JULIA EADIE doesn’t feel she jumped ship or let the side down by switching from a public-sector career to join Netcare, one of the world’s largest private hospital operators.

“I don’t feel there is any contradiction between my commitment to the NHS and my working for a private health provider,” said Eadie, operations director at Netcare. “I have an impact on NHS patients every day.”

Netcare was created in South Africa and brought into Britain in September 2003 by the Labour government as part of its policy for cutting waiting lists. The company is contracted to perform operations on NHS patients in newly built private hospitals. Their treatment is free.

Eadie, now 45, started her training as a nurse in the Royal London Hospital at 18. She remained on NHS wards into her thirties when she became a nurse tutor. “I liked working with nurses who had completed their basic training but needed to keep up to date,” she said.

Eadie was awarded an NHS bursary and took an MBA at Henley Management College. “This was very interesting because it was just at the time that market forces and the private sector were being introduced to the NHS.

“It was good to learn how the private sector deals with complex business issues and that there are different ways of delivering care,” she said.

She worked for the Department of Health, where she helped to draw up policies on controversial matters such as bringing in medical teams from abroad. She was also involved in the flip side of that practice — commissioning treatment for NHS patients abroad. Several hundred patients were treated in Europe in 2002 during the first attempts to reduce the waiting lists.

Netcare’s brief was to devise different ways of delivering healthcare and so help to cut waiting lists. “I don’t want to knock the NHS,” said Eadie, “but the fact that we have waiting-list issues and capacity issues means there is room for improvement.”

One problem the NHS has faced for years is that operations have to be cancelled at short notice because of emergencies such as car crashes. This can be very distressing to patients who are not critically ill but may, for example, have a very painful hip.

“The private sector can take this disruption out of the system,” said Eadie. In the private centres, Netcare does only non-emergency surgery like hip replacements, which can be scheduled well ahead. “The emergency work is still done at NHS hospitals. This removes the main cause for the cancellation of operations,” she said.

The private health companies can also experiment with different ways of providing treatment. “We have been exploding some old myths along the way,” said Eadie “People said that patients would not want to use a mobile unit for dealing with cataracts. Our experience has been that patients find the state-of-the-art mobile units very acceptable. They are now working all over England.

“The doubters said that patients would not want to turn up for hip-replacement operations on a Sunday afternoon. We have showed that they are more than willing to do that,” she said.

Netcare is now providing hip replacement, ear, nose and throat and cataract operations under contract to the NHS. The contracts have been put out to competitive tender to any of the 11 private health companies in the UK who wish to make a bid.

Eadie would not go into the cost per operation on the grounds that this is commercially sensitive information but she said the tendering process should rule out the possibility of any private companies making large profits.

And have the waiting lists fallen? “Yes,” said Eadie. “They have fallen across England from 2002 — when some of them had been as high as 6 months — to 18 weeks in 2005. The government target is to cut the total waiting times to 8 weeks by 2008.

The total number of patients waiting to be admitted to NHS hospitals in England at the end of March 2006 was 784,500; a decrease of 5,200 (0.7%) since the end of February 2006 and a fall of 37,200 (4.5%) since March 2005.

Eadie is confident that the changes in the NHS will continue now that waiting-list management has been successful.

“I don’t think you can ever go back in things like this and I am not sure whether the NHS would want to.

“People travel a lot and they do raise questions about what happens in other countries. They feel that the NHS should be able to adopt good practice from abroad.”

Not everyone agrees with her that the NHS is on the right track. Just last week, in a scathing attack on the financial management of the NHS, a senior medical figure, Paul Miller, chairman of the British Medical Association’s Consultants Committee, said the use of new private hospitals was costly and that the extra capacity had been neither used nor needed.

Before joining Netcare in January 2004, Eadie was working for the Chief Medical Officer's department as one of his business managers. She knows that it sounds bad but she did not go through a lot of soul searching. She wanted a new challenge.

“It was a personal decision for me,” she said. “I wanted to get back into healthcare, to be near the coal face again and part of the change that was going to happen.”

She would not reveal her salary after switching to the private sector, but said it had increased by 33% when the performance bonus was taken into account. Executives working for Netcare at her level can expect to earn salaries of more than £80,000.

“I had to freeze my 20 years of public-sector pension from the NHS and the civil service. I have a good company pension scheme and I have also made private pension arrangements.

“Contrary to what many people think, private health companies are not profligate with their money. One of the reasons that Netcare has been successful is that it values its money and its people. Its pricing is keen and that is okay for me.

I admire businesses where that happens.”

Eadie has no regrets about her move. She points out that her current job is about delivering good-quality care to NHS patients and this has always been her motivation.

“I don't think I have strayed too far from my roots when I trained as a nurse,” she said.

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