Select Committee on Health Minutes of Evidence


Memorandum by the Independent Healthcare Association (PS13)

CONTENTS

EXECUTIVE SUMMARY

INTRODUCTION

  About the independent sector

  About the IHA

  IHA members

PROGRESSING PARTNERSHIP

  The value of partnership

  Partnerships in mental health

  Partnerships in community care

  Concordat Partnerships

    —  Elective care

    —  Critical care

    —  Intermediate care

  Towards best value

QUALITY AND WORKFORCE ISSUES

  Quality and safety

  Workforce partnerships

CONCLUSION

1.  EXECUTIVE SUMMARY

  1.  The Independent Healthcare Association (IHA) welcomes the Health Select Committee's inquiry into the Concordat, the Private Finance Initiative (PFI) and Public Private Partnerships (PPPs). The IHA also welcomes and supports government indications that the independent sector has a greater role to play in the NHS.

  2.  The independent health and social care sector is today a vital part of the nation's health and social care services. The independent health and social care sector today provides 443,000 beds and employs over 750,000 people. Overall, the IHA estimates that the capital invested in the UK's independent health and social care sector is in excess of £15 billion.

  3.  Partnerships between the NHS, local authorities and the independent sector already benefit hundreds of thousands of people each year.

    —  Between 1 January and 31 August 2001, more than 65,000 NHS patients have been treated in independent hospitals, at no personal cost to themselves.

    —  By the end of 2001 the IHA estimates that independent acute hospitals will have treated 100,000 NHS patients under the Concordat signed in autumn 2000.

    —  Independent providers offer around a quarter of the country's combined acute mental health treatment plus 55 per cent of NHS medium secure provision.

    —  Independent nursing and residential care homes provide more than 430,000 beds, offering a wide range of high quality services to local authority and NHS purchasers.

  4.  The levels of partnership in acute care, under the terms of the Concordat, represent a three-to-four fold increase over previous levels of partnership working and stand as a tribute to the government's far-sightedness.

  5.  An analysis of the Concordat's impact in one health authority was published recently in the Health Service Journal. Written by a team from East Surrey Health Authority the research shows how the authority used seven independent hospitals over 11 weeks to remove 1,000 patients from NHS waiting lists. Importantly, the study concluded that:

    "Prices were comparable to, and sometimes cheaper than the NHS. The average cost was £1,120 per treatment. Patient satisfaction seemed high".[12]

  6.  Given the achievements, it is now realistic to expect each independent hospital to treat 1,000 NHS patients a year—or four every weekday. With more than 200 hospitals in the sector, the overall total for 2002 could exceed 200,000 people.

  7.  In order to progress partnerships the IHA is also actively campaigning for adequate funding, particularly for independent nursing and residential care homes. Many local authorities expect on average residential care and nursing homes to provide care for approximately £1.42 and £2.05 per hour respectively. Given this situation, the IHA and its members continue to try and persuade local authorities of the importance of best value care home services and to encourage their commitment with more appropriate and sustainable funding levels.

  8.  To use independent mental health services and acute hospitals for example but not appropriately fund care homes is unsustainable. Using one without the other will achieve very little. For NHS public private partnerships to work, all the nation's health and social care resources have to work together in a sustainable and unified manner.

  9.  The IHA and its members are committed to the highest possible standards of care for all patients. For example, after more than 10 years of campaigning for better government regulation, the IHA welcomes the new National Care Standards Commission (NCSC) setting minimum care standards for independent hospitals.

  10.  The independent sector also has the ability and willingness to work in partnership with the NHS to train the staff needed for the nation's health and social care services. For example, in the year ending 31 March 2001, the independent sector provided 1,380 clinical placements for student nurses, post-basic registered nurses and allied health professionals.

  11.  Probably the greatest myth about the independent sector is that it somehow "steals" nurses away from the NHS. Over recent years, less than 4 per cent of nurses who left the NHS moved to work in the independent sector. The vast majority—more than 96 per cent—simply left nursing altogether.

  12.  To ensure that the NHS Plan succeeds, it is vital that the Concordat is built upon and that more is achieved in 2002. When used to its full potential, the independent health and social care sector is a significant resource which is ready and willing to help the government achieve its policy objectives and ease the pressures on the NHS.

2.  INTRODUCTION

  13.  The Independent Healthcare Association (IHA) welcomes the Health Select Committee's inquiry into the Concordat, the Private Finance Initiative (PFI) and Public Private Partnership (PPPs). The IHA hopes this inquiry will highlight the successes of the recent health Concordat, For the Benefit of Patients, and promote further public private partnerships in health and social care.

About the independent sector

  14.  Every day the independent sector delivers treatment and care to hundreds of thousands of people through its hospitals, mental health services and nursing, residential, domiciliary and extra care sheltered housing services. Importantly, they often do this in partnership with the NHS and social services.

  15.  Overall, the independent health and social care sector provides 443,000 beds and employs 750,000 people. The sector delivers:

    —  85 per cent of residential community care;

    —  more than half of all medium secure NHS mental health care;

    —  20 per cent of all acute elective surgery;

    —  80 per cent of the nation's acquired brain injury rehabilitation;

    —  more than 55 per cent of local authority funded domiciliary care;

    —  over one million surgical procedures a year; and

    —  more than four million out-patient appointments a year.

  For some types of service, such as medium secure mental healthcare, the independent sector delivers a majority of the NHS provision.

  16.  Today, there is a growing recognition that the independent sector can make an important contribution to the NHS because it is fully consistent with the egalitarian principles upon which the service was founded. The widespread popularity of public private partnerships in healthcare can be seen in the recent MORI opinion survey Attitudes Towards Public/Private Partnerships.[13] The research pointed out that:

    "Two-thirds of the public find the concept of the NHS paying private hospitals to provide health services for NHS patients acceptable".[14]

  17.  In reality, the independent sector is deeply inclusive. It encompasses a wide range of providers including a vast array of not-for-profit services run by charities, mutuals and friendly societies, as well as commercial organisations.

  18.  More than 3.5 million trade unionists—over 50 per cent of the TUC's 6.8 million members—now enjoy the benefits of private health cash and medical insurance schemes.[15] Many independent sector not-for-profit organisations have formal agreements with trade unions or have trade unionists in membership. Some offer private medical, permanent health or critical illness cover. Others offer private health cash plans that pay for services including dentistry, ophthalmics, physiotherapy, chiropody, podiatry, maternity services, allergy testing, hospital in-patient stays, nursing home stays, hospital day case admissions, convalescence, home help, mental health and psychiatric treatment, and even the use of an ambulance.

  More than 50 per cent of the TUC's 6.8 million members—now enjoy the benefits of private health cash and medical insurance schemes.

  19.  Today, independent sector organisations such as the Benenden Hospital, Bristol Contributory Welfare Association, Civil Service Healthcare Society, Communications Workers Friendly Society, Hospital Savings Association, Medicash, Simplyhealth, Wakefield Health Scheme, Westfield Contributory Health Scheme collectively have millions of workers in membership—many of whom are trade union members.


  20.  In the other European democracies, there is a clear recognition that partnership working is good for public sector services. In Belgium, two thirds of hospital beds are in the independent sector. In Germany and Spain half the beds are in the independent sector. In Austria, France, Greece and Italy, one third of all hospital beds are in the independent sector. And in Portugal and Switzerland independent hospitals provide more than a quarter of all beds.

  21.  Today, it would require the equivalent of three or four pence on the basic rate of income tax to simply replace current private spending on independent healthcare services. To fully replace the independent sector's entire contribution would cost much more.

  22.  Overall, the IHA estimates that the capital invested in the UK's independent health and social care sector is in excess of £15 billion making it a vital part of the nation's health and social care resource.

  23.  The IHA uses the term "independent healthcare" to encompass all non-public healthcare provision. None of the other terms have sufficient or acceptable scope. The term "private" is inadequate to the task: NHS hospitals provide considerable private healthcare through pay beds, and some independent providers do not consider themselves to be "private sector".

About the IHA

  24.  The Independent Healthcare Association (IHA) is the leading association for the United Kingdom's independent health and social care providers. Members include not-for-profit services run by charities, mutuals and friendly societies, as well as "for-profit" organisations—large and small. These include:

    —  independent nursing, residential, domiciliary and intermediate care providers;

    —  acute hospitals;

    —  mental health hospitals;

    —  substance misuse units;

    —  pathology laboratories;

    —  screening units;

    —  and a host of other health and social care companies.

  25.  The IHA was formed in 1949 with the birth of the Association of independent Hospitals and Kindred Organisations and has existed in its current form since 1987. It is a registered charity (296103), incorporated under the Companies Act (2082270), being a company limited by guarantee.

  26.  The IHA promotes the highest standards in the independent sector and strives to influence policy debate across health and social care. It maintains consultation with government and other bodies on the provision of medical, nursing and social care. It also analyses and disseminates information to members, promotes knowledge of the independent sector to the general public and encourages the right of individuals to choose independent sector treatment and care.

IHA members

  27.  IHA members operate more than 80,000 beds and have a combined turnover of more than £4 billion a year. There are three main groups of IHA membership: mental health, community care and acute medical/surgical hospitals.

    —  IHA members offer 3,000 beds in mental health and substance misuse units.

    —  IHA members provide more than 70,000 nursing and residential care home beds—out of a national total of 430,000.

    —  IHA members include over 200 acute medical/surgical hospitals with more than 10,000 beds.

    —  The IHA's acute group includes all the main independent hospital operators and about 90 per cent of all independent acute hospital provision.

    —  IHA members provide a full range of elective hospital services from simple to complex procedures.

3.  PROGRESSING PARTNERSHIP

  By the end of 2001, the IHA expects that independent acute hospitals will have treated 100,000 NHS patients under the Concordat signed in autumn 2000.

The value of partnership

  28.  The IHA welcomes government indications that the independent sector has a greater role to play in the nation's health and social care services and supports public private partnerships.

  29.  There is no single solution to the health and social care challenges facing the nation. Rising expectations, new technology, skills shortages and an ageing population all conspire to create unique sets of pressures and problems. Finding answers requires teamwork between all of Britain's health and social care services—NHS, local authority and independent.

  30.  The independent sector already provides treatment and care for hundreds of thousands of people each year through partnerships with the NHS and social services. For example, by the end of 2001 we estimate that independent acute hospitals will have treated 100,000 NHS patients under the Concordat signed in autumn 2000.

  31.  However, to ensure that the NHS Plan succeeds, it is important that the Concordat is now built upon and that all independent treatment and care services are appropriately used in order to bring maximum benefits to people across the UK.

  32.  To use independent mental health services and acute hospitals, for example, but not appropriately fund independent care homes (see page nine) is unsustainable. Using one without the other will achieve very little. For NHS public private partnerships to work, all the nation's health and social care resources have to work together in a sustainable and unified manner.

Partnership in mental health

  33.  There is already one area of public private partnership that stands out as a testimony to what can be achieved. For years, NHS medium-secure mental healthcare was inadequate. The services on offer were usually overstretched and significantly under-resourced. They were dispiriting for those requiring treatment, and for the professional delivering it.

  34.  In this context the NHS sought partnerships with the independent sector. Today, the Mental health Act Commission points out that independent providers deliver more than 55 per cent of the NHS's medium secure provision.

    —  Independent providers of acute mental health and substance misuse services offer more than 70 facilities in the UK, providing more than 3,000 beds.

    —  They offer around a quarter of the country's combined acute mental health treatment plus, as already mentioned, 55 per cent of NHS medium secure provision.

    —  They now provide 31 specialist units for treating eating disorders.

    —  The sector provides more than 80 per cent of the country's acquired brain injury rehabilitation.

  35.  Independent mental health services are provided in a diverse range of not-for-profit and commercial settings and their contribution is significant and growing. The sector also makes an important contribution to, for example, maternal mental illness treatment and care for the elderly mentally ill.

  36.  Independent mental health services are examples of partnership working that has brought immense benefits to NHS patients and is a beacon for the future.

Partnership in community care

  37.  Partnership between NHS, local authorities and the independent sector are already an integral part of the nation's wider health and social care system for older people.

  38.  Independent nursing and residential care homes already provide more than 430,000 beds, complementing the 356,000 beds provided by the NHS and local authorities. Mainly used by older people who require longer-term care, the sector provides more than 150 million nights of care a year. Independent nursing and residential care homes are an important part of virtually every community in the land, employing more than 660,000 people.

  39.  The IHA is determined to build on the success of this partnership. That is why the IHA and its members continue to persuade local authorities of the importance of best value care home services, and to encourage their commitment to more appropriate and sustainable funding levels.

  40.  Local authorities currently expect independent residential and nursing homes to provide care for, on average, around £1.42 and £2.05 per hour respectively. Whereas local authority residential care homes are paid 48 per cent more for comparable provision.

  41.  In recent years local authority fee increases have failed to keep up with even basic inflationary pressures, with the result that hundreds of care homes have closed. In the last three years, more than 50,000 places have been lost.

  42.  The effects of this will have an impact across the nation's health and social care services. For example, Department of health statistics show that between October-December 2000 there were 5,801 patients in England over the age of 75 who were ready for discharge but were nonetheless still occupying an NHS acute hospital bed.[16] Reducing further the number of nursing and residential care home beds can only make the situation worse.

  43.  Partnership in community care have achieved much and benefited literally millions of older people. But they can only be progressed in the context of adequate and sustainable funding.

Concordat partnerships

  44.  Nowhere are the strengthening ties between the NHS and the independent sector clearer than in recent Concordat signed between the government and the IHA, For the Benefit of Patients. As the Secretary of State for Health, Rt Hon Alan Milburn MP, makes clear:

    "If there are, for example, in private sector hospitals, operating theatres that are standing idle or hospital beds that aren't being used, it seems sensible to take advantage of them for NHS patients".[17]

  45.  A model of partnership working, the Concordat puts patients above ideological and organisational barriers.

    "There should be no organisational or ideological barriers to the delivery of high quality healthcare free at the point of delivery".[18]

  46.  It also promotes local co-operation in the planning and managing of services.

    "As well as helping to manage winter pressures there should be a move towards a more collaborative and proactive approach to long term planning."[19]

Elective care

  47.  Since signing the Concordat at the end of October 2000, more than 80,000 NHS patients have been treated in independent acute medical/surgical hospitals—at no personal financial cost to themselves.

  48.  Between 1 January and 31 August of this year alone, more than 65,000 NHS patients have been treated in independent hospitals. And it is now hoped that they will see more than 90,000 NHS patients over the course of 2001. Overall, these figures represent a three to four fold increase over previous levels of partnership working and stand as a tribute to the government's farsightedness.

  49.  It is particularly heartening to note that the Concordat benefited as many NHS patients in July and August of this year as at the height of last winter in December and January. This is strong evidence underpinning the Concordat's intention to signal:

    "a commitment towards planning the use of private and voluntary health care providers, not only at times of pressure but also on a more proactive longer term basis . . ."[20]



  50.  Specialist equipment in the independent sector could be made more widely available through partnerships with the NHS. Independent hospitals can offer services including: MRI, CAT scan, spiral CT, DSA suite, cardiac catheterisation labs, echocardiography, ultrasound, nuclear medicine facilities with Gamma cameras, nuclear medicine scanners, digital X-ray, video endoscopy, rotabliation, radio frequency ablation, linear accelerators, computerised vestibular system for audiology, and tele-radiology link.

  51.  The IHA recently completed an exercise to map the capacity of in-house pathology services in the independent sector. The NHS Plan highlights the importance of pathology services underpinning the partnership between the NHS and the independent sector. The mapping exercise indicated that 27 per cent of in-house independent sector laboratories were undertaking NHS waiting list initiatives.

  52.  Given the achievements, it is now realistic to expect each independent hospital to treat 1,000 NHS patients a year—or four every weekday. With more than 200 hospitals in the sector, the overall total for 2002 could exceed 200,000 people.

  53.  This is still a small number when compared to the volume of NHS treatments conducted in each year. As such, it is important to recognise that the independent sector is large enough to make a real difference to the lives of many people but in no way threatens the dominance of the NHS.

Critical care

  54.  For too many years, independent sector critical care—intensive and high dependency—beds were under-utilised by the NHS.

  55.  Today, the situation has improved and independent sector step down and elective critical care beds are more readily used by NHS hospitals on a planned basis. But there is still more to be done to make sure that all these resources are being used to benefit as many patients as possible.

  56.  Guidance on Comprehensive Critical Care in Independent Sector Acute Hospitals has been prepared by IHA to support the ongoing provision of critical care services within the independent health care sector.[21] The document supports the excellent standards of service offered in a variety of locations and provides a common framework linkage to secure linkage with local NHS trust networks. By stipulating the expectations of critical care services in the independent sector, the guidance will promote a firm basis for further development of critical care services in conjunction with the NHS, as supported by the Concordat.

Intermediate care

  57.  Another area covered by the Concordat is intermediate care. To date, there are some good examples of joint working up and down the country but it will take time for this policy to develop.

  58.  While the overall picture still remains patchy, the IHA has worked closely with colleagues in the DoH and both sides recognise the need to disseminate good practice. As such, the IHA is currently working with officials to find more innovative ways forward.

  59.  Clearly the process will be greatly aided when the ring-fenced new monies enter the system in 2002, 2003 and 2004. The IHA remains optimistic about the potential for partnership working in intermediate care, as a way of providing high quality, community based services appropriate to people's needs.

Towards best value

  60.  the time people wait for treatment and care, especially when it is not urgent, is still unacceptably long. But today partnerships are working by reducing waiting times, and they offer hope for many people in the future.

  61.  An analysis of the Concordat's impact was published recently in the Health Service Journal.[22] The research, written by a team from East Surrey Health Authority, shows how the authority used seven independent hospitals over 11 weeks to remove 1,000 patients from NHS waiting lists. As part of the arrangement each hospital was required to:

    —  demonstrate that clinical governance and audit programmes were in operation;

    —  provide details of inspection reports;

    —  ensure adequate staffing levels at all times;

    —  employ only consultants for surgery;

    —  provide exclusion lists of conditions and procedures they lacked the expertise or facilities to manage;

    —  adhere to National Institute for Clinical Excellence guidance;

    —  and agree in advance packages of care, including physiotherapy and occupational therapy.

  62.  Importantly, the study concluded that:

    "Prices were comparable to, and sometimes cheaper than the NHS. The average cost was £1,120 per treatment . . . Patient satisfaction seemed high."[23]


4.  QUALITY AND WORKFORCE ISSUES

  63.  the IHA and its members are committed to the highest possible standards of care for all patients. The IHA is always seeking to:

    —  raise standards;

    —  seeks better regulation;

    —  and respond effectively to patients' concerns.

  64.  The IHA is also committed to seeking better partnerships in areas such as education and training, so bolstering the commitment of health professional to the whole health and social care system.

Quality and safety

  65.  As the committee will know from evidence submitted by the IHA to an earlier inquiry, quality and safety for all patients receiving treatment in independent sector acute hospitals is paramount.

    —  After more than ten years of campaigning for better government regulation, the IHA welcomes the National Care Standards Commission (NCSC) setting minimum care standards for independent hospitals.

    —  The IHA also welcomes the Commission for Health Improvement's role in covering NHS patients who are treated in independent hospitals under the Concordat. The IHA endorses the Care Standard Act's conclusion that the two bodies should work together.

    —  Audited clinical outcomes exist in the independent sector and the sector is currently looking at how to make them publicly available.

    —  IHA member hospitals, including mental health facilities, are currently collecting data as part of the process laid out in the Private Practice Forum's Principles for a private medicine clinical quality framework.[24]

  66.  The IHA recognises the HQS, HAP and ISO 9000 series accreditation models and all IHA member hospitals are already accredited or are working towards it. IHA member hospitals' accreditation systems are equally as stringent as in the NHS—the only difference being that they are specifically geared for independent sector hospitals.

    —  Doctors working in the independent sector are keen to have their independent sector work accounted for as part of the GMC's revalidation process.

    —  The care of children and adolescents in the acute independent sector has been reviewed by a cross-sector working party. Their report, Guidance on the care of children receiving care in independent sector acute hospitals, recommends that all children under three are admitted to dedicated paediatric facilities.[25] Only "well children", following a risk assessment, are admitted to acute independent hospitals with the appropriate services and staffing.

    —  The IHA with the British Association of Aesthetic Plastic Surgeons has produced draft standards for cosmetic surgery services. A proposal for the accreditation of surgeons to practice aesthetic plastic (cosmetic) surgery will be submitted to the Royal College of Surgeons by the IHA.

    —  A cross-sector working party, together with recruitment agencies supplying resident medical officers (RMOs), has met over 18 months to review a set of standards with which RMOs can comply, together with appropriate qualifications for both acute and mental health hospitals. This work has been done to also address the implications of the working time directive.

    —  Every member hospital operates a complaints procedure which meets agreed practice in the sector, in accordance with Independent Health Care National Minimum Standards currently out for consultation.[26] To date, patients receiving care from independent hospitals under the Concordat seem to be confident of the sector's high standards and its continual efforts to improve quality.

Workforce partnerships

  In the year ending 31 March 2001, the independent sector provided 1,380 clinical placement for student nurses, post-basic nurses and allied health professionals.

  67.  As well as working in partnership to deliver treatment and care, the NHS and independent sector can work together to bolster healthcare professionals' commitment to the health and social care system as a whole. As the Secretary of State for Health, Rt Hon Alan Milburn MP, made clear recently:

    "If we're moving into an era of closer co-operation between the private sector and the NHS, then workforce issues become much more of a joint responsibility."[27]


  68.  Today, the independent sector is one of the country's largest employers with a workforce of more than 750,000 people—nearly three per cent of the country's total workforce. As a major employer with a good track record of recruiting, training and retaining staff, the independent sector can be a useful partner to the NHS.

    —  The independent sector has pioneered flexible working practices for many years, including supporting registered nurses returning to the profession after a break. Staff retention levels are high in the independent sector, and the sector can therefore offer the NHS proven human resource strategies.

    —  Many thousands of student nurses now spend up to several months in independent hospitals and nursing homes, where they learn about a wide range of specialities. In the year ending 31 March 2001, the independent sector provided 1,380 clinical placements.[28] This demonstrates that independent sector facilities have the ability and willingness to work in partnership with the NHS to train the staff we need. With the sector taking a lead on care for the elderly, it offers a particular wealth of expertise in the healthcare of older people.

    —  The IHA is also seeking independent sector representation on the 24 workforce development confederations to strengthen education and training links.

    —  The independent sector offers a great deal of post-graduate training for thousands of registered nurses and allied health professionals. Training covers theatres, neuro-surgery, critical care, cardiac, renal, infection control, risk management, care of the elderly and continence management.

    —  Although the independent sector undertakes its own management programmes, the sector is keen to work with the NHS's leadership programmes being established through the Modernisation Agency.

    —  The IHA is actively working to promote high standards in the recruitment and employment of nurses from abroad into the independent sector. In this context the IHA has recently published Supervised Practice Programme for Overseas Registered Nurses: Independent Sector Recommendations.[29]

    —  The independent sector also helps to train post-graduate doctors. In the area of mental health, the sector offers courses in adult psychiatry, brain injury rehabilitation, and child and adolescent care. Independent acute hospitals also run accredited post-graduate study courses for doctors that encourage peer review and provide general practitioners with important up-dates.

    —  the sector's nursing and residential care homes enable tens of thousands of care assistants to achieve National Vocational Qualifications, increasing the level of skilled, qualified staff available to the nation as a whole.

  69.  Probably the greatest myth about the independent sector is that it somehow "steals" nurses away from the NHS. Over recent years, less than four per cent of nurses who left the NHS moved to work in the independent sector. The vast majority—more than 96 per cent—simply left nursing altogether.


5.  CONCLUSION—ACCESS, EQUITY, PARTNERSHIP

  70.  There is no single solution to the challenges facing the NHS and local authorities. Finding answers requires teamwork between all of Britain's health and social care services—NHS, local authority and independent sector.

  71.  The success of the Concordat is a tribute to the Prime Minister and the Secretary of State for Health. They believe what really matters is not who operates the service, but whether that service offers best value treatment and care for NHS patients. As the Prime Minister put it recently:

    "The private sector can in many cases be more responsive than the public sector to the immediate needs of demanding consumers. . . . Where it makes sense to use private or voluntary sectors better deliver public services, we will. That is nothing new."[30]

  72.  By the end of 2001 we estimate that 100,000 NHS patients will have received treatment and care in the independent sector under the terms of the Concordat—widening people's access to the NHS. Public opinion supports this partnership approach, as shown by the recent MORI opinion survey Attitudes Towards Public/Private Partnerships.[31]

  73.  As well as delivering services in partnership, the independent sector, NHS and local authorities have a shared interest in working together to recruit, train and retain staff. As a major employer the independent health and social care sector has an impressive track record and will be a valuable partner to the NHS—sharing resources, skills and ideas.

  74.  To ensure that the NHS Plan succeeds, it is vital that the Concordat is built upon and that more is achieved in 2002. To continue to mobilise independent mental health services and acute hospitals is a priority—as is the appropriate funding of care homes. For NHS public private partnerships to work, all the nation's health and social care resources have to work together in a sustainable and unified manner. The success of the nation's health and social care services depends on partnerships between all service providers.

  75.  That is why no politician should doubt that when used to its full potential, the independent health and social care sector is a significant resource which is ready and willing to help the government achieve its policy objectives and ease the pressures on the NHS.

  76.  The Independent Healthcare Association welcomes this inquiry and looks forward to the Health Select Committee's support for this important government policy initiative.



12   Karen Bryson et al., "Public pain, private gain", Health Service Journal, 6 September 2001. Back

13   MORI Social Research, September 2000. Back

14   Ibid. Back

15   Daniel Kruger, "Why half the members of trade unions have private health care", Daily Telegraph, 11 September 2001. Back

16   Susan Doohan, Costs of Care 2001-The Facts, Independent Healthcare Association, 2001. Back

17   Rt Hon Alan Milburn MP quoted in "Milburn signs deal to treat NHS patients in private units", Hospital Doctor, 2 November 2000. Back

18   For the Benefit of Patients: A Concordat with the Private and Voluntary health and Care Provider Sector, Department of Health, Independent Healthcare Association 2000. Back

19   Ibid. Back

20   For the Benefit of Patients: A Concordat with the private and Voluntary Health and Care Provider Sector, Department of Health, Independent Healthcare Association 2000, op.cit. Back

21   Guidance on Comprehensive Critical Care in Independent Sector Acute Hospitals, Independent healthcare Association, forthcoming. Back

22   Karen Bryson et al, Public pain, private gain, Health Service Journal, 6 September 2001. Back

23   Ibid. Back

24   Principles for a private medicine clinical quality framework, Private Practice Forum, Academy of Medical Royal Colleges, April 1999. Back

25   Guidance on the care of children receiving care in independent sector acute hospitals, Independent Healthcare Association, 2001. Back

26   Independent Health Care National Minimum Standards, Department of Health, 200. Back

27   Rt Hon Alan Milburn MP, quoted in "Rising Cabinet star who dared to go private on hospitals', Daily Telegraph, 4 November 2000. Back

28   Draft report to the Department of Health on the provision of clinical placements in independent sector acute, mental health hospitals and units. Independent Healthcare Association, 2001. Back

29   Supervised Practice Programme for Overseas Registered Nurses: Independent Sector Recommendations, Independent healthcare Association, forthcoming. Back

30   Prime Minister Rt Hon Tony Blair MP, quoted in "Reform or else, Blair tells public services". The Guardian, 17 July 2001. Back

31   MORI Social Research, September 2000. Back


 
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