Members of KONPNE were pleased to meet up with David Smith MP once again, to continue our conversation of May 2025. We brought two issues to the table.
KONPNE members are increasingly concerned about what can only be described as PFI 2.0. Given the disastrous consequences of the Private Finance Initiative of the 1990s – NHS Trusts in England will have paid back on average almost eight times the initial PFI capital put into their Trusts – it is not unreasonable to have huge concerns about the proposal in the Ten Year Plan that a business case is made for “Public – Private Partnerships” (PPP) to fund Neighbourhood Health Centres. History repeating itself? Has this Government really learned the lessons of the past? David agreed with us that the past PFI deal was (and still is) a disaster but, for the time being, remains uncertain regarding the current notion of a PPP until the exact details of such are known – apparently, until the details are made public by the Government, all is speculation, the essence of a “PPP” is unknown. Given that David is a Labour MP under the current Labour Government, we made the assumption that he would be in a position to cast some light on this issue but, surprisingly, this was not to be. It appears that this Government works in secretive ways, even in relation to its own MPs – worrying? We understand that the Chancellor may be providing details regarding PPPs as part of the Budget statement next week, so we (together with David and Labour MPs) shall see…
We move on to our second issue – the nebulous idea that there is some sort of “spare capacity” in the private health system, all ready and waiting to mop up the elective care waiting lists. Last week, the Government announced in a press release that independent providers had carried out 6 million appointments, tests and operations for NHS patients this year, and that this will “help to cut waiting times and free up NHS capacity”. All well and good? Is it? People who work in the NHS all know that if clinicians increase their work in the private sector, then there will be a corresponding decreased availability for work in the NHS. There are a finite number of doctors and nurses in the UK – there is NO spare capacity. This is backed up by recent (2025) research from Graham Kirkwood and Prof Allyson Pollock (Newcastle University) who found that as private provision expanded, NHS capacity fell sharply and waiting times increased. We put this to David, who agreed that staff movement across NHS and private health is an issue to consider further – we agreed to forward a link to the Newcastle University research. David stated his belief that, whilst generally against the growth of privatisation in the NHS, he supports the use of the private sector in the short term as a way of reducing the current huge waiting lists – citing his belief that no-one should be in pain. Absolutely, of course – but one minute. Why couldn’t this money flooding down to the private sector be redirected to bolster and develop NHS provision? NHS staff have the skills. And who says that the use of the private sector will be a short term measure? We see the Governments Ten Year Plan as embedding the private sector more and more, in a number of different ways…
The demands of time brought our conversation to an end. We hope that David has some food for thought, and we followed up our meeting with this email. David has welcomed our further contact which, of course, we will be proactive in arranging next year.
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