privatisation of healthcare, outsourcing
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Health outsourcing has been found to be linked to higher mortality rates, as privatisation of healthcare worsens healthcare services

According to a new study by Oxford Social Policy researchers, higher mortality rates are linked to an increase in outsourcing of health services to the private for-profit sector – showing that privatisation of healthcare decreases the quality of care and worsens patient outcomes.

Outsourcing – which is outsourcing business activity or process that provides support (admin or otherwise) to medical institutions, staff, and organisations – has consistently increased between 2013 and 2020.

Partnered with long waiting lists and an overcrowded NHS, this has corresponded across the country ‘with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of healthcare services’.

Since 2014, out-sourcing has been associated with an additional 557 deaths across 173 of England’s clinical commissioning groups. Private providers could be delivering worse quality care and intensified pressure across the health system.

“Hundreds of millions of pounds worth of expenditures from NHS organisations”

The researchers studied expenditure data of the NHS commissioning groups, and accompanied the data with rates of local mortality from causes that “should have been treatable by medical intervention”.

The results demonstrate that the privatisation of healthcare is not associated with improvements in service provision, but instead has been associated with increased deaths among patients.

Benjamin Goodair said: “This new study represents the first attempts to measure the total impact of for-profit outsourcing from England’s NHS on health outcomes. While the analysis is not able to identify a causal relationship, the results suggest that the privatisation of healthcare is corresponding with worse quality care.

“These findings are particularly timely as the NHS is currently going through a structural transformation, adding new evidence to suggest that for-profit provision of healthcare services may not be the best option for the new commissioning bodies.

“The strength of this research lies in its novel dataset, produced by Dr Charles Rahal and colleagues, it gives us an ability to analyse, at a very granular level, hundreds of millions of pounds worth of expenditures from NHS organisations.

“At the turn of the decade, health campaigners were fearful that the 2012 Health and Social Care Act would increase the level of for-profit outsourcing, reducing the quality of care received by NHS patients. This study finds that their concerns may well have been justified.”

“Our research raises doubts about whether the current extent of private sector use is optimal for the quality of care and suggests that further increases in for-profit provision would be a mistake.”

The report states: “Since the reforms to the NHS in England in 2012, some measures of health-care quality, as well as population health, have been worsening.”

There has been little improvement in life expectancy since 2010

Outsourcing to for-profit providers has increased greatly since 2013, and by 2020 accounted for more than 6% of total reported expenditure – where up to £323 million went to such companies in the first quarter of 2020.

Dr Reeves added: “Troublingly, there has been very little improvement in life expectancy since 2010 and many have argued that austerity has contributed to this stagnation in population health.

“Alongside this, we suggest that outsourcing to for-profit companies is another way that the reforms of the post-financial crisis era have affected NHS service quality and mortality rates.”

The study authors finalised: “Our research raises doubts about whether the current extent of private sector use is optimal for the quality of care and suggests that further increases in for-profit provision would be a mistake.”

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