The British Medical Association and its Look after our NHS campaign have come under heavy fire from think tank Civitas, which claims the Association is “out of touch” with the public and is “shamelessly politicising healthcare”.

The BMA recently stepped up activities under its fight to keep privately run companies out of the NHS with a new drive to enlist the public in its cause, but according to Civitas, its publicity materials - which contain horror stories such as the 70-year old women forced to get care in a private treatment centre who then suffered complications - are based on cherry-picked evidence.

Furthermore, it refutes many of the claims the Association makes in support of de-commercialising the health service. For example, the BMA says the creation of a market in the NHS has sparked a significant increase in bureaucracy, with the number of senior managers leaping 91% between 1995 and 2008 which, it stresses, is more than twice the increase in doctors and nurses.

However, Civitis argues that the large increase in senior managers is also down to the fact that the NHS has historically low and inadequate levels of managers compared to other health systems, and it was also fuelled by the sheer amount of paperwork demanded by the government and numerous regulators to meet central requirements.

With regard to Independent Sector Treatment Centres - private profit-making healthcare companies paid to carry out certain NHS procedures - the BMA states that the first batch of these delivered just 85% of activity paid for, thereby suggesting a shortfall of £220 million on the £1.47 billion contracts.

This is true, says Civitas, but adds that the Association has failed to mention that the quality of care is typically higher in ISTCs than the NHS. It highlights findings by the Healthcare Commission that length of stay and rates of hospital readmission are consistently lower than the national average and that patient satisfaction rates are significantly higher. Furthermore, it argues says there is growing evidence to suggest that adding the element of competition has helped spur NHS providers to strive for better performance.

The NHS could be facing a real-term shortfall of around £20 billion by 2013 and possibly even £38 billion by 2015, and so it is more important now than ever before that the Service boosts efficiency and productivity to meet the rising demand on its resources. But rather than close its doors to the independent sector, the NHS should harness its expertise to help it meet these challenges, Civitas argues.

It points out that NHS productivity slipped 4% between 1997-2007, while average private sector productivity jumped 23% during the same period, and points to other industries – such as electricity and gas - where the introduction of competition induced ‘phenomenal rates’ of productivity growth across the 1990s.

Out of touch?
In conclusion, Civitas says the BMA is “out of touch” with the public and is “trying to protect their own from radical changes that will be required”. And in support of its claim, the think tank highlights findings from a national survey by NHS Partners Network that 74% of respondents said the NHS needed ‘to change to survive” and 74% more closely align themselves with the statement ‘I don’t mind who owns or runs my NHS services so long as the quality is right’.

NHS Confederation director of policy Nigel Edwards has also warned that ruling out use of independent and third sector providers in the NHS would be unwise. “With the £20 billion of savings in the NHS required over the next five years, the focus must continue on reducing costs while also driving up quality [and] given the scale of this challenge, to rule out any use of the independent or third sector would remove a very important source of innovation and change that can help to deliver improvements,” he said.

However, it seems there is still strong resistance among the medical community for private provision of NHS services. Out of 697 doctors surveyed by, 80% either strongly agreed (51%) or agreed (29%) with the BMA’s concerns “that some large multinational companies are making profits out of running local clinical services on behalf of the NHS”, and just 7% either disagreed or strongly disagreed.