Dr Phil Hammond, broadcaster and GP returner in Bristol

Private healthcare providers have lessons for the NHS

I don’t know much about private medicine. As a junior doctor, I once dabbled with a night shift at the local private clinic and enjoyed the big fluffy duvet and on-call Belgian chef a lot more than the responsibility of covering an entire hospital alone. If you were lucky enough to spot someone going off, the safety net was a blue light ambulance to NHS casualty. The cardiac arrest trolley consisted of a bottle of port and the death certificate book.

I have never tried private general practice nor been a private patient, and I don’t have any private medical cover.1 So I was intrigued to be asked to speak at BUPA’s 60th birthday party. BUPA was founded the year before the NHS and you could argue that it is surviving rather better. Thanks to a huge slice of luck, it offloaded all its hospitals before the credit crunch scandal made its mark, and so has lots of money in the bank and a thriving private medical insurance business (as well as care homes in the UK, and services worldwide where health insurance is more socially acceptable).

Intriguingly, the UK insurance market has not shrunk along with the waiting lists. The top reason for going private is apparently to gain access to a clean hospital. Last year, the MRSA rate in BUPA hospitals was zero, thanks to the use of single rooms for patients, and domestic staff who are employed in-house and who have a clear sense of pride in their hospital. Even those BUPA hospitals treating NHS patients had no MRSA outbreaks. And the company that bought out BUPA assures me that the clean streak is continuing.

Why else would you go private? In our increasingly down-skilled NHS, private clients also pay to see an experienced doctor rather than a healthcare assistant, and to have a degree of continuity. According to my dinner companion, NHS doctors and nurses represent one of the fastest growing groups of purchasers of private health insurance, which tells you a lot about the state of the NHS.

So what was the BUPA bash like? It was held at the British Museum and included an exclusive guided tour of the Terracotta Army (the exhibition that punters are queuing from 5 am to see). The food was unbelievable (I have never had caramelised scallops and monkfish at a corporate bash!) and the Norman Foster-designed hall had splendid high ceilings that echoed back the punchlines of my gags after 10 seconds!

Still, the audience was very gracious, and I hooked up with Virginia Bottomley (remember her?) and her husband Peter, who is still causing the Government embarrassment over the Medical Training Application Service fiasco. They boughthree copies of my book Medicine Balls before I realised there is a very unfortunate anagram of Virginia Bottomley on page 29.2

I don’t want the NHS to be replaced by an insurance system but I do think we can learn from companies like BUPA, which for years has been collecting outcomes and quality of life information about various procedures so patients can give proper consent. They also picked up the care homes mantle when long-term care of the elderly by the NHS fell away.

The NHS, by comparison, seems like a fat, bloated lump of Stalinist mediocrity surrounded by islands of excellence desperately trying to stay afloat. It is time to break it up into regions, ditch the Department of Health and let it shine locally, or get private health insurance. It’s all about choice, apparently.

1I do, however, have a private dentist who convinced me that he uses better materials and techniques than the NHS can afford.

2I’m an evil Tory bigot

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