THE Health Department’s tender notice is the clearest possible evidence that it is not going to be diverted from its plans to introduce more private providers into the NHS.

Coming after a week of debate at the British Medical Association’s annual representative meeting in Belfast, where doctors made clear their objections to this policy — and their determination to campaign against it — the call for tenders is also a sharp rebuff to health professionals.

The chairman of the BMA Council, James Johnson, singled out the privatisation of commissioning as totally unacceptable, the point at which the association should “draw a line in the sand”. The Government has now kicked the sand in the profession’s face.

Mr Johnson’s point was that if private companies plan, organise and pay for care (the process known as commissioning), and at the same time run hospitals or treatment centres, there will be a clear conflict of interest. They will be able to dish out public money with one hand and collect it with the other.

The Government believes that the NHS is structurally inefficient, and needs private knowhow to ginger it up. That private companies will have to take a slice of the money in the form of profit is a small price to pay for greater efficiency and productivity.

The Government has a point: most people shop at Tesco, not the Co-Op.

But healthcare is different, say the objectors. Private companies that attract more customers make more money: NHS hospitals that do go bust.

Are there companies capable of doing the job? There are certainly health management companies in the United States that have the knowhow. But they have failed to control soaring health costs, and are deeply unpopular with both doctors and patients.

There is, of course, a barely hidden agenda behind the Government’s plans.

Where the independent sector treatment centres were meant to break the power of the consultants to control waiting lists, the greater involvement of the private sector in other parts of the service is meant to destroy the cosy relationships that ministers believe slow down change and discourage new initiatives. Primary care trusts have failed to curb the power of the hospitals, despite holding the purse strings. Control of the budget has not brought the changes in patterns of care that the PCTs were meant to generate. The whole PCT experiment has failed, at huge expense.

So the new plan is to give power over budgets to GPs, who have a vested interest in preventing all the money from being swallowed by hospitals. Unfortunately, it is not at all clear that GPs want the hassle.

So the Government is seeking private companies to take on the job. It is the last throw of a Government that talks reform, but merely delivers reorganisation.

The doctors and nurses may rail, but they should try, sometimes, to see it from the taxpayer’s point of view.

Doubling the input for a relatively modest improvement in output increasingly looks like a rotten deal. It is not one a private company would tolerate.

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