Mr. Edward Mathews:

To address whether public and private health care is value for money, it is a misnomer that private health care is cheaper health care. In research we conducted when preparing a health strategy statement for our organisation for the consideration of the public, and in our submissions to the committee and other interested parties, we have looked at the delivery of health care across multiple jurisdictions. One does not have to look too far. One can look to the west to the United States that has a predominance of private health care within the delivery of health care that has resulted in a huge increase and a disproportionate actual expenditure on health care versus a very low delivery.

Let us consider the United Kingdom and the commissioning of care in the private sector. The Care Quality Commission in the United Kingdom has recently sounded significant notes of caution about the ability to regulate and the quality of care being delivered in that jurisdiction arising from expenditure in the private sector. There is also the research in the United Kingdom that points quite clearly towards the fact it is more expensive to deliver care in the private sector.

Professionals who deliver care in the private sector must be procured from an international labour market so they will not be paid a lower rate. In the private sector increased sign-on bonuses are now being offered to registered nurses and midwives that draw recruits away from the public service and into the private sector. The amount paid to the staff will remain the same.

The extracted profit is the raison d'êtrefor a business delivering a service. There is no ability, in the same manner, to regulate the delivery of care. We do not believe that the value for money argument holds water. If one says one gets greater value for money, we believe that research shows that it costs more. We believe that the labour market does not support paying people less to deliver the service and, therefore, why should the State be funding an additional layer of expenditure, which is the profit margin involved? We have no difficulty with profit margins in a general sense but we are here to deliver a health service to the nation, to maintain the health of the nation and to improve the health of the nation. I believe we are illegitimately spending additional money to do so. We do not have any reasonable value-for-money analysis that can point to either higher quality or reduced cost and, therefore, the State should deliver it on a direct employment basis.

I shall hand over to my colleagues who will address additional points.