Incentives used to entice NHS consultants to do private work must be disclosed
In January 2021, as London buckled under the weight of treating thousands of Covid patients, the medical directors of the main NHS hospitals wrote to their medical consultants, pleading with them to stop doing non-urgent private work and to turn their attention to high-priority NHS cases.
Under the 2003 NHS consultant contract, there should have been no reason to issue such a plea. NHS consultants can only do paid work in the private sector with the permission of their NHS employer and only if it does not cause a detriment to NHS care.
In doing so, the medical directors publicly acknowledged something many people have long suspected, namely that the lure of highly lucrative private work, particularly in large cities, can pull a sizeable number of NHS consultants away to focus on those who are prepared to pay.
As NHS waiting lists have soared during the pandemic, so has the demand for fee-paying private work, with waiting lists for treatment now also occurring in the private sector, a further pull on the loyalties of NHS medical consultants.
In 2021, for the first time since 1948, more orthopaedic activity – such as hip replacements – took place in private hospitals than in the NHS. This fact can only mean that last year a significant number of consultants were doing more hip and knee replacements privately than for their NHS employers, since there is only one pool of (mainly) NHS consultants to treat both NHS and private patients.
It also means that since the pandemic hit, access to certain operations is being determined not by need, but ability to pay.
The private hospital companies have for many years clocked the need to keep NHS consultants close to them, showering them with lavish corporate hospitality and offering them
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