<P> Social care will cost more in future according to research by Liverpool University, University College London, and others and higher investment are needed . Professor Helen Stokes - Lampard of the Royal College of GPs said, "It's a great testament to medical research, and the NHS, that we are living longer--but we need to ensure that our patients are living longer with a good quality of life . For this to happen we need a properly funded, properly staffed health and social care sector with general practice, hospitals and social care all working together--and all communicating well with each other, in the best interests of delivering safe care to all our patients ." </P> <P> Rising social costs have led to a significant increase in the time between patients being declared "medically fit" and finding social care placements in many cases. . </P> <P> Although the NHS routinely outsources the equipment and products that it uses and dentistry, eye care, pharmacy and most GP practices have always been provided by the private sector, the outsourcing of hospital health care has always been controversial . </P> <P> According to a BMA survey over two - thirds of doctors are fairly uncomfortable or very uncomfortable about the independent sector providing NHS services . The BMA believes it is important the independent sector is held to the same standards as the NHS when giving NHS care . The BMA recommends: data collection, through impact analysis before independent providers are accepted to ensure existing NHS services are not disrupted, risk assessment to find out likely results if NHS staff are unwilling to transfer to the private sector, transparent reporting by the private sector of patient safety and performance, independent providers should be regulated like NHS providers, patients should be protected if independent providers terminate a contract early, transfers from independent providers to the NHS should be regularly reviewed to establish how much this costs the NHS, private sector contracts should be amended so private sector providers contribute to the cost of staff training financially or by providing training opportunities . There were renewed calls for transparent reporting in the private sector following Ian Patterson's criminal conviction for wounding private sector patients by carrying out unnecessary operations . </P>

Which one of the following is not a key issue of health systems