It’s hard to stand beside a hospital bed and not feel utterly helpless when the person lying there is someone you love. I’ve been in that place more than once. I lost my wife to complications during a Caesarean section. It was a wound that never fully healed. And just days ago, I came perilously close to reliving that nightmare, this time with a family friend.
She was in labour for hours, a dangerously prolonged one. The baby, it turned out, was in the occiput posterior position, which should have been detected before active labour even began. But a scan wasn’t done. Not because the technology wasn’t there, but because someone somewhere had probably deemed it unnecessary. The result? A rushed emergency C-section that barely saved her life. And once again, I was forced to confront an unsettling truth - some lives in hospitals come second to profits.
This incident reignited a belief I’ve long held: healthcare should never be a business. And the recently published study in The Lancet Public Health by Benjamin Goodair and Aaron Reeves gives that belief a solid, evidence-backed foundation.
The Profit Motive vs. The Patient’s Life
The study, a systematic review of health-care privatisation and its impact on care quality, takes a hard look at hospitals that have shifted from public to private ownership. The findings? Staggering. Almost uniformly, the transition to for-profit status resulted in lower quality of care, worse health outcomes, fewer staff, and increased mortality rates from treatable conditions.
Let that sink in. In countries like the U.S., England, Germany, and even Sweden, outsourcing hospital functions, from cleaning to core care, correlated with rising avoidable deaths and reduced access to services for patients deemed less profitable. In fact, hospitals were found to intentionally adjust their patient mix, accepting more patients with good insurance and turning away those who relied on Medicaid or other less lucrative options.
If you ever thought healthcare was too important to be left to market forces, the data screams it louder than ever. The market doesn't care about the mother in labour who can’t afford a private scan.
Staffing Cuts That Cost Lives
One of the most striking revelations in the Lancet review is how quickly privatised hospitals start slashing staff. Studies included in the review noted a sharp decline in the number of nurses and support personnel, particularly those with the highest qualifications. Why? Because quality care costs money. And in a for-profit model, costs are the enemy of profit.
Yet, it’s precisely that highly trained nurse, that extra set of eyes, or that attentive cleaning crew that makes the difference between life and death, especially in complex situations like childbirth. When I watched that family friend almost slip through the cracks, I couldn’t help but wonder, was her care team stretched too thin? Was the scan skipped because of overwork or underfunding? The science tells us: probably yes, if profit had anything to do with it.
Outsourcing Care, Outsourcing Accountability
The review also shows how outsourcing even non-medical functions like cleaning can elevate infection rates in hospitals. One study from England linked outsourced hospital cleaning to a rise in MRSA infections, a bacteria that thrives in poorly sanitized environments. In another case, mortality rates rose among prisoners in the U.S. as more of their healthcare was handed over to private contractors.
Privatization, it seems, doesn’t just outsource services, it outsources accountability. The more layers between the patient and the ultimate decision-maker, the more room for negligence, corner-cutting, and life-threatening errors.
And while advocates of privatisation argue that competition will drive quality, the Lancet authors caution that there’s little evidence to support this in health care. Unlike other industries, healthcare outcomes aren’t always visible or easily measured and competition often leads to obscuring data rather than improving it. Hospitals compete on costs, not on whether patients live or die.
A Nigerian Lens on a Global Problem
If this is the case in high-income countries with relatively strong regulatory oversight, imagine what this means in places like Nigeria. We already deal with understaffed hospitals, crumbling infrastructure, and medical brain drain. Adding profit motives to that mix is a recipe for disaster. Here, where data systems are poor and accountability is weak, privatisation could magnify inequalities and increase avoidable deaths, especially for the economically disadvantaged.
We’ve seen cases where doctors skip essential procedures, or where diagnostics are ignored to manage costs. My wife’s case, and the recent brush with death from a mismanaged labour, are not isolated. They’re echoes in a system where profits can sometimes whisper louder than patient outcomes.
A Better Way Forward
This isn't to say the public system is flawless. But the answer is not to privatise but to fund, reform, and build accountability into public systems. The Lancet study suggests that not-for-profit transitions may fare slightly better than for-profit ones, but even they tend to mirror profit-driven behavior under financial pressure. True reform must come from systems designed around health as a human right, not healthcare as a commodity.
Governments need to invest in preventive care, staff retention, data transparency, and infrastructural upgrades. Patients must be empowered to demand better. And perhaps most importantly, we as a society must confront the dangerous illusion that privatising healthcare equals efficiency. It doesn't. Not when lives are at stake.
My Signing Off
When I buried my wife, I thought that was the end of my trauma with childbirth and medical negligence. But standing in that hospital corridor about a week ago, holding my breath as another woman I cared about underwent an emergency C-section, I realised that the battle is far from over.
Hospitals should be sanctuaries, not business enterprises. And the latest science finally gives my grief a voice grounded in data. It’s not just a personal opinion anymore.
It’s public health fact.
Resources
- The Lancet Public Health – Health-care privatisation and mortality: a systematic review of observational studies
- World Health Organization (WHO) – Universal Health Coverage
- Health Affairs – The Pitfalls of Profit-Driven Health Care
- National Institutes of Health – Impact of hospital ownership on care outcomes
- Commonwealth Fund – Comparing Healthcare Systems Across High-Income Countries