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!
Based on the evidence that we have seen of wheelchair services we wouldn't necessarily view privatisation as a bad thing. Generally speaking the work that we see clinicians undertaking is sound but there seems to be distinct lack of investment in technology to help them do their jobs.
Obviously, as a software provider in this field we have a fairly narrow perspective but all too often we see a lack of integration between clinical systems and the home grown systems that are used by workshops, rehab engineering and the back-office.
Services provided on a more integrated basis by efficient, commercially motivated companies competing for business has got to be a step in the right direction.
I can't wait for this to happen, i currently work with young children with disabilities. They can wait up to 12 weeks for an assessment and then are given a wheelchair that doesn't suit their needs but that they have in stock!
One size fits all - NOT.
It seems ridiculous that children are having to wait so long, and not receiving the right sort of wheelchair to help them get mobile and keep up with their friends.
If private companies or charities can offer a better service, they should have the chance to do so.
I see so many private companies and charities offers good services, they even donate wheelchairs. Some big companies do offer motorized wheelchairs as well, however we all know that they are very expensive wheelchairs. These type of steps, we should take for disabled persons because they always need our help. I think we should do work together for this issue.
Phil Morrell is the father of a 17-year-old with Duchenne muscular dystrophy, and Chairman of the Aspire Powerchair Football Club. He raised the money to buy his son's power chair, because NHS wheelchair services would not provide a chair with the functionality he needs, and this is his experience of the service that has been provided subsequently:
“With regret, I feel really let down by NHS Wheelchair Services in so many respects. If I need someone to come and assess my son’s needs if he is in pain, it can take up to seven months to see a specialist. They won’t pay for adaptions or servicing to Jack’s Etac Balder powerchair as his condition changes and due to a ridiculous loophole in the current Road Traffic Act, our local NHS Wheelchair Service will not cover the maintenance of the chair as they class the 150kg wheelchair as a car! This issue is currently affecting many young adults who desperately need a powerchair, however I read recently that there is to be a possible overhaul of children’s Wheelchair Services, which may increase efficiency through private sector investment. This is desperately needed as the tortuously slow process of dealing with the NHS in this sector commonly fails the needs of young less able individuals both in terms of time and solution provision.
Currently all I seem to hear are excuses and even though I do understand budgets have to be cut these days, surely several priorities are wrong when it comes to considering the welfare of young disabled people such as my son. He never complains and as a family we couldn’t be more proactive in researching and funding all the accessible adaptations valuing approximately £60,000 we have had to make at home, without any significant help from Hertfordshire NHS. Even when Jack had spinal surgery that resulted in him needing additional side supports on his powerchair, it took four months for Wheelchair Services to write back to me. Why is the system so complex and inefficient and they never even meet me halfway? If I talk to Etac for example, issues and concerns are resolved quickly and accurately. I get so frustrated as we could not make any more phone calls to help ourselves but still come up against brick walls with the NHS. I also know that as Jack turns 18, we will receive even less potential support from charities or the NHS which I’m sure is a major concern for many other families with less able members."
The current infrastructure requires investment, with accredited training for all the professions. The wheelchair service has never been properly resourced or managed. Throwing away the skills and hoping for the best is hardly a solution. The private companies won't have the resources to cover all the elements. It will become a postcode lottery of the worst kind.
As the Managing Director of Newton Products Ltd, manufacturers of the Vixen Range of powered wheelchairs, I wish to express my frustration with the problems within the NHS wheelchair service and the proposed changes. We have recently made substantial changes to the design of our childs chair, The Scamp, but we CANNOT find anyone within the NHS who can give us the necessary information to get this chair to the children who need it. We are also frustrated when we hear about delays in supply. We can produce a specifically 'built to prescription' chair in about two weeks, sometimes less. Why this then takes months to reach its intended client, is beyond me!
Please, if anyone wishes to talk to me about this matter, look me up and give me a call.
This will mean you can choose where to get your wheelchair, which would mean more choice and a better service...in theory! My concern is that regional purchasers will put contracts out to tender, much as they have with enteral feeds and pumps. This could mean a big variation in options depending on where you live. Of course, the cheapest services will win!
I also worry where this will stop. How far will the NHS become a PHS - privatised health service!
It is good if they focus not only for children's wheelchairs, but also the entire facility that include furnishings and other important home appliances.
Cheers,
Krissy