Why Does It Matter?

"It doesn't matter who provides service as long as its free at point of use"? Oh, but it does.

The purchaser-provider split is costly and bureaucratic. Private profits are taken, not only out of frontline care, but very often out of the British economy altogether, by companies that in any case cherry pick the most profitable services, adversely affecting the ability of NHS facilities to provide the full range of services to their local communities.

Private poaching of NHS staff creates shortages that drive up recruitment agency and locum costs. There is fragmentation, rather than integration, of care pathways. Due to the replication of services, there are inefficiencies such as excess capacity.

There are advertising costs. There is the inevitable privatisation of policy-making. And transparency and accountability are reduced by considerations of commercial confidentiality.

All in all, it matters very, very, very much, indeed.