Businesses that fail patients while making profit margins of 15%-20% are no substitute for investment in the NHS

New evidence of the extent of the privatisation of mental healthcare in England is extremely concerning. Ministers and health bosses must explain why the independent sector is earning almost £2bn a year for treating patients with psychiatric conditions – or 13.5% of NHS England’s entire mental health budget. Overall, about 7% of spending is on private providers, although this rose during the pandemic. It is difficult to think of a good reason why the proportion of mentally unwell people treated by private providers should be so much higher than the proportion of those with other conditions.

If patient safety and care quality were the only considerations, extremely vulnerable mental health patients would seem to be among the least suitable candidates for outsourcing. After all, the general rule is that while standardised treatments such as cataract operations can be delivered via the independent sector relatively straightforwardly, more complex and long-term work is kept in-house. Why inpatient psychiatric care for under-18s should defy this rule, with 55% of all NHS-funded treatment delivered privately, is a troubling question for anyone who cares about the future of healthcare.

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