Not tonight Josephine: on private incursions into primary care.
Year: 2006
Type: article
Abstract: ‘“When a man walks into your office, sits down in front of your desk, and tells you that he is Napoleon Bonaparte, do not get drawn in a discussion of cavalry tactics at the battle of Austerlitz” … They conceal the central point. The thing is mad.’1
When private providers argue why they are good for UK primary care, we need to consider not only their ‘cavalry tactics’, but also the possibility that there is something inherently unsound about what they propose.
The main opportunity for private providers to gain access to the NHS tends to be practice vacancies, both real and manufactured, in deprived areas. An argument has been developed, therefore, that private providers have a particular contribution to make in such areas, delivering high quality care and narrowing health inequalities. While a little rhetoric appears to go a long way in securing NHS contracts, the claim merits inspection. What is it about private providers, and their understanding of the problems of primary care in deprived areas, that justifies support for their approach?
The continuing inverse care law comprises an old problem and a new problem.2 The old problem is that a flat distribution of medical and associated manpower in primary care is insufficient to address the burden of health problems in deprived areas, which is 2.5–3 times greater in the most deprived tenth of the population than in the most affluent tenth.3 With more cases and less time, the circle can only be squared by leaving many things undone. A culture of low expectations has evolved.
1948 solved one type of access problem, providing everyone with …
Source: PubMed
Author: Graham Watt
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2120639071