Shadow health minister Jamie Reed blames spending cuts for increase in ‘self-pay’
By Hui Shan Khoo and Tim Wood | 7 January 2013
“Private-hospital groups suggest that rising NHS waiting lists are a significant factor in the increase in their self-pay patients” – Philip Blackburn, economist, Laing and Buisson
Ministers stand accused of driving people to the private sector for medical treatment because of longer waiting times in the UK’s National Health Service.
Jamie Reed, shadow health minister, is blaming spending cuts in the NHS for forcing patients to pay privately for one-off procedures.
His comments come as new research shows that while private health-care overall has remained static in the three years since 2009, this sector of the industry – known as “self-pay” – has grown by 14 per cent in the same period.
Spending on self-pay rose by £33 million in that time, an increase of nearly six per cent. The same period saw a seven per cent fall in spending on private medical insurance.
Reed told Exaro: “Older people are, sadly, being hit hardest because cataract, hip and knee replacements are among the services most commonly rationed.”
He blamed the prime minister personally. “On David Cameron’s watch, more patients are making the agonising choice of paying to go private.”
Jeremy Hunt, health secretary in the Conservative-led coalition government, insists that NHS is maintaining spending overall, but is seeking efficiency savings throughout the service.
A report by Laing and Buisson, a leading source of data on the UK’s health-care market, reveals the growth in self-pay, saying: “Overall, in the last three years (2009-2011 inclusive), self-pay revenues for independent, acute hospitals increased by an estimated 14% in real terms.”
It points out that the increase has “bucked” poor economic conditions, suggesting that “non-economic drivers”, such as long NHS queues, are the cause.
The report said: “Private self-pay decisions can be particularly sensitive to NHS performance because they are typically made at a time when treatment is needed to cure an acute condition, which requires immediate attention.”
NetDoctor, a website that offers medical advice, gives a price guide for typical self-pay surgery. Fees for a hip replacement start at £8,200, a hernia repair at £1,650 and £300 is the minimum quoted for the removal of a mole. The average cost of a private consultation is put at £150.
Philip Blackburn, an economist at Laing and Buisson and author of the report, told Exaro: “Private-hospital groups suggest that rising NHS waiting lists are a significant factor in the increase in their self-pay patients and revenues.
“Other factors that contributed to good growth in this area are the development of certain private areas such as cosmetics, fertility and cancer, and an increase in marketing by private-hospital groups.
“Anecdotal evidence from trusts also suggests that people are no longer covered by the NHS for minor surgical treatments and acute medicine because of budget constraints.
“Low priority services are cut first, so there is limited service offered by the NHS. People are directed to the community rather than NHS hospitals.”
Several private health companies, including BMI Healthcare, HCA Hospitals, Ramsay Health Care and Spire Healthcare, reported growth in self-pay.
Spire Healthcare said in its annual review for 2011 that the demand for procedures from self-pay customers increased as “the proportion of longer [NHS] waits increased materially.”
The report added: “We also expect volumes in the self-pay market to continue to improve, driven, at least in part, by the NHS rationing the procedures that it undertakes.”
Netcare, which owns just over half of BMI Healthcare, said that growth in self-pay revenue in 2012 was “driven by NHS waiting times increasing further because of financial constraints and regulatory changes in the health-care sector.”
Latest figures from the Department of Health show that in October 24,735 patients had waited for more than 18 weeks to be referred for treatment. This compares with a figure of 20,662 at the time of the election in May 2010.
A department spokeswoman said: “Waiting times are important to patients, and remain a high priority for us. Waiting times are low and stable.
“The numbers of people waiting more than 26 and 52 weeks to start treatment are at the lowest level since records began. There could be no clearer sign that the NHS is taking patients’ experience seriously.”