An Alternative View on Healthcare – Can Labour’s lessons from the past save the NHS?

Jim Easton, Practice Plus Group

In light of the announcement of a UK Election, Practice Plus Group’s CEO Jim Easton, gives his view on how he believes the Private Sector can potentially help the NHS to recover. Jim Easton is Chief Executive Officer at Practice Plus Group and a leading authority on all matters on NHS healthcare. In 2009 Jim was appointed as National Director of Transformation for the NHS, with responsibility for, among other areas, the programme to deliver £20bn of efficiency savings while improving quality across NHS services nationally. Jim was snapped up by Practice Plus Group as CEO in 2013. Jim is a passionate advocate for health matters and speaks nationally and internationally on how healthcare services can deliver quality, the role of leaders in achieving that objective and the importance of healthcare services.

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The NHS saved my life in my 40s at the time when it had achieved its best ever performance. Of course it is still saving lives today – but sadly it’s hard to recognise many aspects of the NHS I knew back then with the health service we have today.

I have spent much of my career working in the NHS, with the NHS and for the NHS, and the issues it faces today are the most difficult in its history. Post COVID, many staff are burnt out. Some services are overwhelmed. Too many patients are suffering too long.

To love and protect it, it needs to change.

The good news is that change is coming, and whether that’s a new government or not, there is now cross-party agreement that there are lessons we can learn from history.

We could learn from history how to get patients waiting for life changing treatment seen more quickly. Tony Blair’s New Labour, under which I worked as National Director for Improvement and Efficiency and National Director of Transformation, established more than 25 Independent Sector Treatment Centres (ISTCs) within just two years of launching the NHS Plan. Designed specifically to take the low risk, most common operations off the NHS’s shoulders, the centres were hugely successful in bringing down the then record waiting lists. We could do that again.

Public satisfaction with the NHS rose from 34% when Labour came into power in 1997 to 70% by the time they left office. It wasn’t perfect, but the contract with the public was in place; you worked hard, paid your dues, and when you needed it, the ambulance came, you could see your GP, you could get your new hip in 18 weeks. This was in no small part thanks to a combination of the best of the NHS and private investment and reform.

Can history repeat itself? It will be harder. Public satisfaction is even lower, at a record 29%. The workforce challenges are greater now. The public finances won’t allow for a huge increase in spending. The COVID legacy is real and long lasting. Industrial unrest continues. But these are not arguments for defeatism – they reinforce the need to redouble our efforts.

The private sector doesn’t have a silver bullet, but, working with its NHS partners, it can make a significant difference as it did 20 years ago.

One of the criticisms most often levelled at private hospitals is that they skim off the routine operations and leave the most complex cases and emergencies to the NHS. I’ve never understood why this is a bad thing- it’s just another example of the NHS using external suppliers to their advantage, as they have always done with myriad of suppliers and contractors from construction and big pharma to global technology firms providing MRIs and X-Ray machines. The NHS has some of the most brilliant teams in the world at dealing with complex conditions. We can free their time and facilities to do that by using the private sector to treat less complex NHS patients – with a payment method that rewards the different levels of patient complexity.

This was precisely what the Independent Treatment Centres- now better known in the areas they still serve as simply hospitals- were always intended to do, and what they do so well, day in day out. If that means NHS patients can get the treatment they need, sooner, this can only be a good thing. These operations may be classed as ‘routine’ but for people waiting for them at large NHS Trusts, being cancelled, not getting on the waiting list- they are transformative.

The only real question is what that balance between NHS and private will look like in the future when it comes to direct patient care, especially in a climate where the NHS needs the private sector’s investment, and in a new world where younger generations are taking out private health insurance and ordinary working people in their 60s are increasingly choosing to pay to beat waiting lists. In my view, the publicly operated part of the NHS always will be the central, and overwhelmingly the largest part of our country’s healthcare provision. But in the light of the challenges we face, we should not let dogma stand in the way of using private partners, with the right standards and values, to support that system, bringing it innovation and capacity as a partner.

What we need now is a plan to set out how it will happen and the difference it will make.

I hope that like the NHS did for me, the private sector can help get it back on its feet.

Four ways the private sector can help the NHS recover:
• Invest in additional capacity i.e open new hospitals to take more NHS patients
• Treat the NHS ‘long waiters’ needing routine but transformative surgeries
• Train and develop tomorrow’s healthcare professionals to increase workforce capacity
• Invest in and develop new technology that can be adopted at scale in the NHS