The business of healthcare – ethical issues for doctors, vets, and dentists
The third meeting of the Centre for Evidence and Values in Healthcare took place on the 19/6/26 in Edinburgh, just off the Royal Mile. A full capacity audience were treated to views across Edinburgh with the accompanying (sweet) sound of bagpipes drifting in.
The mix of dentists, doctors and veterinarians, secondary care doctors, policymakers, journalists, patients, and lay people, independent experts, and civil servants created a unique and unusual opportunity to discuss, compare, and consider the shared challenges of the three healthcare professions, and crucially what can be learnt from each other.
The Centre was delighted to welcome speaker Professor Emerita Allyson Pollock to deliver the keynote ‘Corporate control and the evolution of General Practice into a business: a historical perspective’. This was an interesting and enlightening presentation retracing the history of the NHS general practice from its inception in 1948, following through to the various amendments to legislation over the years. There was a clear message that a change in law is required to keep private equity out if primary duty is to remain to patients rather than shareholders.
It was a privilege to have such a mix of speakers at the event with diverse expertise, skills, and views. Professor Kevin Orr of the Business School set the scene discussing the difference in theory and practice between the ways that public and private services are delivered. Two vets, Caroline Scobie and Dr Rachel Dean, shared insights into the dilemmas, and stresses caused by working in either a fee-for-service or insurance-based model, and the importance and seriousness of the oath that vets take to ensure health and welfare of animals. Professor David Conway spoke about the inequalities in oral health and in access to dental care. David described how, similar to general practice, small practices have increasingly been bought over by large corporations, sometimes with private equity, which is a potential risk to the delivery of NHS dentistry in Scotland. Dr Chris Johnstone explained his recent research into the GP ‘megapractices’ forming in Scotland; and Dr David Blane who is co-chair of the Deep End project, described ‘proportionate universalism’, the differences between equity and equality, and the ways that primary care can help.
Four engaged and lively group discussions were held in the afternoon discussing the key issues. The outputs will be used for future essay themes. The afternoon also included presentations of prize-winning essays by two medical students from Birmingham, funded by the Della Fish Foundation. It was great to hear from students, at the start of their professional careers, think about the challenges they will face in trying to balance the need to earn money against the choices these bring – especially with the student debt that this generation is likely to be burdened by.
This meeting was truly inter-professional and multidisciplinary with delegates describing the event as ‘epic’, ‘another brilliant event’, ‘inspiring’, and ‘unique’. Thanks as always, go to the Della Fish Foundation for supporting the Centre for Evidence and Values in Healthcare. The Centre was particularly pleased to have Lynne Thorogood, a trustee of Della Fish, choosing to join as a delegate for the event.
Read the full report of the event on the CEVH website.
The next event will be a fully online event on 22nd October entitled Conflicts of Interest in Healthcare: what they are, what do they mean, what can we do about them?