Private Practice—Does It Have a Place?

The National Health Service and the private sector should be complementary; each needs the other. It is highly improbable that the Health Service will be privatised; much more likely that private practice will be publicised by bringing it within the National Health Service. This article discusses the size and growth of the private sector, looks at cost containment and quality and examines the problems and opportunities of the new Health Service structure. In 1979 the Royal Commission on the National Health Service reported: "We have reached no conclusion about the overall balance of advantage or disadvantage to the National Health Service of the existence of a private sector. Whichever way it lies, it is small". In that year the pay beds in NHS hospitals were markedly reduced. At that time over half of all NHS Consultants were working full-time; maximum part-time Consultants, on average, derived one-third of their income from private practice; about half the patients receiving treatment in private beds were covered by health insurance. People chose private treatment for privacy, for the convenience of booking a date for admission, to guarantee seeing a particular Consultant and to reduce the waiting time for an outpatient appointment or inpatient treatment. The Royal Commission noted that pay beds in the United Kingdom had decreased from just over 6,000 in 1965 to just under 3,000 in 1979 and that patients treated in pay beds had declined from just over 120,000 in 1972 to just under 94,000 in 1977.