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Consultants (Private Work)

Volume 81: debated on Monday 17 June 1985

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asked the Secretary of State for Social Services (1) what representations he has received regarding the alleged incidence of consultants artificially prolonging National Health Service waiting lists for hip replacement or other operations so as to encourage patients to have the operation performed privately; what action he proposes to take in response; and if he will make a statement;(2) if he is satisfied with the adequacy of the systems and controls installed in National Health Services hospitals for the identification of private patients; whether he proposes to make any changes to those systems and controls; and if he will make a statement;(3) if he will make a statement about the audits carried out by his Department into the provision of private health care by consultants within the National Health Service, stating how many were carried out, what their conclusions and recommendations were and what action he proposes to take as a result;(4) what is his policy towards the treatment of private patients by consultants within National Health Service hospitals.

Our policy is that National Health Service facilities should be available for the treatment of private patients by consultants, but private practice in the National Health Service should not prejudice the interests of National Health Service patients. The statutory requirements must be observed, and private practice in the National Health Service must be conducted according to the rules. We are determined to stamp out abuse, and to ensure that arrangements for collecting income due to the National Health Service are operating effectively.A special audit investigation in 37 health authorities last year showed that some health authorities had failed to maintain proper control. Every case of alleged irregularity that was discovered is being pursued and we shall follow up all defects reported to ensure that the health authorities concerned have rectified the inadequacies identified.I wrote to all health authorities last December instructing them to review their systems and procedures. Regions have confirmed that so far 106 districts have completed and implemented reviews. All the remainder will have done so by September. We recognise that existing advice needs to be brought together and clarified in some respects. We will therefore be issuing revised and consolidated guidance on the management of private practice in National Health Service hospitals, and ensuring that this guidance is brought to the attention of all relevant National Health Service staff.It is quite unacceptable for any consultants to extend waiting lists artificially so as to encourage patients to have operations performed privately. We have no evidence to suggest that the practice is widespread but would expect health authorities to investigate thoroughly any allegations they receive and to take disciplinary measures where necessary. If the waiting list in any locality for a particular operation is long we would expect the health authority concerned to investigate the causes and to find whether adequate priority is being given to that operation in NHS theatre time.