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Have the new UK ministers that you mentioned shown an interest in visiting the facility and seeing for themselves what is happening?

Thank you very much and good morning to the witnesses. I am already learning a lot, so thank you very much for the evidence that you have been giving.

The issue of private diagnosis has come up a couple of times in the conversation already, and I wanted to ask some specific questions about that. We have heard the reasons why diagnosis is so important. We have heard the fact that private diagnosis may be quicker and easier to achieve if someone has the money. I am not quite clear whether that is entirely because of capacity in the private sector or whether it is because of different practices in the private sector.

We have heard about the unfairness and the amount of money that getting a private diagnosis costs. Mark McDonald mentioned people moving into significant debt because of that. He also used the phrase “wild west” with regard to the variation in standards, what private diagnosis consists of and whether it is recognised in other services. In the written evidence, we also see a big variation in what it costs and in the prices involved. Again, I am not clear on the reasons for that.

Can I ask you to either comment about the current situation or, ideally, say what the role of private diagnosis should be? Who would like to kick off?

I get the point, and I share that concern. However, I am also aware of other evidence that we have heard, especially in our earlier session, that many people who do not have access to the NHS find themselves being forced to go private and so going into debt. It seems to me that an approach that would involve contracting externally to the NHS, would not involve fees for individuals and families, and had an agreed standard of delivery so that its diagnoses would be recognised would feel better than what we have now.

Thank you all very much. That is really helpful.

Can I ask you to say a little more about the variation within private provision? You have talked about quality, but there is also the price variation. How does that compare with the cost to the NHS of NHS diagnosis? We can acknowledge that somebody else is paying for it—the taxpayer is paying in one case and the individual is paying in the other—but does the cost of providing the service compare between the private sector and the NHS?

Thank you. Do any of the other witnesses want to talk about any aspects of this general theme of private provision?

Dani Cosgrove, do you want to come in?

May I check? Do you mean that some of the private providers are doing NHS work and private work?

The follow-up questions that I had about the variation in standards were mostly addressed, and there were also some comments about the desire for some clarity and consistency around shared care agreements.

My last question on this theme is this: if—and it is a big if—we need to use capacity outside the NHS to bridge the gap between the capacity and the demand that is there at the moment, is there a case for saying that that external capacity should be located in the third sector and that there should be an agreement between NHS providers and voluntary not-for-profit organisations that could operate to an agreed standard for an agreed price? That would be private in the sense that it is not the NHS, but it would not be paid for by individuals. Would that increase the capacity across the sector to meet demand more affordably and inclusively?

Good morning. My question is on aspects that are quite close to what you have just covered in your answers.

I go back to Matthew Day’s comment, right at the start of our discussion, about his organisation’s experience. Matthew, forgive me if I picked it up wrongly, but it sounded as though you said that you were being used to clear the backlog but were then dropped because the funding had ended, and that there was some frustration around that. However, at the same time, I hear from witnesses that voluntary sector, third sector or community-based organisations can be really effective at joining the dots across the various forms of support that people need—and do so in a much more inclusive way that we might wish the NHS would deliver, but which is not happening.

During the rest of the committee’s inquiry, and when we put questions to other witnesses, should we ask whether the voluntary sector should be given not just a temporary role to clear the backlog but an on-going, long-term role to deliver assessments and diagnoses in concert with other forms of support? Should we explore whether the voluntary sector could be effective not only in clearing the backlog but also in the long term? Should we consider whether it could meet people’s needs not only in relation to assessment and diagnostic issues but more widely and holistically, and whether that approach could be cost effective when compared with scaling up capacity in the NHS?