EPQ Essay

Could the NHS reform place people in danger

by creating a service that is not joined up?

A close analysis of the privatization of our National Health

Service and how it will affect the people.

Dillon Wilson
Holy Cross College 9178
Dillon Wilson Pin: 9178

Contents
Introduction .......................................................................................................................................... 2
Privatisation And The Current System Explained. ................................................................................. 3
What Will Privatisation Change?........................................................................................................... 4
Reasons For Privatisation ...................................................................................................................... 5
Public Consultation ............................................................................................................................... 7
Quality of Care ...................................................................................................................................... 9
Lacking in Equipment and Facilities?................................................................................................. 9
Are Patients Safe? ........................................................................................................................... 10
So should we oppose the change? ...................................................................................................... 12
Bibliography ........................................................................................................................................ 13

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Introduction
In early 2013 Professor Terence Stephenson, Chair Designate of the General Medical Council,
spoke his opinion regarding a National Health Service reform. During the interview, a strong
concern was conveyed. In this essay privatisation of our NHS will be looked at in great detail.
Many sources of concern will be examined, from obvious to unforeseen reasons such as what
potential long term effects could be caused as a direct result of a change. Once understood, I
will then begin to debate for and against arguments for change. Considering the extent to
which our government is safeguarding the process and ultimately patients within care, will
provide good grounds for judgement on any danger posed. In addition, effects on quality of
care will be a major point within my essay. Considerations, such as how effective different
providers, both private and national, are at meeting basic expectations of healthcare. After all
points are exhausted, I will begin to draw my own conclusive summary, stating what I have
learned, closing with my opinion.

The essay will consult from many sources. Trusted independent news outlets that aim for an
unbiased portrayal will be used to render an overview of the threat. This will be difficult to do
as many journalists hold an angle, but an established source such as BBC News should provide
me with solid reliable information. I will also seek information from medical journals,
government documents and public figure speeches.
The quote used to construct the title of the essay has been extracted from Professor Terence
Stephensons interview with the BBC. [13]

[13] BBC News, (2013). 'People in danger' from NHS changes. [online] Available at:
http://www.bbc.co.uk/news/health-21649307 [Accessed 30 Nov. 2014].
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Privatisation And The Current System Explained.

The term privatisation defines the process in which a government owned service or business is
transferred to a privately owned entity. This means that the government would no longer
manage and direct the relevant institution. For example, a service that becomes privatised is
open to shareholder investment. It also means there would be no public ownership of the
privatised service. In effect this means that the all parts of service would be privately controlled,
even if some parts [very unlikely] were to remain in public ownership.

FIG 1.1
Data collected from The Guardian [9]

Currently the NHS has a majority of around 86% spending on non-private parts within a
particular trust. This means that 86% of all annual funding is spent on the respective services
provided by the NHS, shown in FIG 1.1. Hospitals have nearly half of all spending.
Prescriptions and Mental healthcare account for 20% of spending. Community care, which is
long term care for elderly or vulnerable people provided in alternative locations, accounts for
15%. The management and commissioning, which is also publicly owned, takes only 3% PA.
Other spending (accounting for 5%) includes dentists and optometry businesses. GPs (9%) in

[9] Ridley, J. (2013). Government spending by department, 2011-12. 1st ed. [PDF]
The Guardian. Available at:
http://www.theguardian.com/news/datablog/2012/dec/04/government-spending-department-2011-
12 [Accessed 22 Nov. 2014].

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the UK are already private. This means they run as business that are funded by the NHS. This
works by the NHS providing sufficient funding to the General practitioner for them to employ
staff, pay bills and rent, also taking home enough salary afterwards. This has been the case since
1948, when all GPs were made private. However, this does not mean restrictions are not in
place. For example advertisements are disallowed and rules to where surgeries are allowed to be
located are in place.[2] Since 2004, rulings have allowed GP clinics to be opened up for
bidding from people who are not General Practitioners. This means every five years the
current contract expires and private companies such as Virgin Healthcare and BUPA can bid
on the surgery, against the NHS. Here the highest profit bid will win, effectively removing the
attention of longevity and security for patients. GPs will stick by their surgeries and patients in
many situations, where private business will not, simply leaving when profits run dry.

What Will Privatisation Change?

The proposed action within the National Health Service white paper [3] proposes that the GPs
will undertake control of 80% of budget. It has been indicated however [1] that the service (of
governing the budget) will be delegated to private budget management companies (as shown in
FIG 1.2), which are paid for doing so by the practice. This therefore means that the
Management of NHS will be private - no longer in our ownership. This leads to the public
having no control of the NHS management, and in effect still having say in what money is
spent where. This currently may not seem a problem, however when the private companies
change the budget spending in a way disliked unanimously by the population there will be
nothing that the people can do.
Further into the document the plans for a social enterprise are described. A social enterprise is
a business model where commercial strategies are used to maximise income that is then used
for improving the service, or in any other way seen beneficial to the wellbeing of people. This is
instead of maximising profits for shareholders.
Shown on the following page is a pie chart reflecting the proposed changes.

[1] Blogger, R. (2014). NHS Privatisation. [online] YouTube. Available at:

https://www.youtube.com/watch?v=sNiruX2gZDc [Accessed 14 Nov. 2014].
[2] WRIGLEY, D. (2014). GPs Aren't Private Companies - But The Private Takeover
Is Nearing. OURNHS.com. [online] Available at: https://www.opendemocracy.net/ournhs/david-
wrigley/gps-aren't-private-companies-but-private-takeover-is-nearing [Accessed 14 Nov. 2014].
[3] NHS, BEVMAN, H. AND FAIRMAN, S. (2014). White Paper: The new era of
thinking and practice in change and transformation.

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FIG 1.2
Data collected from The Guardian [9]
Percentage of annual 106 Billion Budget
The charts above shows the potential changes, where the department has split, the respective
percentage has been indicated in white. This plan includes extinction of the current NHS
Trusts. In result Social Enterprise will be the only option for almost all NHS care providers. In
turn, this results with none of the National Health Service being owned by the Public. As
shown in FIG 1.2, the green segments are where social enterprise will be adopted and
employed by the government. The red indicates that the respective proportion will be totally
private. This means that private providers, such as BUPA, Virgin and Care UK amongst others
will be directly providing the healthcare, on a standard business model. Profit for external
shareholders will be maximised with these allocations.

Reasons For Privatisation

The current system seems effective when observed from many aspects, so why the lean towards
change? The change should only be necessary if there is a greater demand for care than can be
currently be provided by the current system, even then the dramatic shape up would still not be
required. Historically the NHS has leaned on the private companies for reserve ambulances, for
use during busy periods exclusively for minor injuries. Over time this tenancy has developed,
the NHS regularly uses private ambulances. The NHS now spends over 7 million pounds per
year in private contracts for private ambulances, while NHS ambulances are often left unused
due to shortage of NHS staff.[5]

[5] Blackburn, P. (2014). EMAS spending 7m on private ambulances due to lack of staff.
[online] Nottingham Post. Available at: http://www.nottinghampost.com/EMAS-spending-7m-private-
ambulances-lack-staff/story-20830377-detail/story.html#ixzz2yrf4LSif%20%20%20 [Accessed 16 Nov.
2014].
[9] Ridley, J. (2013). Government spending by department, 2011-12. 1st ed. [PDF] The
Guardian. Available at: http://www.theguardian.com/news/datablog/2012/dec/04/government-spending-
5
department-2011-12 [Accessed 22 Nov. 2014].
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Data below looks at whether other factors, such as medical advancements increasing life
expectancy, have caused additional strain on the NHS.

Available Hospital Beds per 1000 People in the UK.[6][4]

Number of Hospital Beds
(per 1,000)

Year

The graph above (FIG 2.1) shows the number hospital beds per 1,000 people of the
population. This trend shows how drastic the change over the past 50 years has been.
The Number of beds (per 1000) has fallen from 10.7 in 1960, to just 2.9 in 2011. There are
many factors that contribute to this change. The population growth, since 1960, has increased
from just over 50 Million, to 64 Million. This demonstrates the significant strain the NHS has
been put under since starting up in 1948.
But how does this truly affect the NHS? The system, already coping with financial strain, is
struggling. The need to refer and bring in private contractors to provide care, due to excessive
wait times or lack of staff is growing. Figures obtained by The Yorkshire Post reflect the
increasing demand for care, versus the lack of medical staff and facilities. Just under 2,800
FIGwaited
patients that arrived in ambulances to York and Scarborough hospitals in 2013-2014, 2.1 at
least 30 minutes but less than 60 minutes, before receiving care from A&E staff. 900 Patients
waited more than one hour, and 51 waited more than two hours. On average 1 in 10 patents
arriving by ambulance had to wait more than half an hour to receive urgent medical care. [7]
Furthermore, the BBC has recently reported the increase in demand for appointments at
General Practitioner Surgeries. The number of consultations undertaken per year at GPs

[6] [4] Data taken from World Bank Group, (2014). Graph generated using Google
Public Data Tools. [Data Taken 16 Nov. 2014].
[7] Yorkshirepost.co.uk, (2014). Worsening casualty pressure a sign of NHS under
strain. [online] Available at: http://www.yorkshirepost.co.uk/news/main-topics/general-
news/worsening-casualty-pressure-a-sign-of-nhs-under-strain-1-6789290 [Accessed 16 Nov.
2014].
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Surgeries across the nation has increased by 50 million in just 5 years. The demand for new
GPs is greater than ever, figures suggest that to supply the demand, more than 8,000 GPs are
needed before the year 2020.[8]
The use of private contractors, ambulance staff and care facilities then further strains the
budget, stuck in an endless loop, strain grows and grows. Some suggest a massive shape up
would eradicate this issue, a new NHS could do better, but it has to be questioned. The
probable motive to maximise external shareholder profit is a stark threat from private
contractors. The healthcare budget could soon be employed into the shareholders pockets.

Public Consultation
The changes to the NHS system are already taking place. This would surprise many, given there
has been little publicity on the matter, let alone consultation. In 2012, a bill opened the
possibility for the abolition of the current NHS trusts system. But far more shocking, the can of
worms opened back in the year 2000 when
labour laid out the possibility, which is now a
sore reality, of private investment and
contracting of the National Health Service.
Since then the private healthcare market
within the United Kingdom has grown
tremendously. As reflected earlier, many
services, such as GPs are now private. The
latest statistics [12] (at time of writing) indicate
that private healthcare facilities are set to win
more than 9Billion worth of contracts. This
is mainly due to the latter bill of 2012, which
many people mark as the year our NHS was put up for sale[13]. The most recent campaign to
save the NHS, was dubbed #BACKTHEBILL with the aim of social media drive. It has backing
from the TUC (Trades Union Congress) and other many other trade unions. The purpose of
the campaign is to encourage locals to pressure their Members of Parliament to vote for the
newly drafted bill. This vote will take place on 21st November 2014.
In our democratic nation, the decision does ultimately lie with the MPs. Votes on any change,
such as this one, take place in Parliament. The vote in parliament took place on whether to
amend the current bill and enforce Labour MPs, Clive Effords Amended Duties and Powers

[8] BBC News, (2014). Patients 'struggling to book with GP'. [online] Available
at: http://www.bbc.co.uk/news/uk-30072905 [Accessed 17 Nov. 2014].
[12] The Huffington Post UK, (2014). We Need a More Courageous, Robust Response
If We're to Save Our NHS. [online] Available at: http://www.huffingtonpost.co.uk/caroline-
lucas/nhs-reform-bill_b_6197206.html [Accessed 22 Nov. 2014].
[13] BBC News, (2013). 'People in danger' from NHS changes. [online] Available at:
http://www.bbc.co.uk/news/health-21649307 [Accessed 30 Nov. 2014]. 7
Dillon Wilson Pin: 9178

Bill, giving the government less power therefore weaker ability to shift the NHS towards the
private sector.[9] Essentially a law to reverse NHS privatisation. The outcome of the vote was
unanimous, 241 YES, versus just 18 NO votes.
This does not simply draw an end to the issue, the title of the new bill, implies that the
responsibility of the Secretary of State would have to provide the NHS. [11] The bill however
does not contain the same message. The new bill, now voted for, will give the Secretary of State
the responsibility of commissioning NHS. This will leave the door open for private healthcare
providers. This then, does not have that great of an impact. The NHS can still be privatised.
The 2012 act proposing abolishing the NHS trust system is still well within viable. The whole
of the NHS is still not securely exempt from the Transatlantic Trade and Investment
Partnership Treaty. Critics insist there are just far too many loopholes, which could will be
manipulated through by shareholders.[11]
These weaknesses were expressed by the KNOP (Keep Our NHS Public) members before the
bill was passed.

Although the Efford Bill is not completely satisfactory in its present form in
meeting all of KONPs demands for the NHS, it is worth campaigning for because
it raises the publics awareness of NHS privatisation. [10]

The founder of KNOP explains that the Efford bill is a step in the right direction. The vote is
keeping the NHS on top of the current political agenda. The vote also makes opportunity for
highlighting the key demand of the people: to reinstate the NHS to full public ownership.
Furthermore, in anticipation of making this happen, Professor Allyson Pollock (one of KNOPs
founders) has drafted a set of laws that would need to be put into play to reverse the already
shocking actions, also preventing any future changes.
So the question then becomes: Do MPs reflect their constituencys opinions? Quite simply,
NO. Although the Efford bill was passed, the chances of the Pollock Bill being passed are slim,
purely because it would completely cut any possibility of private contracts. The many ties
between politicians and private healthcare firms is rather startling in fact. Figures from
socialinvestigations.blogspot.co.uk, show that 141 lords and MPs have ties and close
connections to these firms. Although their level of involvement varies, from some being
chairman or directors of the firms to others receiving cash donations, their political agenda is
expected to be swayed. Politicians are politicians after all.

[9] Ridley, J. (2013). Government spending by department, 2011-12. 1st ed. [PDF]
The Guardian. Available at:
http://www.theguardian.com/news/datablog/2012/dec/04/government-spending-department-2011-
12 [Accessed 22 Nov. 2014].
[10] Leftfootforward.org, (2014). No time to waste - six months to save our NHS | Left
Foot Forward. [online] Available at: http://leftfootforward.org/2014/11/no-time-to-waste-six-
months-to-save-our-nhs/ [Accessed 22 Nov. 2014].
[11] Compton, S. (2014). 38 Degrees | Blog | A law to reverse NHS privatisation: how
MPs voted. [online] Blog.38degrees.org.uk. Available at:
http://blog.38degrees.org.uk/2014/11/21/a-law-to-reverse-nhs-privatisation-how-mps-voted/ 8
[Accessed 22 Nov. 2014].
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Quality of Care
Many people can cast opinions on what should happen. One common problem with this is the
lack of first-hand experience with the NHS, more importantly, experiencing the NHS through
the most important perspective: the hospital bed. In many situations patients within the system
can be unhappy not solely to the quality of care, often sometimes due to their illness. The
fairest way of analysing the performance of the NHS and other private services is to look at the
quality of care delivered. To evaluate this topic many attributes such as: timeframes of delivery,
complexity of services offered, availability of staff, equipment and continuity of service. More
importantly, general patient comfort will be analysed. This will be done using specific cases of
patients in addition to official reports.

Lacking in Equipment and Facilities?

Although many private hospitals are willing to provide procedures beyond the usual scope of
complexity there are many situations where the patient in the private facility would result in
being transferred to a public NHS hospital. On average over 6,000 patients have to be admitted
to NHS hospitals after complications within private hospitals. [14] Due to the lacking
requirement of private health facilities to publish detailed statistics specific details are
unavailable. One assumption can be made however: private hospitals typically treat low risk
patients, whom are less likely to present complexities and abnormal reactions, post-surgery.
Does this then mean the facilities are simply far too insufficient to deal with unexpected
scenarios or are the private hospitals making basic errors resulting in situations that are passed
over to the NHS to save their budget?
The answer is rather quite grim. The CHPI report indicates that the vast majority of private
hospitals do not have intensive care facilities. Even more worrying, the figures show that less
than half of private hospitals performing cosmetic surgery during 2010 had a fully equipped
operating department.[14] For contrasting purposes it should be noted that a small NHS
hospital, such as Bedford Hospital, Bedfordshire, (with just 520 hospital beds) has 8 operating
theatres with over 100 members of staff. This shows that if any complications were to arise the
patient would require transferal to an NHS hospital. This is not only an additional strain on
the NHS, who are responsible for funding the patient from there forward, it exposes the
patient to extreme risk. Putting a patient requiring immediate medical attention into an
ambulance and transporting them to a better equipped facility for the care they need, can result
in their condition worsening due to the length of time it takes. Surely this alone is a reason to
maintain a NHS thats public and streamlined, not suffering from fragmentation. This
evidence supports a conclusive answer Professor Terence Stephensons initial remark of

[14] Leys, C. and Toft, B. (2014). Patient Safety in Private Hospitals - The known and Unkown
Risks. 1st ed. [ebook] CHPI. Available at: http://chpi.org.uk/wp-content/uploads/2014/08/CHPI-
PatientSafety-Aug2014.pdf [Accessed 1 Dec. 2014].

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concern a link between a service that is not joined up and placing people in danger. As
shown reflected by the data, yes it could and it [using private healthcare thats non NHS] quite
possibly already does. Consider this: Time in acute care is critical; often minutes can be the
hash difference between life and death. Therefore a Fragmented health service would risk and
inevitably contribute to loss of time. If all private hospitals were forced to have adequate
operating facilities then perhaps the number of unexpected deaths (802) and number patients
seriously injured within private hospital care (921) in the past four years [14] could be
significantly reduced. Once again due to the lack of documentation requirements for private
hospitals, it is unknown whether the deaths and injuries should be of concern, but it is a very
reasonable assumption that a proportion of these mishaps could have been prevented if
theatres, where lifesaving operations could be performed, were in existence. My opinion is that
the government should enforce stricter requirements. I think it should be law that private
hospitals have at least one operating theatre. Furthermore, they should have the capacity to
handle unexpected complications as effectively as the NHS do. After all, every hospital should
be able to do exactly that care for injured and unwell patients.

Are Patients Safe?

The main objective of NHS care is to improve patients health improves as much as possible, as
quickly as possible. This objective drives our NHS forward and ensures patients come before
paperwork wherever possible. As long as the NHS remains a social enterprise, this should be
the case: the system abides to provide care and does not generate a profit in any way. This is
important to consider when introducing private contractors into use. This is because they will
always run as a business regardless of whether always doing right by the patients. This does not
mean to say mistakes should never be made, the NHS makes mistakes, but the rate of which
the mistakes and mishaps take place should be very low. The problem with introducing a
tertiary objective of maximising profits introduces an impossible business model. Upon close
analysis, a clear correlation of the sacrifices being made to meet this objective is discovered.
BUPA are renowned for this reason. Recently, Judge Mark
Brown ruled that BUPA are putting profits first and cost "A society has to be judged by
cutting, when speaking prior to a trial regarding a case of the way it treats the elderly and
neglect leading to a premature death within a BUPA care vulnerable. Mrs. Farrow fell
home. The trial resulted in the care home manager being into both categories. I am sure
the public will be appalled to
convicted of wilful neglect, and was sentenced to 8 months in
hear the way she was looked
prison, 120 hours of unpaid work, a two year suspension and
after at this home." Judge
fine of 4,500.[15] This case reflects two concepts very clearly.
Mark Brown [15]
First, BUPA are unable to provide a safe level of care due to

[14] Leys, C. and Toft, B. (2014). Patient Safety in Private Hospitals - The known and
Unknown Risks. 1st ed. [ebook] CHPI. Available at: http://chpi.org.uk/wp-
content/uploads/2014/08/CHPI-PatientSafety-Aug2014.pdf [Accessed 1 Dec. 2014].
[15] Bunyan, N. (2012). Bupa put profit first at filthy and understaffed care home, says judge -
Telegraph. [online] Telegraph.co.uk. Quote: "A society has to be judged by the way it treats the
elderly and vulnerable. Mrs Farrow fell into both categories. I am sure the public will be appalled
to hear the way she was looked after at this home." Judge Mark Brown. Available at: 10
http://www.telegraph.co.uk/health/healthnews/9149296/Bupa-put-profit-first-at-filthy-and-
understaffed-care-home-says-judge.html [Accessed 8 Dec. 2014].
 Dillon Wilson Pin: 9178

the lack of funding reaching the patients. Secondly, rather reassuringly people are bothered
by this. The hefty punishment handed to the care home manager is no consolation for death,
however it encourages the fact profits maximised in private care settings are unacceptable. This
was clearly promoted by Judge Mark Brown while delivering the verdict. Quite sadly there have
been a countless number of stories telling the same parable and although this was not a private
healthcare hospital, it reflects the companys immoral behaviour and attitude towards how
healthcare should be run. The reality?

BUPA is a quintessential example of how healthcare should NOT be run.

Inviting BUPA and similar business to demolish a principal our modern society has pride in,
is a move only an imbecile would make. It is not the solution to assisting our overstretched
NHS.
Private healthcare in its entirety is not a bad thing. It allows people whom do not wish to wait
for treatment on the NHS, be treated whenever they wish. It enhances the level of choice a
patient has it enables a freedom of choice. This dynamic can also contribute to reducing the
strain on the NHS. The use of private care through NHS referral, funded by NHS budget is
wrong. This referral process may well appear to reduce strain on the NHS, by diverting patients
to another care outlet, however this is not quite true. Because the private care is being funded
by the NHS, taxpayer money quickly makes its way into the pockets of BUPA, Virgin Care and
Care UK to name just a few. This then creates an endless loop because the spending leads to
an overstretched NHS budget in addition to the problem of an overwhelming demand for care.
The monetisation of any infrastructure as fundamental to human life as healthcare services are
should be forbidden. The financial motive of non-social enterprise operations means far less of
the taxpayers money goes into the frontline of healthcare treatment.

The problem pictured: A Scenario:

Martin requires treatment as an NHS patient.
NHS Budget
This will cost approximately 900 if done by the
201Bn PA NHS. Wait times are long and the NHS decide to
refer Martin to a local Private facility. They will
pay for the procedure. Martin is referred however,
Outsourced Healthcare
(Due to strain) of the 900 the NHS will pay to the private
facility only 660 will be spent on Martin and
caring for him. The result: 240 further increases
Spending on patients
and staff Into pockets of shareholders the companys annual profit margin while
Martins quality of care suffers, exposing risks to
him that he would not on the NHS.
Primary Care Secondary Care
(100% On patients
If Martin develops complications, or worsens due to
(100% On patients and
staff) and staff) this, The NHS WILL have to pay or reabsorb him into
an NHS facility.

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So should we oppose the change?

Changing to a private system involves many risks. The sector would become more
competitive, but as already reflected upon the danger level is too high. There are simply far
too many cases of neglect and suffering due to the inhumane attitude towards budget
spending. It is clear to see that within the currently operational private healthcare
companies businesses within the UK. Until trust can be established, or even better, rigorous
laws are engaged to prevent profit margins from exceeding specific limits, private healthcare
should not be used by NHS (through paid referral). If a patient wishes to use private
healthcare, they should do so out of pocket. Using NHS money enhances the overstretch and
condones the money obsessed behaviour of the private board managers.
I think that the current system works. There may be the odd anomaly produced from time to
time however these are issues that are due to human error. The doctors who work in private
healthcare are often also working for the NHS, therefore the care and success rate of any
procedure is not improved. The changes proposed, favoured by some; offer no improvement to
the current system. No clear benefits of a private and fragmented healthcare system are visible.
The issue of long waiting times would simply migrate along with the majority of patients.
Where there is a demand for care, there will be a wait for care. An increasing demand will lead
to an increase in referral times. Therefore privatising our National Health Service will not solve
this problem, if anything it will make it worse. My biggest problem with a privatisation
movement is the loss of money (from tax payers) to shareholders pockets. A privatisation
would mean less money, same patients, therefore a worse situation. Further the fragmentation
will cause safety of patients to be compromised. The facts show, and it is clear to see that
private health facilities are immature and inexperienced, in comparison to our well-developed
and matured Public National Health Service.

I say OPPOSE THE CHANGE.

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Bibliography

[1] Blogger, R. (2014). NHS Privatisation. [online] YouTube. Available at:

https://www.youtube.com/watch?v=sNiruX2gZDc [Accessed 14 Nov. 2014].

I found that this source was useful as it provided the concept of the pie charts used on
page 2 and 4 however, because the source itself [unaccredited YouTube user] could be
considered unreliable, I had to find my own data and generate my own pie charts.

[2] WRIGLEY, D. (2014). GPs Aren't Private Companies - But The Private Takeover Is
Nearing. OURNHS.com. [online] Available at:
https://www.opendemocracy.net/ournhs/david-wrigley/gps-aren't-private-companies-but-
private-takeover-is-nearing [Accessed 14 Nov. 2014].

I found that this source was useful because it provided the ground rules set out for GPs clinics. It
also highlighted that GPs already run privately.

[3] NHS, BEVMAN, H. AND FAIRMAN, S. (2014). White Paper: The new era of
thinking and practice in change and transformation.

I found that this source was useful as it provided a reader friendly interpretation of the
government white paper produced to explain the proposed changes to the NHS.

[4] World Bank Group, (2014). World Bank Group. [online] Available at:
http://www.worldbank.org/ [Accessed 16 Nov. 2014].

This source was very valuable as it enabled the graph on page 5 to be created; this data shows
the clear increase in demand for care to the reader.

[5] Blackburn, P. (2014). EMAS spending 7m on private ambulances due to lack of

staff. [online] Nottingham Post. Available at: http://www.nottinghampost.com/EMAS-
spending-7m-private-ambulances-lack-staff/story-20830377-
detail/story.html#ixzz2yrf4LSif%20%20%20 [Accessed 16 Nov. 2014].

I found that this source was useful as it highlighted something that many people do not already
know.

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Dillon Wilson Pin: 9178

[6] Graph generated using Google Public Data Tools. [Data Used 16 Nov. 2014].

This tool was very useful as it automatically collected data from the World Bank Group [4]
Website and created an easy to interpret graph.

[7] Yorkshirepost.co.uk, (2014). Worsening casualty pressure a sign of NHS under strain.
[online] Available at: http://www.yorkshirepost.co.uk/news/main-topics/general-
news/worsening-casualty-pressure-a-sign-of-nhs-under-strain-1-6789290 [Accessed 16
Nov. 2014].

This online article provided a deep insight into the hash times the NHS is going through. The
detailed statistics regarding the patient wait times are startling and provide good evidence for
the points made within the essay.

[8] BBC News, (2014). Patients 'struggling to book with GP'. [online] Available
at: http://www.bbc.co.uk/news/uk-30072905 [Accessed 17 Nov. 2014].

I found that this source was useful as it also reflects the strain of the NHS, although
controversial as it supports the fact private services function no better, since GPs are already
private.

[9] Ridley, J. (2013). Government spending by department, 2011-12. 1st ed. [PDF] The
Guardian. Available at:
http://www.theguardian.com/news/datablog/2012/dec/04/government-spending-
department-2011-12 [Accessed 22 Nov. 2014].

This document was very helpful as it provided reliable data for use within the pie charts on
pages 2 and 4.

[10] Leftfootforward.org, (2014). No time to waste - six months to save our NHS | Left
Foot Forward. [online] Quote: Although the Efford Bill is not completely
satisfactory in its present form in meeting all of KONPs demands for the NHS, it is
worth campaigning for because it raises the publics awareness of NHS
privatisation. Available at: http://leftfootforward.org/2014/11/no-time-to-waste-six-
months-to-save-our-nhs/ [Accessed 22 Nov. 2014].

I found that this quote was very suitable as it documents a recent backlash regarding the
current situation the NHS is in.

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[11] Compton, S. (2014). 38 Degrees | Blog | A law to reverse NHS privatisation: how
MPs voted. [online] Blog.38degrees.org.uk. Available at:
http://blog.38degrees.org.uk/2014/11/21/a-law-to-reverse-nhs-privatisation-how-mps-
voted/ [Accessed 22 Nov. 2014].

I found that this source was useful as it reflected the fact MPs are aware of the demand,
however it also shows the rigid support for privatisation some show.

[12] The Huffington Post UK, (2014). We Need a More Courageous, Robust Response If
We're to Save Our NHS. [online] Available at:
http://www.huffingtonpost.co.uk/caroline-lucas/nhs-reform-bill_b_6197206.html
[Accessed 22 Nov. 2014].

I found that this source useful as it shows the sheer competition for contracts there is within the
healthcare sector.

[13] BBC News, (2013). 'People in danger' from NHS changes. [online] Available at:
http://www.bbc.co.uk/news/health-21649307 [Accessed 30 Nov. 2014].

This source provided a valued opinion from a very relevant public figure. This enabled the
construction of the title which poses a very interesting question.

[14] Leys, C. and Toft, B. (2014). Patient Safety in Private Hospitals - The known and
Unkown Risks. 1st ed. [ebook] CHPI. Available at: http://chpi.org.uk/wp-
content/uploads/2014/08/CHPI-PatientSafety-Aug2014.pdf [Accessed 1 Dec. 2014]

I found that this source was useful as it provided detailed rules and statistics that relate to
danger within private hospitals.

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[15] Bunyan, N. (2012). Bupa put profit first at filthy and understaffed care home, says
judge - Telegraph. [online] Telegraph.co.uk. Quote: "A society has to be judged by the
way it treats the elderly and vulnerable. Mrs Farrow fell into both categories. I am
sure the public will be appalled to hear the way she was looked after at this home."
Judge Mark Brown. Available at:
http://www.telegraph.co.uk/health/healthnews/9149296/Bupa-put-profit-first-at-filthy-
and-understaffed-care-home-says-judge.html [Accessed 8 Dec. 2014].

I found that this source was useful as it provided a real case that proves the combination of
healthcare and business profits in hospitals are too great a challenge and risk for the UK to take.

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