I recently read an interview with the former chief executive of Virgin Healthcare, a brand which is now providing 80 separate services to the NHS across the UK. As the interviewer notes, you can either see this as "corporate greed driving privatisation of the NHS", or you could contend that Virgin believes it has something to offer the NHS and patients. No prizes for guessing which its ex-boss chooses.
He describes a recent visit to A&E with a suspected heart attack (unfounded, as it happened), and says that while the clinical care was excellent, the patient experience was far from it. Poor signage, poor access, limited parking ("the staff car park was three times bigger than the patients'") and customer service scripted by John Cleese. You know the sort of thing.
Arguably, that kind of experience is much less prevalent in primary care, especially dentistry. When there is such a direct connection between the success of a business, its ownership and staff, and the satisfaction of patients. It is not surprising that the CQC found our services to be the most compliant of any sector so far regulated; particularly when the patients attend electively for the most part.
Indeed, the attention paid to customer service (I know it grates, but 'patient service' just doesn't sound right) in medical healthcare seems to be inversely proportional to the physical distance between the waiting area and the chief executive's (or principal's) place of work.
Imagine if the chief executive of, let's say a hospital in Staffordshire, had a glass fronted office adjacent to the casualty department. You would like to think that any issues that arose would fairly quickly be brought to his/her notice. Which reminds me; I once learned of the new chief executive of a large district general hospital who put holders containing 'pink forms' around the building. Patients or staff could report any failings, concerns or 'near misses' in the service and the aforesaid CEO undertook to respond to every comment on the same day.
It was a great and successful idea, and relevant on a smaller scale to dental practice. It is, of course, essential to have a 'no blame' approach to such a scheme but, in essence, a prompt response to any issue, however seemingly trivial, is (as the defence bodies will confirm) an excellent first step towards defusing any issues and heading off any sources of future mishap. Plus, of course, being valuable evidence of good clinical governance for assorted regulators.
I'm not suggesting that you should dash off an impromptu response to a complex complaint – whether it's clinical, employment or management – without taking some expert advice. But an immediate acknowledgement and an assurance that action is being taken is one of the most positive ways of dealing effectively with actual or potential issues. Things can only 'get dealt with or get worse' as they say.
Anyway, going back to Virgin (and other private providers), are they indeed a threat or an ally to the NHS in these austere times? It's interesting to note that, after staff salaries, the cost of private suppliers and services, at 23 per cent, is the second largest segment of expenditure for the NHS, ranging from locums agencies and treatment centres, to beds and pharmaceuticals.
It's obvious to see that a huge public enterprise can only exist alongside a reliable and efficient supply chain. Hinchingbrooke is, to date, the only example of an NHS hospital entirely managed by a private company, perhaps it could be a model to watch.
It used to be said that dental practices were a good example of private micro-enterprises contracted, in whole or in part, to the NHS. Whether that can still be regarded as the case, given that in England at least, the PCTs have effectively taken over the goodwill of NHS lists (insofar as they can communicate with patients and have control of their transfer to another contractor), remains to be seen.
Arguably as private suppliers to the NHS, dental practices are models of efficiency and indeed of patient care (so long as a reasonable degree of competition exists). If you are the only dentist for miles around there is undoubtedly a monopoly and the possibility (were GDC standards and professional ethics ignored) of a failed market for the consumer as the OFT would say, but even its own research suggested this is not the case.
New contracts and working arrangements may be in the pipeline, and confused and confusing management structures changed around us, but like many 'little Virgins' we still offer superb value for healthcare in both the private and the public sector.