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She\’s got it wrong to insist on a state monopoly – Scotsman.

Geoff Mawdsley
Scotsman, 9th July 2008

THERE is plenty of evidence that NHS patients in Scotland would benefit from a wider variety of healthcare providers.

Such diversity, whether provided by the private or voluntary sectors, can help drive innovation and so raise standards and improve value for money.

In England, outcomes for patients have improved as a direct result of this greater diversity. For example, the waiting-time target for hospitals of 18 weeks is set to be achieved this year, whereas in Scotland it is unlikely to be met until 2011.

And it\’s not just in England that such diversity exists, but in many other European countries that achieve high standards of care while ensuring everyone is guaranteed access to healthcare irrespective of their ability to pay.

What is the justification for preventing private companies from even bidding for GP contracts? If another provider can convince the health board that it can meet local health needs by providing high-quality care and better value for money, then why should they not be awarded the contract? After all, many GPs are themselves private contractors to the NHS and it seems unfair to exclude others simply because they are private companies.

It would be better to leave the decision to health boards as they are better placed to make such a decision.

What matters in all this is the service provided to the patient. By preventing private-sector companies from even bidding for GP contracts, Nicola Sturgeon is closing off an option that could lead to major improvements.

Surely it is worth at least seeing if such a move can improve patient care for the benefit of all.

And, as we have seen in many other countries, diversity of provision can be combined with a largely taxpayer-funded service.

There is no reason why we cannot have such a service here. One that puts the patient first and where there is a level playing field for different healthcare providers in Scotland. That is the pragmatic way of finding out what works.

Maintaining the NHS monopoly in service provision may bring applause at the BMA conference, but at what price for patients if key health indicators continue to lag behind those of other countries?

Geoff Mawdsley is director of Reform Scotland, an independent think tank. Its aims are increased prosperity and more effective public services based on limited government, diversity and personal responsibility.

To read the Scotsman article click here.