Amount of private work NHS hospitals can take to rise from 2% to 49%

vivatifosi

Heard this on the news this morning and just caught it in the press. Thought it would make for an interesting debate:

http://www.bbc.co.uk/news/health-16337904 (it's dreadful)

http://blogs.telegraph.co.uk/news/janetdaley/100126162/let-the-nhs-increase-its-private-earnings-everyone-will-benefit/
(in the spirit of the panto season "oh no it isn't")

corbyboy

I am in the "for" camp for this proposal. The Labour argument is pathetic and full of nonsense as we have come to expect from them.

They keep talking about "half the beds full of private patients" but the proposal is for the 49% limit to represent the income of the hospital, not the number of patients they treat.

And if Labour think there are enough private patients around to fill 49% of hospital beds then they are living in a dream world.

BobQ

corbyboy wrote: »

I am in the "for" camp for this proposal. The Labour argument is pathetic and full of nonsense as we have come to expect from them.

They keep talking about "half the beds full of private patients" but the proposal is for the 49% limit to represent the income of the hospital, not the number of patients they treat.

And if Labour think there are enough private patients around to fill 49% of hospital beds then they are living in a dream world.

If I relied on the NHS rather than Private Healthcare I would still be worried by the development.

While I agree is not related to the number of patients and it is an income maximum, the increase does represent a massive increase in the proportion of income that can be gained by allowing private healthcare providers to use NHS facilities. The question I would ask is whether the intention is to mop up spare capacity and so reduce hospital running costs; or to ration NHS provision via longer waiting lists and giving priority to private healthcare providers.

vivatifosi

I can't imagine paying for a private operation and staying in a shared ward. In that respect I would imagine that a hospital's own facilities cap their own capacity. However DH has before now paid for private nursing (and private room) while having an NHS op and that was a great deal (c£300 per day for two days, op would have been about 5 times that privately).

I'd like to have a better understanding of other (non-US) health systems though, as they seem to work ok and seem to be what this is modelled on.

Graham_Devon

As corbyboy stated, labours argument on this one is pathetic.

49% of income does not mean 49% of beds. Andy Burnham, being the opposition health secretary should know this. Either he doesn't know this, which says a lot about him, or he does know it, but is hoping to stoke fear through spreading malicious lies. I'm betting on the later.

The Royal Marsden hospital is also a good one to look at, as they have been doing this for a while now, and it hasn't affected NHS patients like labour state it will.

michaels

Is there going to be any less money for the state bits because of this? Assuming no, why should it affect what the state bit can provide? Except possibility in a positive way is equipment is more fully utilised and thus the overhead spread over more users. Don't forget that every person in front of you on an NHS weighting list who goes private the sooner you will get your operation.

Kennyboy66

Graham_Devon wrote: »

As corbyboy stated, labours argument on this one is pathetic.

49% of income does not mean 49% of beds. Andy Burnham, being the opposition health secretary should know this. Either he doesn't know this, which says a lot about him, or he does know it, but is hoping to stoke fear through spreading malicious lies. I'm betting on the later.

The Royal Marsden hospital is also a good one to look at, as they have been doing this for a while now, and it hasn't affected NHS patients like labour state it will.

Surely if you wanted a rough proxy on number of patients treated then cost or income would be a reasonable starting point.

Maybe it will work, maybe not, but it seems likely we are heading for an era of vastly increased private health provision or some kind of co- payment system. And to help all this along will be increased waiting times to 'encourage' those who can afford it to go private.

Kennyboy66

michaels wrote: »

Is there going to be any less money for the state bits because of this? Assuming no, why should it affect what the state bit can provide? Except possibility in a positive way is equipment is more fully utilised and thus the overhead spread over more users. Don't forget that every person in front of you on an NHS weighting list who goes private the sooner you will get your operation.

Don't you think all of this is a little naive ?

The number of people who had private health insurance (in dependents) rose from 2.3 million in 1978 to 6.6 million in 1990 (two thirds of this provision is paid or part paid by employers).

It has since fell slightly.

The only way to increase this number (surely the objective) is to make NHS provision worse and waiting lists longer.

Cleaver

My humble opinion is that most patients won't notice much change. The private sector will not want to go within a million miles of 'messy' patient pathways - patients with complex and multiple health and social problems, complicated surgery, palliative care and mental health. Essentially any patient who cannot be put in to a nice, neat treatment path will not be attractive to the private sector.

The private sector will cherry pick the services which are relatively easy, risk free and simple to provide. Surgical procedures with a 'start and end' (hip replacement, ophthalmic surgery etc.) will be the first purchased. Very easy to schedule which means that staff can be utilised and deployed routinely. But better than that is that if you currently get your hip replaced, for example, in a beautful private clinic in rural Berkshire then if something goes wrong then you're maybe 20 miles from the local hospital which is full of the surgeons and anesthetists who will save your life. This new deal is amazing for a private company, as that risk is now mitgaged - they're on your doorstep. I guess the private companies will take the routine medical procedures, radiology and support services etc. as well.

So the only difference I can see is that routine aspects of care will get better as the NHS outsources it, thus selling the family jewels to some extent. The NHS will be left with all the tricky, difficult stuff that costs a lot and is difficult to manage, both in terms of quality and service. Will probably work well for the Torys who will be able to point at what a good job the private sector are doing compared to the NHS, but that'll be more because it's much easier to run a non-emergecy routine foot surgery list than it is to manage a complex mental health service in a low-income area.

Just my two penneth really. Presume we're moving to a more US type system where health care is ace if you can afford it, but isn't even an option to the 25% of society that can't.

Guitar

michaels wrote: »

Don't forget that every person in front of you on an NHS weighting list who goes private the sooner you will get your operation.

But isn't there a waiting list there because the hospital doesn't have the resource to treat all the patients? So in this instance everyone that goes private is just jumping ahead of you in the queue. It would only be an improvement for you if the extra money went into improving capacity.

While the money raised is restricted to investment rather then profit, since many trusts are facing financial difficulties due to the £20 billion the NHS has to save over the next few years, how can we be sure the 'extra' revenue isn't eaten up just keeping the hospital running?

BobQ

Cleaver wrote: »

Just my two penneth really. Presume we're moving to a more US type system where health care is ace if you can afford it, but isn't even an option to the 25% of society that can't.

Yes I think you are right. It seems that the minority who can afford the best treatment have won their argument and the majority who cannot afford it have now convinced themselves they will be content with an inferior service.

I must buy more shares in US inspired healthcare providers, sounds like it will be a very profitable industry in the brave new world.