poses fascinating questions.

In the government's ten-year national plan for the NHS - published in July 2000 - promotion of the private sector is dismissed, as likely to cause higher labour and administration costs, and fragmentation of the service.

If that was true then, why is it not true now?

Bad deal for NHS patients

John Edmonds, general secretary of the GMB union, accepted that there could be a case for using private sector beds on a temporary basis:

"But to use it on a permanent basis - and that's what this looks likely to be - seems to me to be a very bad deal for NHS patients," he said.

The government argues that if the beds and staff are available, they should be used, provided that they remain free to the patient.

Duplicated management

But Alan Milburn's ten-year plan warned that "the more fragmented commissioning of health care became, the more prices would be likely to rise... administrative costs would rise significantly".

Many management and financial tasks too, like fixing the prices charged for operations are also likely to be duplicated.

Clare Hollingsworth, BUPA's managing director of hospitals, was adamant that there would be no confusion:

"When the Redwood Hospital deal gets into operation there will be only one set of managers and that will be BUPA. We will have very clear arrangements about where people's responsibilities start and finish," she said.

Cabinet at odds

And there are further questions about who is really running health policy. Gordon Brown has been at odds - with Tony Blair over the plan to match average European spending on health - and with Mr Milburn over the attraction of ring-fencing taxes raised, to pay for the NHS.

The shadow health secretary, Dr Liam Fox, said current government policy was: "a totally toxic mixture of confusion and incompetence:
"It really leaves us wondering who, if anyone, is running NHS policy."

Israel

In the Middle East, Israel has - to all intents and purposes - declared war on the Palestinian Authority. If anyone doubted this, the missile fired through the outer entrance of offices occupied by Yasser Arafat - while he himself was inside - brought the point home.

This raises the question of what Ariel Sharon hopes to achieve - is it the elimination of Yasser Arafat, or the destruction of the Palestinian Authority?

It surely marks the end of the peace process begun in Oslo nearly a decade ago. But not all in the unity government support what is happening.

Shlomo ben-Ami, former Labour foreign minister is one of many in the Labour Party who are convinced that they should not have joined the government in the first place, and should now withdraw. Binyamin Netanyahu, the former prime minister, has long been critical of Mr Arafat and the Palestinians.


To listen to the interviews, click on the links above.

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 ON THIS STORY
News image John Edmonds:
"A very bad deal for patients"
News image Liam Fox:
"Who is running NHS policy?"
News image Shlomo ben-Ami and Binyamin Netanyahu:
Reactions to Israel's actions against the Palestinians
Links to more World at One stories are at the foot of the page.


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