Private work has negative impact on NHS, expert says

Senior doctors can do both NHS and private work Image copyright AndreyPopov/ Thinkstock
Image caption Senior doctors can do both NHS and private work

Private practice may "prey on the needy" and doctors should question whether they can morally juggle it with NHS work, an expert argues in the BMJ.

Dr John Dean, who quit private medicine, describes it as "largely a con" in his opinion, as it does not necessarily lead to better care.

He believes it has a negative impact on the NHS - taking staff away from wards.

But the British Medical Association says there should be no conflict of interest between private and NHS work.

'Five-star hotels'

Dr Dean, who works at the Royal Devon and Exeter NHS Foundation Trust Hospital, says he initially took up private practice to help put his children through private education and renovate his house.

But, according to the article, he grew increasingly uncomfortable with his career choice as it proved difficult to keep his private and NHS work separate.

"No matter how high I set my own moral and ethical standards, I could not escape the fact that I was involved in a business for which the conduct of some involved was so venal it bordered on criminal - the greedy preying on the needy," he says.

And from a patient's point of view, "the whole business is largely a con", he says.

While patients think they are getting higher quality medicine, in his view, the main advantage is jumping the NHS queue.

He warns: "Private hospitals are like five-star hotels but for the most part they are no place to be if you are really sick."

In his report he suggests privately-funded care could have a wider negative impact on the NHS.

Since a senior doctor cannot be in two places at once, time spent in the private sector "deprives the NHS of a valuable resource," Dr Dean says.

He says perhaps medics who choose to undertake private practice should not be allowed to do any more NHS work.

But commenting on the article, a spokesperson for the doctors' union, the British Medical Association (BMA), said: "There should be no conflict of interest between NHS and private work and this principle is contained in consultants' employment contracts.

"Consultants who want to do private work must first offer to do extra work for the NHS, ensuring NHS work is the priority."

According to the BMA, contracts in England, Scotland and Northern Ireland stipulate that before consultants accept private work, they must tell their clinical manager who can then request they work additional NHS hours before they embark on any private work.

Dr Peter King-Lewis from the Independent Doctors Federation, added: "If Dr Dean feels unable to provides private healthcare in parallel with his NHS commitments and personal life, then he has probably made the right decision.

"For those who can structure their lives to provide private healthcare without compromise, they will be able to practise medicine more independently of NHS targets and quotas and spend more time on one-to-one care of their patients."

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