Rethink urged on NHS outsourcing

Digitalis-based drugs like digoxin have been used for centuries to treat patients with irregular heart rhythms and heart failure and are still in use today. In the Dec. 16 issue of the Proceedings of the National Academy of Sciences, researchers at the Johns Hopkins University School of Medicine now report that this same class of

Full Post: Old Digitalis-based drugs show promise as a treatment for cancer

The government needs to rethink its approach to NHS reforms, says UNISON, in the wake of a new damning report on the cost of commissioning and outsourcing.

It should concentrate on giving NHS patients the care they need - and value for money - rather than using reforms to outsource services and ‘throw precious money away to the private sector’ says the union, following publication of the report, Driven by Dogma, by the Office for Public Management.

The report says outsourcing in the NHS has failed to deliver value for money, patient involvement or improved working conditions.

The government’s pre-budget report in November made much of the potential efficiency savings to be made by the NHS from shared services operations with the private sector.

But first hand evidence in the new report, looking at the experience of those commissioning and delivering services, reveals that in fact promised cost benefits have simply failed to materialise, and quality has suffered.

“At a time when finances are increasingly tight, the NHS cannot afford to be throwing precious money away to the private sector and wasting time and resources on the complexity of the commissioning process,” commented UNISON general secretary Dave Prentis.

“Patients want more involvement in decision-making and staff want to spend more time on providing excellent patient care than tendering for contracts.

“Unfortunately this report shows that the various reforms to outsource or privatise parts of the NHS are working against these goals.”

The report draws on the experiences of NHS senior managers and commissioners to highlight the sheer complexity of the commissioning process, and the mountains of bureaucracy and paperwork attached to it.

“My experience has been that the problems associated with monitoring contracts far outweigh the benefits of the outsourcing,” said one of those intereviewed: “We will go on spending more and more money on this - contract negotiation skills, transaction costs, etc.”.

UNISON points out that there are alternatives - Scotland has recently announced that it will no longer permit any contract cleaning and Wales has done away with the purchaser-provider split in favour of a more integrated system.

The report makes clear that markets should not be the only option and that those working in the devolved administrations did not feel they were disadvantaged by the minimal use of outsourcing in their systems.


A provocative debate in this week’s PLoS Medicine examines whether the private sector should step up its involvement in delivering health care in low-income countries. These countries suffer a disproportionate burden of disease, and often struggle with weak health systems. Both the public and private sector deliver health care in these countries, but the appropriate

Full Post: Should the private sector play a greater role in delivering health care in low-income countries?

Giving patients money to buy their own healthcare paves the way for top-up payments and undermines the founding principles of the NHS, UNISON has warned as the Government published its Healthcare Bill. The bill will allow NHS patients in England to be given cash payments to buy physiotherapy, home nursing and other healthcare. Ministers have

Full Post: Healthcare Bill threatens to undermine NHS principles

According to a new report more Australian privately insured patients used the public hospital system last year than previously and there are concerns that encouraging people to take out private health insurance is doing little to reduce the burden on the public health system. According to the report by the Private Health Insurance Administration Council

Full Post: More private patients in public Australian hospital beds

Following yesterday’s release of the Competition Bureau’s report, “Benefiting from Generic Drug Competition in Canada: The Way Forward,” the Ontario Pharmacists’ Association (OPA) is emphasizing that competition in the generic drugs industry is already benefiting Ontarians through accessible, high quality, cost-effective professional pharmacy care. “The current pharmacy funding model in Ontario is feasible because

Full Post: Generic drug competition benefits Ontarians

Australian researchers say job stress is forcing many age care workers to leave and is jeopardising the industry. The researchers from the University of Melbourne warn that almost a third of registered aged care nurses are contemplating quitting their jobs because of job stress, created by excessive workloads, cost cutting, a hostile work environment and

Full Post: Age care in jeopardy as workers quit because of job stress