Jim

I guess you need to decide whether Mr and Mrs Taxpayer want to pay for tattoo removal, obesity services, varicose veins and other elective care. If you do not, there is no harm in having a private system to offer those services, especially if you are training medical staff- how will they learn to do these procedures unless somebody in town is offering the service.

IME the best doctors are unlikely to abandon your public system and move in droves to private unless you are being stupid and paying so much less in public than in private that you drive them out. I say this for a simple reason: the comradery and intellectual challenge of "tough cases" is a major driver for physicians; in a mixed system these cases are unlikely to be offered in private for reasons of cost. So you can expect mixed public/private service from your physicians.

Regards

JR