Lse Health and Social Care Discussion Paper Series the Provision of Health Care: Is the Public Sector Ethically Superior to the Private Sector? the Provision of Health Care: Is the Public Sector Ethically Superior to the Private Sector? Contents

The debate concerning public/private partnerships in the NHS has been characterised more by ideological rhetoric than by reasoned analysis. This paper is a partial attempt to rectify this situation, focusing on the ethical issues involved. It lays out the arguments concerning the public versus the private provision of health care, distinguishing between those addressing questions of fact and those dealing with questions of value. It argues that several of the moral principles involved in the latter may clash; and therefore any resolution of the debate is likely to involve trading-off one principle against another. In particular, policy-makers may have to trade-off the moral advantages of public sector altruism against equally valid moral claims relating to health care outcomes and to possible exploitation.