17 October 2018 | OPINION
The tectonic plates of medicine, its focus, its funding, its regulation and its practitioners are shifting rapidly. The healthcare landscape of the future will look very different from that of today. Whilst the NHS has been designed to deliver healthcare to the collective, the private sector treats individuals, and it is within this individualistic approach the future of healthcare delivery will increasingly rest.
The question many ask: is funding for private medical care ethical? The NHS is the closest thing the UK has to a national religion, but it is over-stretched, inefficient and lacks co-ordination. It was designed to provide a safety net for those unable to pay for their care but societal changes and the evolution of new technologies mean that it is increasingly viewed as a divine right for all, regardless of lifestyle choice.
If government is able to de-politicise the issue of an alternatively funded healthcare system where migration between public and private sector becomes the norm it may be possible to reduce pressure on the NHS. Different working patterns and practices would also improve morale of an increasingly disenfranchised workforce.
What would this change in funding strategies actually mean?
– First of all, emergency and immediate life preserving care, at which the NHS excels, would continue to be provided by the NHS.
– Less urgent types of care will start to be accessed privately with more affordable models and options being developed by providers.
– Private practice as it is currently understood, with most consultants operating independently or in a group arrangement, would change. This will necessitate a balancing act between coordination of care, professional autonomy and demonstrable quality and value.
– The funding barriers between public and private sector will need to become more permeable so that there will be increasing use of private investigative and diagnostic modalities. As Patients flip between the sectors, new technologies will need to be adopted to allow for better coordination and maintenance of personal records. Private Medical Insurers (PMIs) will need to adapt their products to this changing consumer demand.
– As newer and more affordable and transparent PMI products are developed there will be a marked expansion of the private healthcare market opening up the above option to those who have not considered private medicine previously.
To continue to be fit for purpose our healthcare system, however it is funded, must become more patient centric and accessible. The future will belong to those who establish understandable and relevant measures, such as long term sepsis rates or cancer survival rates, that prove the value they provide for their patients and allow for a truly informed choice to drive delivery of care. Much will depend on how the NHS develops and how this relationship with the private sector evolves.