News and media

What does "NHS privatisation" really mean to the public?

Date of publication: 30th Apr 2019

Categories: Independent Healthcare Voices

With current NHS proposals for legislative change being billed as necessary to “end NHS privatisation”, IHPN Policy Director, David Furness, looks at the latest research on what the public really believe “NHS privatisation” represents. 

Should Benjamin Franklin be around today, I’d invite him to update his famous aphorism, that in this world nothing can be said to be certain, except death and taxes, and newspaper articles about NHS privatisation. Only last month, we heard that Matt Hancock is going “full steam ahead with NHS privatisation”. And prominent campaign groups make headlines by noisily arguing against any use of the private sector by the NHS and calling to return the NHS “fully back to public ownership”. A casual observer would be forgiven for thinking that this issue is a major concern for the British public.

But what do we actually mean by privatisation? It turns out that the general public don’t support the extreme positions of campaign groups and in fact have a pragmatic view of the role of the private sector in the NHS.

Recent public opinion research conducted on behalf of IHPN found that two thirds of people (68%) agree that they do not mind whether their NHS care is provided by a public, private or voluntary organisation as long as it is of high quality and free at the point of use. This is exactly the situation as we have today where NHS commissioners can contract with the best providers of care, regardless of whether they are public, private, or third sector organisations.

Similarly, two thirds of people think there is a role for the private sector when standards aren’t good enough in NHS organisation. Two thirds (67%) of English adults agree that the NHS should be able to replace a public sector provider that is delivering a poor service with a private sector provider if it improved the service and is free at the point of use for patients. Again, this is exactly the situation we have today.

Less than a quarter of English adults actively disagree with each of the statements (18% and 24% respectively) which suggests little opposition among the public to private health services replacing NHS services so long as they remain free at the point of use and of high quality.

This suggests that far from there being major concern about NHS privatisation, a large majority of the general public support the current arrangements where NHS care is delivered free at the point of need, with service quality being the most important consideration.

We found that the issues that really do concern people are to do with charging patients for NHS treatment, and selling off NHS clinical services. A majority of English adults say that being charged for accessing NHS services (62%), and clinical services currently owned by the NHS being sold off to the private sector (57%) would make them think that the NHS is being privatised. We agree! IHPN and its members are firm supporters of the model of NHS care free at the point of use and agree that the NHS should not be owned by private shareholders.

But this is not the same thing at all as private providers supporting the NHS by delivering clinical (like hospital operations) and non-clinical services (like catering and cleaning). Only 28% say private organisations being used to deliver NHS clinical services (and 25% non-clinical services), free at the point of use would make them think the NHS is being privatised. This suggests the majority do not see this as a form of privatisation.

So let’s hear no more about the allegedly widespread concern about privatisation and take a lead from the public who tell us they don’t mind who provides an NHS service as long as it is free to use, and of high quality.

Methodology note: ComRes interviewed 1,777 English adults aged 18+ between 12th and 14th April 2019. Data were weighted to be representative of all English adults aged 18+ by key demographics including age, gender, region and social grade.