Just when the government is discussing the right mix of public, private and charity sector provision i n health, fly on the wall spy camera documentaries reveal cases of private sector maltreatment or poor performance. Channel Four does do a similar operation on an NHS hospital and shows some nurses in a bad light, but it does not have the same impact.
I fear there are cases of poor treatment, abuse of patients, low quality care and inefficiency in both the private and public sectors. The BBC treats these very differently. They rightly gave tough interviews to private sector institutions that had performed badly, not letting them off the hook. Yet when it came to the Care Quality Commission, the public sector regulator of care , they were asked by the Today programme if they had insufficient funding and insufficient people to monitor and control the wicked private sector.
The provision of public service in the UK is much more complex than a simple division into public and private would suggest. The NHS relies on for profit drug companies to supply the treatments. It relies on private sector businesses to supply everything from bandages to replacement body parts, from crutches to ear grommets. Many GPs are private sector contractors, and the NHS now contracts out some operations and medical treatments to private sector institutions.
Public service in the UK is supplied by a mixture of monopolies and competitive businesses, by a mixture of institutions employing public sector and private sector employees, and mixture of provision between free at the point of use and customers paying for what they need. The NHS itself is largely monopoly but now contains competitive elements. It is largely free at the point of use, but charges many for prescriptions, dentistry and glasses. Private companies deliver cleaning and catering, banking and consultancy to it.
It is high time journalists accepted that the public and private sectors are much more muddled up and interwoven than they often allow, and important that we should recognise that both the public and private sectors can do a bad job. It would help the public debate if we had more fly on the wall documentaries about parts of the public sector.When it comes to health, we should remember the dominance of public provision, and expect more exposure of what they are up to.