Letter: The undermining effect of buying health-care

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Sir: I was somewhat baffled by the suggestion by David Tod, the president of the National Association of Fundholders, that the ability of fundholders to buy private-sector care is of benefit to the NHS ('When the practitioner becomes the purchaser', 15 July). Given that such purchasing undermines the spread of work and the contracts available to NHS community and hospital units, it has exactly the opposite impact.

Rather than absorbing the variety of costs which arise in any provider unit, the private sector is able to pick off the easy, high-turnover, minor procedures, while the NHS is expected to cope with expensive, high-technology, longer-stay treatments. Contrary to what Dr Tod implies, unit costs for the latter forms of treatment are therefore pushed up, endangering their viability and the scope and quality of services available to NHS patients.

This is a nonsensical state of affairs in which the obsession with competition, rather than caring for the sick, becomes the rationale behind the purchasing of health services. It also demonstrates again that simply allowing ever more GPs to adopt fundholding status is not the panacea for the problems created by fundholding in the first place.

Yours sincerely,


MP for Sheffield Brightside (Lab)

House of Commons

London, SW1

The writer is shadow Secretary of State for Health.