Hospitals rely increasingly on income from fee-paying patients, warns BMA report


Hospitals in England are increasingly relying on income from fee-paying patients, as NHS budget pressures continue to mount.

One in six hospitals in England has expanded private treatment options this year, with critics warning that a “two-tier” NHS, in which those who can afford to pay get the quickest and best treatment, could already a reality.

Trust managers claim that paying patients are not allowed to “jump the queue” for services, but doctors say that the practice “undermines the principle of equity that should be at the heart of the NHS”.

Most NHS trusts already offer some private services to their patients but new figures obtained in an investigation by the British Medical Journal reveal that the range of treatments available has expanded as cost pressures on the health service increase.

Changes to Government rules under the Coalition mean that hospitals are allowed to up to raise 49 per cent of funds through non-NHS work – a huge increase on the 2 per cent cap set by the Labour government.

Twenty-one trusts added new private treatments for 2013-14 – often euphemistically categorised as “self-funded” services. Ninety per cent of NHS trusts already offer some form of private service to patients – often for treatments that are no longer available on the NHS, or have long waiting lists or high treatment thresholds.

Paul Flynn, chairman of the British Medical Association’s Consultants Committee, said that the schemes might be adversely affecting the majority of non-fee paying NHS patients.

“The BMA has concerns about self-funding, as it could create a two tier system whereby some patients can get treatments that others can’t because they can afford to pay for it. This undermines the principle of equity that should be at the heart of the NHS,” he told the BMJ. “We wouldn’t want NHS [hospitals] to be taking on significant numbers of self-paying patients, as this could impact on the services offered to NHS patients.

“We would also be concerned if self-paying patients jumped ahead of NHS patients due to the fact that they are paying for treatment.”

Among the hospitals that have expanded self-funded services this year are Epsom and St Helier University NHS Trust, which was one of the first to offer IVF to paying patients and Homerton University Hospital NHS Foundation Trust, which offers self-funding options to patients who “do not meet eligibility criteria for NHS funded treatment, or do not want to wait for NHS funding to become available.

Other treatments being self-funded included screening for hereditary diseases, MRI scans and vasectomies.

Fees for self-funded treatments are determined by what the cost would have been to the NHS, which is often less expensive than that offered by private healthcare companies.

The findings come a week after health leaders admitted the NHS was facing a funding gap of £30bn by 2020.

A spokesman for NHS England, said, “Access to NHS services is based on clinical need, not an individual’s ability to pay. NHS trusts and foundation trusts are permitted to offer private services to patients, provided that any such services do not interfere with their obligations to NHS patients.”

Arts and Entertainment
tvThe C-Word, TV review
Arts and Entertainment
The Ridiculous Six has been produced by Adam Sandler, who also stars in it
filmNew controversy after nine Native American actors walked off set
Danny Jones was in the Wales squad for the 2013 World Cup
rugby leagueKeighley Cougars half-back was taken off after just four minutes
Life and Style
The original ZX Spectrum was simple to plug into your TV and get playing on
techThirty years on, the ZX Spectrum is back, after a fashion
Life and Style
ebookNow available in paperback
ebookPart of The Independent’s new eBook series The Great Composers
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Senior Digital Marketing Consultant

    £28000 - £45000 per annum: Recruitment Genius: A Senior Digital Marketing Cons...

    Recruitment Genius: Assistant Stores Keeper

    £16640 - £18500 per annum: Recruitment Genius: An Assistant Stores Keeper is r...

    Recruitment Genius: Claims Administrator

    £16000 - £18500 per annum: Recruitment Genius: This is an excellent opportunit...

    Recruitment Genius: Software Developer - C# / ASP.NET / SQL

    £17000 - £30000 per annum: Recruitment Genius: Developer required to join a bu...

    Day In a Page

    'It was first time I had ever tasted chocolate. I kept a piece, and when Amsterdam was liberated, I gave it to the first Allied soldier I saw'

    Bread from heaven

    Dutch survivors thank RAF for World War II drop that saved millions
    Britain will be 'run for the wealthy and powerful' if Tories retain power - Labour

    How 'the Axe' helped Labour

    UK will be 'run for the wealthy and powerful' if Tories retain power
    Rare and exclusive video shows the horrific price paid by activists for challenging the rule of jihadist extremists in Syria

    The price to be paid for challenging the rule of extremists

    A revolution now 'consuming its own children'
    Welcome to the world of Megagames

    Welcome to the world of Megagames

    300 players take part in Watch the Skies! board game in London
    'Nymphomaniac' actress reveals what it was really like to star in one of the most explicit films ever

    Charlotte Gainsbourg on 'Nymphomaniac'

    Starring in one of the most explicit films ever
    Robert Fisk in Abu Dhabi: The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers

    Robert Fisk in Abu Dhabi

    The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers
    Vince Cable interview: Charging fees for employment tribunals was 'a very bad move'

    Vince Cable exclusive interview

    Charging fees for employment tribunals was 'a very bad move'
    Iwan Rheon interview: Game of Thrones star returns to his Welsh roots to record debut album

    Iwan Rheon is returning to his Welsh roots

    Rheon is best known for his role as the Bastard of Bolton. It's gruelling playing a sadistic torturer, he tells Craig McLean, but it hasn't stopped him recording an album of Welsh psychedelia
    Russell Brand's interview with Ed Miliband has got everyone talking about The Trews

    Everyone is talking about The Trews

    Russell Brand's 'true news' videos attract millions of viewers. But today's 'Milibrand' interview introduced his resolutely amateurish style to a whole new crowd
    Morne Hardenberg interview: Cameraman for BBC's upcoming show Shark on filming the ocean's most dangerous predator

    It's time for my close-up

    Meet the man who films great whites for a living
    Increasing numbers of homeless people in America keep their mobile phones on the streets

    Homeless people keep mobile phones

    A homeless person with a smartphone is a common sight in the US. And that's creating a network where the 'hobo' community can share information - and fight stigma - like never before
    'Queer saint' Peter Watson left his mark on British culture by bankrolling artworld giants

    'Queer saint' who bankrolled artworld giants

    British culture owes a huge debt to Peter Watson, says Michael Prodger
    Pushkin Prizes: Unusual exchange programme aims to bring countries together through culture

    Pushkin Prizes brings countries together

    Ten Scottish schoolchildren and their Russian peers attended a creative writing workshop in the Highlands this week
    14 best kids' hoodies

    14 best kids' hoodies

    Don't get caught out by that wind on the beach. Zip them up in a lightweight top to see them through summer to autumn
    Robert Fisk in Abu Dhabi: The acceptable face of the Emirates

    The acceptable face of the Emirates

    Has Abu Dhabi found a way to blend petrodollars with principles, asks Robert Fisk