Covid Enquiry And Private Health Care – Effect On NHS Care

The Covid enquiry into how health services and provisions were provided during the pandemic will technically be starting shortly.  It has apparently declined to take testimony from individuals affected. Partially this may be a result of the sheer number but it does seem to be missing the point in doing so.

At the same time, however, as questions are being continually asked about the provision of PPE contracts, the issue of the independent hospital sector also has come into question.  The NHS took over in essence the private health sector during the pandemic.  There was a £2 Billion contract to do so.

Covid Enquiry: The question is what actually did the private sector do?

It is clear that the waiting lists haven’t been reduced as a result.  It is quite clear that for some periods hospitals were not taking patients in any event.  It is certainly not clear that those members of the public who had private insurance were using those hospitals rather than the NHS ones available.  Understandably people were reluctant to consider any hospital care which wasn’t necessary for the period of the pandemic.

The Health Secretary was given powers to enable him to use the resources of the private sector as required but it is a little confused as to what they actually were required to do or did. Actually, the end result is that the private sector was guaranteed their operating costs with little work involved.  There were no targets for them to reach.  They could continue to perform work for their private patients as and when.  To a large extent they did not take on additional work. It isn’t clear that they even completed the same amount of work as per the pandemic.

During the pandemic the NHS bought the spare capacity of the private hospital system but largely that wasn’t used for NHS patients.  Private hospitals essentially focussed on fee paying patients for the vast majority of 2020 and there were a number of private hospital groups that in fact continued to treat just private patients rather than NHS patients during this period.

It is reported (but it is certainly not clear how commonplace it was) that in London consultants were being requested to stop doing non-urgent private procedures in independent hospitals and concentrate on treating urgent and serious ill NHS patients in the system.

The End Result?

The final costs of the contract are not yet known but are estimated in the region of £2 Billion.  There appears to have been very little delivery of care for any Covid patients.  Overall in the NHS there was clearly less care of those who didn’t fit the seriously ill criteria and private patients appear to have largely been able to continue as they did.

There is no doubt that having taken over potentially the control of private hospitals it was an opportunity to move some patients who would have been treated in NHS facilities but for the pandemic into private facilities where the same care could have been provided.  It was certainly an opportunity to use those facilities for at least non-urgent care for NHS patients to prevent the waiting lists becoming as significant as they have.

What appears to have been the case is that although it appeared a decisive decision the reality is that the resources of the private sector were simply not utilised properly and effectively for the benefit of all patients but in fact essentially subsidised the private health companies in a time when their income may have been reduced.

As lawyers we are now beginning to deal with the care provided during the pandemic- not just for those who were suffering a life-threatening virus but for others who had less serious conditions.  There is no doubt that the circumstances of the time are relevant but it does appear that there was a missed opportunity to alleviate some of the difficulties with proper harnessing of resources. Whether the covid enquiry will identify the issues and extent is not clear.  The impact for our clients may be significant.

Not all issues during the pandemic related to the virus itself.  The enquiry may identify what as lawyers we already understand – that a valuable opportunity to reduce the effect for others with medical issues appears to have been wasted with the obvious consequences for those who are now considering litigation.