• Increasingly, though, services provided by the NHS are commissioned by people in the public purse from private companies. So, in some forms of complex care you might find yourself in a private facility, run by a private company, but with everything paid for by the NHS. T**here's no longer a clear-cut distinction between NHS and private. **In fact, the NHS is moving to separate its commissioning functions from its provider functions completely to encourage competition between public providers and private providers.

    True Nigel; had that come about by the nationalisation of private clinics I'd celebrate it; but it's come about by the underhand privatisation of the NHS, so I don't. Anecdotal evidence is always to be treated with caution but I know quite a few GPs none of whom are happy with what's happening and a couple who have direct experience of tendering being rigged to ensure that new practices are run by private companies.

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