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Government 'illogical' to block co-payments in NHS

22 July 2010 Breaking News

The government must broaden the funding base for healthcare by allowing co-payments, according to the chief executive of Britain's largest private hospital group.

Adrian Fawcett, chief executive of General Healthcare Group (owner of BMI Healthcare), told the thinktank Reform's conference today that "allowing people to contribute for themselves must be the logical way forward to increase the funding base."

He said: "It seems illogical to reorganise the NHS around freedom of choice yet continue to prevent people from topping up by removing their entire NHS entitlement if they do."

Fawcett warned that the self-pay market has effectively halved over the past three years, increasing the burden on the NHS.

Current Department of Health guidance states that patients will not be denied access to NHS care if they choose to privately purchase elements not funded by the NHS (such as certain cancer drugs not approved by NICE) but that the care must be delivered separately to avoid the NHS subsidising private healthcare.

Choice and competition

Discussing the potential impact of the new government's move to increase competition in the NHS, as outlined in last week's white paper, other speakers warned that it would not be a panacea for the problems faced by the NHS.

Lord Warner, a former health minister under the Labour government, said there was a "growing appetite" for choice among the public but that this was frustrated by inadequate information and insufficient diversity of providers.

However, Mark Pearson, head of the health division at the Organisation for Economic Co-operation and Development (OECD), questioned whether giving patients information on quality had an impact on healthcare systems, raising questions for those private hospital groups who have called for more transparent data on quality to demonstrate the value of their services.

"Patients value choice very much, but most often choose to be treated by local providers and seldom use information on quality," he said. "Worse, extended user choice of providers and high density of physicians favours induced demand, leading to physicians becoming more responsive to medically unjustified demands from patients, who can shop around until they find the provider responding to their wishes."

He pointed to the fact that insurance companies in Europe are now trying to steer patient choice by providing them with incentives to register with a primary doctor acting as a gate-keeper.

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