MODERNIZATION OR PRIVATIZATION? THE FUTURE OF THE NHS AND IMPLICATIONS OF GOVERNMENTAL REFORMS FOR PSYCHOTHERAPY SERVICES

Abstract

In this paper I argue that close attention should be paid to the changes that have been taking place in the National Health Service over the last 15 years as a result of governmental initiatives. The identification of the direction that the recent health reforms have been taking should allow us to draw significant conclusions regarding the possible fate that the NHS is facing in the not‐too‐distant future. The introduction of the internal market in health care, the Private Finance Initiative, private Diagnostic & Treatment Centres and Foundation Trusts may indicate that the privatization of the NHS has begun in earnest. The relevance of such considerations to all NHS workers and users needs to be appreciated, as it may go some way towards answering the important question of what kind of NHS we will be having and using in the future. The implications for the NHS in general, and for psychotherapy services in particular, of the insidious but invasive process of privatization inherent in the ongoing changes in the structure and funding of the NHS are discussed.

ACKNOWLEDGEMENTS

I would like to express my gratitude to Prof. Allyson Pollock for providing me with relevant material and information

Notes

This is a modified and expanded version of an invited paper read at the Royal College of Psychiatrists, London, 2 December 2003.

It is worth reminding that private public partnerships are a cornerstone of policy by the current government and privatizations and PFI schemes have included the railways, highway construction, prisons, schools, the London Underground, police stations, airports' traffic control, etc.; in other words most of Britain's infrastructure.

If the results of the pilots are found to be satisfactory, then the funding for these services will be devolved to PCTs: no extra money beyond the 11 pilots is mentioned at this stage.