The need for considered debate about the future of the NHS

Elliot Bidgood, 27 August 2013

On Thursday, the Health Service Journal reported on the possibility that as many as 20 NHS trusts were exploring establishing branches in India, according to former Labour Health Secretary and current UK India Business Council chair Patricia Hewitt. This is under the auspices of the government’s ‘Healthcare UK’ initiative, aiming to raise funds for the NHS by helping trusts sell their NHS expertise abroad, which I wrote about in February after it was formally launched by current Under-Secretary of State for Health Lord Howe, former Labour Health Minister Professor Lord Darzi and Howard Lyons, who has worked in NHS management, the private health sector abroad and international development. It also aims to stimulate British business by promoting the UK’s smaller private health sector abroad.

At the time I addressed how Healthcare UK had drawn fire for being an example of the “commercialisation” of the NHS by the coalition and a potential “distraction” from NHS challenges, pointing out that these criticisms overlooked that the scheme continues the Labour ‘NHS Global’ initiative and, with some caveats, could at least in theory help the service by raising revenue for a severely cash-strapped domestic NHS and thereby slightly reduce the burden of austerity. HSJ also pointed out that these particular plans could help India develop its primary care sector and the UK to learn from cost-effective Indian coronary bypass practices.

However, though the HSJ story essentially showed that the scheme is now potentially bearing fruit, on Friday a new and truly absurd line of attack was opened up on the initiative. Dr Kailash Chand, deputy chair of the British Medical Association, told The Daily Mirror: “I am extremely concerned that the next step will be patients being flown to India for treatment because these trusts think that it could save them money.” This sensationalist claim was reported widely elsewhere.

The warnings of a senior BMA official are by definition noteworthy even if far-fetched, so responsibility also lies with Dr Chand. But this story again shows that if the NHS is to have any hope of confronting modern challenges, more responsible and reasoned discussion of innovative proposals will be vital.

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