Public-Private Relations in Health Care

Justin Keen, Donald Light and Nicholas Mays.
Kings Fund
ISBN 1 85717 257 4

A highly topical book given that making use of
private health care facilities is a key part of the government’s
strategy to meet the ambitious targets in the NHS Plan.

Public-Private Relations in Health
helps to take some of the political heat out of the
debate by pointing out that the private sector has always played a
crucial role in the delivery of health care. GPs are independent
contractors, NHS consultants have private patients, and the
interdependence of the NHS and the pharmaceutical industry are some
of the more obvious examples.

Rather than an ideologically driven response,
the authors argue that the focus of the NHS should be on improving
outcomes and on improvements in equity as a key step in that
direction. Securing consistency across the country to end the
postcode lottery is part of that process. The authors explore more
radical options, including the abolition of user charges for those
in need, but recognise that the patchwork quilt of means-testing
and charging is not susceptible to easy rationalisation.

For social care where the role of the private
sector has tended to be direct care provision in the domiciliary
care and residential sectors, the book has interesting

Terry Bamford is chairperson,
Kensington and Chelsea Primary Care Trust and a member of the
General Social Care Council.

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