If we want decent healthcare it's time for us all to cough up

One minute Adrian Fawcett is managing a giant pubs operator, the next he is supposedly looking after patients.

But when I put this to the General Healthcare Group boss, he grimaces and shakes his head violently.

"A lot from the leisure industry can be applied to health," he says. "They're both multi-disciplinary, they're both about management of multi-sites, buying the right services, facilities management and maintenance." Then he beams. "Even the words have similar origins - from hospital to hospitality is not a big jump."

He was at those aggressive corporates, Ford and Mars too, before Punch. Again, hardly organisations that are associated with caring for people? He disagrees again. "Ford and Mars supplied really good management training. I found myself working with some very good and able colleagues, who went on to do great things, like Allan Leighton, Justin King, David Cheesewright, Sara Weller."

All top of the tree in business but not known for their commitment to the sick. There again, the head of the NHS isn't a doctor either. Nevertheless, it's that profit-seeking element that sticks in the craw of so many. That's because as a nation we like to think of healthcare as ours by right, something we receive more or less for nothing. Yet, it's a constant battle. Only this week a report paints an awful portrait of a health service unable to cope with an ageing population, of elderly patients having to suffer all sorts of indignity and in some cases outright maltreatment.

Instead of the simmering discontent that still surrounds private health firms, Fawcett wants to see a wider acceptance of what his company does, an understanding that public and private can coexist. "What started in 1948, offering healthcare free at the point of care, is struggling to cope." Life expectancy is increasing all the time, so, Fawcett points out that, "in 1981, a 65-year-old man would be expected to live a further 12 years whereas in 2011, he is looking at another 26 years".

He wants to apply to healthcare a lesson learnt from Leighton (who went on to head the Royal Mail), which is "to leave the past behind and concentrate on moving forward" and would prefer it if we stopped dwelling on the roots of the NHS and concentrated on the UK's overall medical need. "It's true," says Fawcett, "we're always compared with a state that aspires to give excellent healthcare to all its citizens but there's also room for vibrant businesses that can provide quicker diagnostics, quicker treatment processes for those who want to pay for them."

General Healthcare operates 75 hospitals with 3000 beds under the BMI Healthcare brand. He trots out the numbers: "We see 1.3 million outpatients every year and 300,000 inpatients. We employ 13,700 staff and have 7000 consultant surgeons. We're twice the size of anybody else. We're opening one hospital on average every 12 weeks." Revenue last year was £855 million, producing earnings of £222 million.

A stock market listing could well be on the cards, although Fawcett would want calmer economic conditions.

What concerns him for now is changing our attitude to companies such as his. During last year's election, General Healthcare even launched its own manifesto, challenging political leaders to debate the NHS and how private firms can meet ever-growing demand. Fawcett points out that we expect to receive an awful lot for virtually nothing - a taxpayer pays on average just under £2000 towards the NHS, this against the backdrop of a service that has seen its budget soar from £40 billion to £130billion over the past 10 years.

The Government's recent White Paper was a step in the right direction, with its emphasis on greater patient choice. But he would like to see patients furnished with information about all the options open to them and tax incentives to encourage them to go private. He wants, above all, to remove the stigma that exists around private health so that, for instance, mobility between the two codes is eased and patients can move from public to private and back again without finding it's difficult to re-enter the NHS. Or that co-paying is seen as standard, so patients pay on top of their NHS care, for medicines or for their own room with extra facilities.

"We have to face the fact that the nation's healthcare cannot be met from the tax system, it's simply unsustainable." And accompanying that, he says, is the fundamental belief that people "should not be penalised for wanting to put their hand in their pocket to try and get the best healthcare they can".

He is also anxious to change the view of those who pay for health insurance of their private healthcare service. For many customers, it's just something which they do as a matter of course, on the assumption they will never have to use it, same as insuring a car or a house. That's where he's determined to improve their experience, which is where his pubs background comes in handy.

Instead of regarding private health as a negative, he is willing us to see it as a positive, to take a keener interest in our healthcare and the various treatments on offer. To that end, General Healthcare has moved strongly into the beauty market, buying a major share in Transform, the plastic surgery chain.

It would please him too if more of us self-paid for healthcare. At present, the UK is low down the league table of countries where people pay cash, rather than rely on insurance cover. In the US and other parts of Europe, patients coughing up for consultations and services themselves, as and when they have them, is standard. Here, it's a relative rarity, except in the non-insurable cosmetic area.

His customer breakdown is 70% insurance, 15% using their own money and 15% sub-contracting for the NHS, as his hospitals assist the stretched service.

That last proportion is significant as it illustrates how public and private can work together to create what he terms "an intelligent partnership".

His aim is for "blurring" between the two, for the one to complement the other and not be seen as competition, or worse, a hindrance. "We can have a symbiotic relationship with the NHS, where we're not seen as somehow just stealing from them."

We have to ask, what do we want, "a giant colossus of an NHS", which just carries on getting bigger, but heaven knows how, or a private service that can alleviate that strain? It's a simple question. Fawcett claims to be able to assist with the answer, if only the powers-that-be would listen.