Public and private healthcare must work together

Scientists are in the spotlight and giant pharmaceutical companies are bathed in a rare positive glow as public and private healthcare forges new alliances to combat the coronavirus. The gravest threat to global health has been met with heroics, ingenuity and inspiring collaboration, but how we emerge from the shadow of this deadly pathogen will be as significant as how we tackled it.

Families have been torn apart and economies wrecked by the pandemic, but its legacy could be a recalibrated healthcare system featuring a more flexible and resilient NHS, which has many big battles ahead. Aside from potential secondary or winter waves of the virus, healthcare is facing the relentless march of non-communicable diseases and a growing, ageing population living with multiple morbidities.

The uplifting view is that public and private healthcare can work together and operate comfortably with the pharmaceutical industry. Previous lines in the sand have been obliterated over the last six months with private health providers making staff, equipment and facilities available to meet the COVID-19 patient surge.

Public and private healthcare collaborate on vaccine

Vaccine research has been accelerated thanks to government flexing clinical trial regulations while AstraZeneca, partnering with Oxford University’s Jenner Institute, has agreed to manufacture and supply two billion doses on a not-for-profit basis.

“COVID has changed everything. The NHS reacted brilliantly, but so did a number of private companies,” says Andrew Corbett-Nolan, chief executive of the Good Governance Institute, a consultancy that advises NHS executives, health authorities and commercial clients. “But we need grown-up conversations about where we go next. The NHS should be free at the point of delivery, but we need to think seriously about what percentage of national wealth we commit to caring for our citizens and we need to deal with social care.

“It is lazy thinking to characterise private healthcare as solely caring about money. They don’t spend their time discussing balance sheets; they are proud of what they do and talk passionately about treating patients. They can innovate, move at pace and can energise public services. Private healthcare is not a panacea, but we need to take this opportunity to work together to create a better health system.”

How private healthcare supported the NHS

The Independent Healthcare Providers Network (IHPN), which has 70 member groups across the UK, freed up 8,000 hospital beds, supplied 1,200 ventilators and made 10,000 nurses, 700 doctors and 8,000 clinical staff available to the NHS during the pandemic. The deal demonstrated the benefits of collaboration in healthcare and was so successful that the NHS has signed a £3-billion extension.

“It was absolutely the will of the sector to respond because at that stage there was a worry the NHS would not be able to cope on its own,” says IHPN chief executive David Hare. “The last few months have demonstrated that high-quality service provision in normal and emergency times requires the public and private healthcare sectors to work together. The exam question is how you make that work properly, not whether you do it at all.

“The NHS has to evolve and NHS England has set out very well the challenges of an ageing society and it is now incumbent on all of us in healthcare to solve them and put some of the divisions of the past behind us.

“If we get the political and cultural debate right, we can move forward with confidence that everyone is trying to improve the quality of care for patients, not agonising over ownership structures.”

Keeping up collaboration post-COVID

The NHS Confederation, which represents healthcare organisations and leaders, is advocating an NHS Reset Campaign that restructures the way care is planned, commissioned and delivered post-pandemic.

“We now look forward to a reshaped future in which social care, the independent sector, and voluntary and community services are seen as part of an integrated system, rather than wholly separate from one another,” says Dr Layla McCay, director at the NHS Confederation.

“Of course, it is vitally important to make sure there is adequate funding going forward, for the NHS and social care too, as pouring money into the NHS will not be enough if its sister service cannot cope, as well as to rebuild local service provision to meet the physical, mental and social needs of communities hit by massive economic and social disruption.”

Collaboration, an established trend in pharma, has been supercharged with companies, academia and health systems joining forces as patent rights have been waived and proprietary data shared to accelerate clinical trials.

The life sciences industry in the UK, which supports 250,000 jobs and generates £70 billion in economic value, believes the benefits of collaboration in healthcare are improved services and faster adoption of technology.

Future healthcare must blend private and public

Dr Richard Torbett, chief executive of the Association of the British Pharmaceutical Industry, believes the unprecedented public and private healthcare union through the pandemic must be a template for the future. “It’s important that the lessons learnt from COVID-19 collaborations are taken and used in the fight against other diseases for which there are currently no treatment options,” he says.

The NHS was already en route to a more technologically focused existence, but COVID-19’s convulsions present a golden opportunity for improvement if it can blast through concreted regulations and practice, and ensure the public does not equate change with a betrayal of principles. Many politicians and unions remain concerned that a race to embrace the private sector could corrode the provision of free care to those in need who cannot afford alternatives.

But Corbett-Nolan believes successful healthcare must include an enriched mix of private and public healthcare. “It is an undoable task if you don’t work with the private sector. The more the NHS looks in on itself, the harder it will be; now is the time to reach out to other sectors,” he concludes.