Page last updated at 00:03 GMT, Tuesday, 2 December 2008

Patients going 'private' on NHS

By Nick Triggle
Health reporter, BBC News

Patients have been given choice over where they go since 2006

Thousands of patients a month in England are using a government reform to get what is effectively private treatment paid for by the taxpayer.

Patients have the right to opt for any NHS hospital or private unit that can offer the care at NHS cost.

In little over 12 months, the number opting for private hospitals has risen 10-fold to over 3,500 a month.

Doctors said patients needed to think carefully as vital NHS money was being lost to private health providers.

Patient choice was launched at the start of 2006 to give people the right to choose where they have non-emergency treatment such as hip and knee operations.

It is good patients are being offered this choice, but I think it is a sad reflection of the state of NHS hospitals
Joyce Robins, of Patient Concern

Ministers also allowed private hospitals to be added into the mix where they could provide treatment at NHS cost.

It was felt the policy was a way of driving up standards by getting hospitals to compete for patients.

In the early summer of 2007 just over 300 patients a month were opting for NHS care at a private hospital.

But in September this year the monthly figure had risen to 3,634, costing the NHS 7.6m in fees to private hospitals - although it still represents less than 1% of overall non-emergency treatment.

While patients using private hospitals do not have access to any drugs or implants not available on the NHS, they benefit from the individual rooms, free parking, lower rate of hospital infections and higher staff-to-patient ratios that are commonplace.

Private health care providers told the BBC they now viewed the NHS market as a key source of work at a time when the amount of money coming from private payers was falling.

The flood of hospitals agreeing to NHS prices means there are now 147 on the approved list.


Australian firm Ramsay Healthcare, which has over 20 hospitals on the list, said the prospect of getting NHS money was one of the key reasons they bought their way into the English market a year ago.

Firms have also started advertising their service to GPs - who are responsible for helping people choose which hospital they go to - as well as marketing direct to patients.

But the moves have caused concern among those working in the health service.

Jacky Davis, co-chair of the NHS Consultants' Association and senior member of the British Medical Association, said patients needed to be told about the consequences of their choices.

"This is money that is being lost from the NHS.

"That can compromise services and patients should be told that by going private in this way they are potentially putting care they may need in the future under pressure."

Nigel Edwards, director of policy at the NHS Confederation, said in principle he was in favour of giving patients choice.

But he agreed as money now follows the patient around the system it could leave some hospitals with cash shortages.

But he added: "It won't be catastrophic, but some trusts could find it difficult."

And Joyce Robins, of Patient Concern, said: "It is good patients are being offered this choice, but I think it is a sad reflection of the state of NHS hospitals."

But a Department of Health spokesman said: "Choice gives providers the incentive to tailor services to the needs and preferences of patients which, in turn, will lead to better outcomes and the reduction of health inequalities."

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