Privatisation of the NHS has taken another step forward, as Health Secretary Andrew Lansley opens up eight further areas to competition from private companies and charities. Until now, competition has been focused on routine surgery, and the involvement of organisations outside the NHS has not had as great an impact as predicted: less than 5% of routine operations are undertaken outside the NHS, not the 15% predicted five years ago when competition in this activity was introduced.
This time round, one of the services to be opened up to private sector competition is provision of wheelchairs for children, and this may well prove a catalyst for positive change. It has long been the case that, whilst NHS assessment of clinical need and ongoing support of the patient and prescribed equipment may have been exemplary, the equipment possibilities available from wheelchair services have been limited, simply because the funds are not there to provide the best and most highly functional products available, when enough resources must be found to give everyone a certain minimum prescription appropriate to their need.
For the parents who could afford it, or could access financial support elsewhere, the solution has been to buy the desirable equipment privately, even perhaps using the NHS wheelchair services voucher to pay for part of the cost. By doing this, however, they were losing the benefits of a relationship with wheelchair services, such as ongoing clinical review and product support.
In the future, "any qualified provider" may offer services and will be paid according to an NHS tariff, with the aim that competition is based on quality, not price. The change is being regarded as a positive opportunity by at least some organisations working in the field, as they see the possibility of closer collaboration with NHS wheelchair services, to speed up the process of assessment and provision. The gap between minimum necessary equipment and optimal is there to be brooked, if the various interested parties can work together effectively.
What are your thoughts? If you are involved in any way, either as a provider, specifier, or user, it would be great to hear your opinions here!