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Private sector involvement in the NHS is making a difference only "at the margins," a senior civil servant admitted last week. The NHS's group director of health and social care services delivery, John Bacon, made the comments to MPs on the health select committee, which is inquiring into health spending.
The independent sector has been credited with reducing waiting lists, but MPs heard that the proportion of procedures done privately remained low. For example, the number of cataract operations carried out by the NHS in 2003-4 was 300 000, compared with 20 000 in the private sector. In the previous year 262 000 cataract operations were carried out in the NHS.
Independent MP Richard Taylor said, "It's very hard to see how the involvement of the private sector in cataract surgery has made that much difference."
Mr Bacon acknowledged the limitations but added, "They are tackling pockets where we have had real difficulties. It has enabled us to crack some difficult issues."
MPs also asked civil servants to account for the growing financial problems faced by many NHS trusts. A forecast of the figures for six month published by the Department of Health on the same day shows that a third of NHS bodies are failing to balance their books. Thirty seven NHS organisations account for two thirds of the projected gross deficit.
In a ministerial statement, the health secretary, Patricia Hewitt said that the NHS is forecasting debts of around £620m ($1073m; 917m) for the current financial year. Sir Nigel Crisp told MPs that he expected the debt to be reduced to £200m by the end of the financial year. He admitted that spending on GPs' budgets was £300m more than originally planned, adding, "But we are getting a lot more for that." Labour MP Doug Nay-smith said, "Our GPs must be the best paid in Europe for the services they provide."
The government also expected to spend £90m more than anticipated on the consultants' contract this year, bringing total spending on consultants' pay to more than £2.8bn. It had anticipated an increase of £250m. In addition the health department faced flak over its decision not to apply a ring fence to the extra £300m set aside for sexual health services this financial year. MPs said that they had had reports that the money pledged to modernise sexual health services was instead being used to bail out primary care trusts.