THE chairman of York Hospital has today warned of the risks of introducing too much competition into the NHS.

In an exclusive interview with The Press, Alan Rose said a “degree of competition” in the health service may be appropriate.

“But forcing large elements of the health service to be exposed to competition could be highly disruptive to local health service delivery,” he said.

York Hospital has already had to fight off competition from the private sector to continue running physiotherapy services, Mr Rose said.

The hospital had won the tender, by offering a more community-based service. That was a “challenge, but a good outcome.” But physiotherapy only represented a small proportion of what the hospital did.

“If a large proportion of our services were put out to tender it would cause disruption and would fragment the integrity of local health care delivery.”

Mr Rose, who took over as chairman of York Hospital from Prof Alan Maynard just over a year ago, said the hospital was generally supportive of the coalition government’s NHS reforms, which will see two whole tiers of NHS bureaucracy – primary care trusts and strategic health authorities – swept away, and responsibility for deciding how local NHS cash should be spent placed firmly in the hands of GPs. But he said the success of the reforms would depend on those GP consortia being “well-intentioned”.

By that he meant that GPs, who would have a great deal of discretion over which health services should be put out to tender, should “carefully consider when competition processes are appropriate to the local health economy,” he said.

It would be “completely inappropriate” to put certain hospital services, such as A&E, intensive care, and acute services such as cancer treatment and heart care, out to tender.

Despite his concerns, he stressed he did not consider the Government’s health reforms amounted to privatisation by the back door. “I believe that fears of “privatisation” of the NHS have been exaggerated,” he said.

York GP Dr Brian McGregor speaking from the National Local Medical Committee Conference in London, said: “We would like to see competition where appropriate and NHS money being spent on patient care rather then going into shareholders’ pockets.”

York Press: The Press - Comment

Is NHS right place for privatisation?

THERE are those who suspect the coalition government’s NHS reforms are a step towards privatisation by the back door.

York Hospital chairman Alan Rose isn’t one of them. Such fears have been exaggerated, he says. Nevertheless, the reforms – which will see two tiers of health bureaucracy swept away, and responsibility for how health cash is spent placed largely in the hands of GPs – could well see more private sector competition.

Already, York Hospital has had to go out to tender in order to keep control of local physiotherapy services. We may see that happening with other areas of health care.

That is all very well up to a point, Mr Rose says. But it should not go too far.

There are areas of health care that should never be opened up to competition, he stresses – accident and emergency for one, and acute services such as for cancer or heart patients.

In future, he believes, it may well be up to local GP consortia to decide which local health contracts are opened up to the private sector.

They will need to “carefully consider when competition processes are appropriate,” he said. “Forcing large elements of the health service to be exposed to competition could be highly disruptive.” We entirely agree. There may be areas where competition could benefit health care. The private sector is often leaner and more efficient, and the threat of competition may force traditional health providers to up their game.

But allowing private companies to cherry-pick the easiest and most profitable health contracts, leaving the NHS to deal with the rest, would be a disaster. Care and compassion, not profit, should be at the heart of our health service.

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