Pre-election blog: Private sector capacity and the NHS workforce crisis

Welcome to the second in our series of occasional pre-election blogs by CSP director of strategy, policy and engagement Rob Yeldham.

by Rob Yeldham

The Conservative government has been pushing for more use of independent providers to provide NHS services for some time: NHS to expand use of private sector to tackle waits

But this week Labour’s shadow health secretary Wes Streeting MP has been in the news for discussing the role of the private sector in NHS services.

Whilst saying he would never privatise the NHS, he hit out at people who can afford to use private healthcare themselves but want to prevent the NHS using independent sector capacity to treat those who can’t afford to go private but are on long NHS waiting lists.

The CSP position has long been that, in principle, we believe NHS services are best provided by the NHS itself. However, there is a big caveat. Where there is capacity in the independent sector, and the NHS is under pressure, we have also always supported that capacity being used to relieve pressure on the NHS. So, we have no problem with Wes Streeting’s position in principle.

Whilst there is no policy objection, there are, however, real world issues. Firstly, the amount of unused capacity in the independent sector is likely to be limited currently. The very waiting lists which need to be addressed are driving more desperate patients to seek private healthcare.

Secondly, the main limiting factor for all healthcare providers, regardless of sector, is the limited pool of trained clinicians.

So arguably, the debate about using the private sector misses the most important point. If politicians of any party want to address access to healthcare they need to focus on the workforce crisis.

Currently, we are seeing the Conservative government restraining NHS spending, resulting in some areas freezing vacancies or cutting posts

This is leaving the NHS unable to recruit those people who want to work for them, and who are needed to address growing waiting lists. This is despite clear NHS England workforce plans which show more physios, not fewer, are needed.

The CSP is arguing for a comprehensive approach to addressing the NHS physio workforce shortfall, including:

  • More pre-reg apprenticeships and support worker roles
  • Guaranteed contracts for any newly qualified physio who wants to work in the NHS
  • Investment in development of NHS physios to meet the growing need for extended scope, advanced practice and consultant roles
  • Better pay and conditions, including more flexible working, to retain physios and support workers in the NHS.

Without a clear commitment to addressing the workforce no government, of whatever party, will be able to turn around the problems that the NHS faces.

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