BMA (NI) believes that the health service should be true to the founding principles of the NHS – providing a high quality, safe, patient-centred service, free at the point of delivery, based on need and publicly funded.
We believe that the health service should be free, as far as possible, from private sector involvement and that the private sector should only be used when no alternative within the health service is available.
When used, the private sector should be clearly for the benefit of patients.
We do not think that large scale use of the private sector should be a permanent or recurrent feature in healthcare delivery.
Those consultants employed in the private sector provide a service which is subject to the same regulation as any other health sector, but the fault lies within a system which seeks such healthcare provision outside the framework of the health service.
If there is a recurrent or indeed permanent request for services, then they should be met within the health service rather than allowing a loss of public funding to the healthcare sector.
Such funding would be better invested in future proofing infrastructure and workforce in primary, community and secondary care settings, taking account of increasing levels of chronic disease and an ageing population.
The BMA has long advocated for better workforce planning to meet future service demands.
Unfortunately, there does not appear to be any clear long-term strategic thinking and the short-term goal of hitting waiting list and other targets is resulting in the increased use of the private sector. Ensuring a well planned, managed and effectively resourced public sector delivered health service, with any use of the private sector being a last resort, should be a priority for the health service in Northern Ireland.
Dr Paul Darragh is chair of British Medical Association (BMA) in Northern Ireland