Goodbye Patient's Passport

According to the BBC, David Cameron is set to announce that the Tory “patient’s passport” policy is to be scrapped. About time too, but there’s not much information on what’s going to replace it.

The Patient’s Passport was clearly a bad idea, a means of redistributing wealth from the poor towards the middle-classes. That was why it was popular with the Tories so I can’t see this announcement going down well with them.

From the BBC report:

Mr Cameron rejects such calls but he will also use his speech to claim he would go further than Labour on reforming the NHS.

He will say he wants to give hospitals more autonomy and "break down the barriers" between private and public sector providers so the NHS becomes more efficient and effective.

I’m not sure how more autonomous than foundation hospitals trusts can be and breaking down the barriers sounds like something someone would say when they’re not really certain of what they are talking about. Much like a lot of David Cameron’s soundbites in fact.

There is a little bit of red meat thrown to the Tory base by Andrew Lansley who says there would be no limit on the amount of private companies being used as providers of NHS services. Maybe surprisingly, I completely agree, I can only speak about my experience here in East Somerset, but I know that given a level playing-field, there’s no private company that would be able to match us.

My fear is that private companies will be allowed to negotiate an artificial floor on the amount of business they get. So even if there’s patient choice and no-one chooses the private provider, they are guaranteed to receive the minimum payment. An example in the Health Service Journal (free registration required) shows Ashton, Leigh and Wigan PCT paying Netcare nearly £500,000 for 688 surgical procedures, but only 67 patients wanted to be treated there. Result, Netcare were paid for 621 procedures that they didn’t have to perform.

I have no philosophical objection on private providers in a free at the point of need NHS. If private companies can provide a more efficient service then it would be churlish to object. But if everyone else is expected to stand on their own two feet and get paid by results, then the likes of Netcare must be subject to the rigours of the free market too. Why don’t the Tories agree with that?