Private Health Care is expanding… and it’s strength reflects the weakness of the 4 Health Dispensations

The experts on trends in health care, and especially private health care, and Private Medical Insurance (PMI) are Laing and Buisson whose reports cost a great deal.

Their reports into “Private Acute Healthcare, Mental Health Hospitals, Cosmetic Surgery, Children’s HealthCare Services, Digital Health and the UK Healthcare” are all “Market Reports”. This is a market where you pay for what you get, and sometimes for what you cant get. In the case of taxpayers at the peripheries of the country, these lacunae of services are greater than centrally. Especially worrying is the report on Private Acute Healthcare. British citizens may all have to consider choices and whether to travel long distances to centres of excellence, even for emergencies, in the next decade. The figures provided by the BMA in 2018 have got worse, and remember these only apply to England!

Private Health Care is expanding… and it’s strength reflects the weakness of the 4 Health Dispensations, and the hard choices ahead for all of us. With obesity and diabetes the main demands.. But there’s always denial.

See the source image

PressReader and the Independent report 19th Jan 2020: Britons spend more than £1bn on private surgery.

The Nuffield Trust report in 2016 indicated that much more money was needed just to keep up with internationally comparable countries;

Since then (2009) , however, the gap has started to widen (particularly against countries that weathered the global financial crisis better than the UK) and looks set to grow further. UK GDP is forecast to grow in real terms by around 15.2 per cent between 2014/15 and 2020/21. But on current plans2, UK public spending on the NHS will grow by much less: 5.2 per cent. This is equivalent to around £7 billion in real terms – increasing from £135 billion in 2014/15 to £142 billion in 2020/21. As a proportion of GDP it will fall to 6.6 per cent compared to 7.3 per cent in 2014/15. But, if spending kept pace with growth in the economy, by 2020/21 the UK NHS would be spending around £158 billion at today’s prices – £16 billion more than planned.

The London School of Economics opines 1st October 2019: Flawed data? Why NHS spending on the independent sector may actually be much more than 7%

,,,the amount spent by NHS England on the independent sector was around 26% of total expenditure, not 7% as widely reported. 

Cannabis is not a frontline drug, but some people seem to benefit.. Just like with dementia drugs the value is very small.. Andrew Ellson in Jan 2020 reported in the Times; More than a million Britons buying cannabis illegally to treat illness

The French have rationed out dementia drugs, and will be able to give much more care. The same argument may apply for cannabis, depending on numbers, and remember demand always increases once a service is free.

The Scottish Daily Mail (Pressreader) points out that there are 3700 visits to A&E every day (In Scotland alone) which could have been dealt with by GPs is there were enough of them, with enough time and resources. What an incentive to start private general practice.

Mailonline December 2018 reports that: Patients spend a record £1.1BILLION on private healthcare to avoid soaring NHS waiting times which leave them ‘let down and suffering’ and this has been updated for just surgery by the Independent.

The BMA opines 7th Dec 2018 on: Hidden figures: private care in the English NHS (and its got worse since)

Breaking Point, NHS info graphics
Do (ISPs) independent sector providers give good and good value care? NHS spending on (ISPs) independent sector providers keeps increasing.

The health service in England is facing the greatest financial challenge in its history, and yet the independent sector is increasingly involved with the provision of patient care within the NHS.

The English health service is heading towards a projected £30 billion funding gap in 2020/21; the government has committed £10 billion to help mitigate the situation, although the BMA has argued that in real terms, and factoring in the cuts to other services, the figure is closer to £4.5 billion. Within this climate, one of the few areas where funding is increasing is amongst ISPs (independent sector providers) of NHS care.

We want to find out what this means for the provision of patient care.

Key points

Building on our 2016 report on privatisation within the NHS in England we’ve looked into the data behind these headlines.

Our analysis uncovered the following key points:

  • NHS spending on non-NHS and independent sector provision grows each year (there was an increase of £2.6 and £2.1 billion respectively between 2013/14 and 2015/16);
  • The proportion of the total Department of Health budget spent on ISPs is also increasing (from 6.1% in 2013/14 to 7.6% in 2015/16);
  • There needs to be more transparency about the level of private provision of NHS services;
  • The principal area of spending on ISPs is in the community health sector;
  • The NHS relies very heavily on a small number of ISPs despite acknowledged risks from individual ISPs having an excessive market share;
  • CCGs spending a higher proportion of their budget on ISPs received worse ratings from NHS England than their counterparts.

Claire Milne for Full Fact reports before the election on How much public health spending goes to the private sector? 

…..This takes as its starting point the £13.7 billion figure from the DHSC accounts.

The £1.3 billion spent by NHS trusts on services from non-NHS organisations is added to that.

Added to that is the £14 billion the NHS spent on commissioning primary care from the private sector. This includes things like GP services, pharmacies, and opticians. This may not be what everyone things of when they think of the NHS spending money on private providers, but technically they all are. Mr Rowland acknowledges there is “genuine debate” as to whether the provision of GP services fall under private spending “given that they derive almost all their income from the NHS”.

Finally, it includes the £830 million the NHS in England spends on social care services and a lot of these are provided by private organisations.

Another health think tank, the Nuffield Trust, has used a similar method to determine that, over the last decade, between 20% and 22% of annual public spending on health in England has gone towards procuring healthcare services from private providers.

Sensible rationing of dementia drugs – a lead from France

‘Wasteful practice’ CQC says is due to ‘ongoing issues with poor recruitment, training and safeguarding processes’ Private ambulances and Taxis: The Independent reports 27th August 2019. 




This entry was posted in A Personal View, Medical Education, Rationing, 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.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s