Tom Mihaljevic laughs. “No, we do not charge extra for rooms with a view.” He’s laughing because that view is of Buckingham Palace, and Mihaljevic is the chief executive of the Cleveland Clinic, one of America’s biggest healthcare providers, which is poised to open a state-of-the-art 184-bed hospital on Grosvenor Place, looking out over the palace gardens.
“This is a new model of healthcare,” says Dr Jamanda Haddock, a consultant radiologist at the NHS Royal Free Trust, who is also associate chief of staff at Cleveland.
Amid the gleaming equipment in the vast operating theatres, and along the pristine 29-bed intensive care unit, an array of specialist surgeons drives home that novelty. “In this country, the private sector is relatively limited to what it can do,” says Siva Anandaciva, chief analyst with the King’s Fund think tank. “High-volume, low-capacity procedures.” He’s talking about usually straightforward operations – such as hip replacements or cosmetic surgery. Really complex interventions, on the other hand, are the preserve of NHS England, with its £136 billion budget.
But the Cleveland Clinic is different. “We expect to be able to see to all the medical needs of our patients,” says Brian Donley, an American orthopaedic surgeon who is running the Cleveland’s London offshoot. As Mihaljevic boasts, the new hospital will push the boundaries of what is possible. “We are where people come when they have no hope,” he says.
“We care for the sickest of the sick.” Anandaciva concurs. “They are absolutely mind-blowing.” So, after decades on the fringes of British healthcare, are private providers finally about to challenge the very essence of NHS provision? And in a nation where, as then chancellor Nigel Lawson put it in 1982, “the NHS is the closest thing the English have to a religion”, will their efforts be regarded as epiphany or blasphemy?
Either way, there is no debate about the scale of NHS waiting lists. The latest figures show that a record 6.1 million patients – one in nine of the English population – are awaiting treatment. The median delay is about three months. A quarter wait more than six months. But for hundreds of thousands it is much longer. At the end of January, some 311,528 patients had been waiting more than a year, and 23,778 more than two. Such figures are chipping away at that celebrated public faith in the NHS. According to a major recent survey by the Health Foundation, some 56 per cent think NHS performance has got worse in the last 12 months, and 42 per cent predict it will get worse this year.
