The NHS, the private sector, and the virtual asylum

摘要

The British government is promoting close cooperation between the NHS and the private sector. In mental health care, an outcry over conditions in private "madhouses" led to legislation and the establishment of county asylums in the early 19th century, almost eliminating private care. The number of beds for people with mental illness in the NHS dropped from a peak of 148 000 in 1954 to 35 740 in 2000. As this decline accelerated, a thriving private market in the provision of beds for long stay patients emerged. It is time to consider the consequences.