Americans hold keys to London’s hospitals for the rich and famous

The Times Andrew Clark Deputy business editor reports 10th June 2013:

“Offering private rooms, gourmet food and impeccable discretion, London’s private hospitals attract wealthy patients from around the world — yet a single American multinational controls the lion’s share of the capital’s medical industry, according to the Competition Commission.

HCA, a Wall Street-listed company based in Tennessee, accounts for more than half of the private hospital beds and treatment rooms in London, including many addresses along Harley Street, and has been accused of seeking deals with medical insurers that “lock out” competitors.”….

Its worth reflecting on why people go privately, and that 6% of Londoners, 8% of people nationally and about 10% in my area have PMI (Private Medical Insurance). Of course if you are super rich then you don’t need insurance at all – you just pay. But what are they paying for?

Firstly choice of Hospital and Surgeon.

Secondly personalised care.

Thirdly, timing of their choosing: they will not be cancelled due to “emergencies” as the Regional Health Service does these..

Fourthly, less iatrogenesis (doctor and hospital related diseases and complications of treatment) such as MRSA and Clostridium Difficile.

So “You get what you pay for” (Andrew Clark The Times 10th June 2013.

And what are the disadvantages? Over investigation, over treatment and prolonged follow-up are all perversely more incentivized in the private system, but they probably rarely happen.

As a self-employed GP I was booked in for a hip replacement some years ago in the Welsh Health Service. I signed the agreement for a locum on the Monday of the week the operation was “arranged” but I was cancelled due to “an emergency – a lady with an infected hip who cannot wait, and the managers have instructed me to fit her in” (my surgeon on the phone). My operation was “postponed” but I had to face the problem of the already contracted locum. When I asked how long I would have to wait it was “uncertain”, and could be as long as a month. What did I do? I went privately as the cost of the operation was about equal to the money that would be lost by hiring a locum unnecessarily… The Health Service is not designed for self-employed people: is there a case for treating them differently once waiting lists become lengthy..? Should the regional Health Services aspire to private standards? If so, commissioners will need to think about the physical separation of the planned from the acute …


This entry was posted in A Personal View, Commissioning, Perverse Incentives, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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