You recover your health, they recover their costs

A new report suggests that pay beds could help to secure the future of the NHS. Paul Gosling reports

There will be more pay beds, and more NHS patients will pay for add-on facilities, such as evening appointments and better meals, predicts Healthcare 2000, the independent report on the future of the National Health Service published last week.

As the market reforms take an ever-tighter hold over the NHS, more patients and trusts accept the principle of a wider range of charges within the the service. Chris Ham, director of Birmingham University's health services management centre and a member of the Healthcare 2000 panel, says: "As we are moving towards more of a mixed economy in the NHS, it is inevitable that hospitals will want to offer pay beds, and I don't see any problem with that. It is a useful way of topping up budgets."

In 1993/94, the last year for which figures have been published, 158 NHS trust hospitals earned pounds 185m from pay beds, giving them a market share of 14.4 per cent of private health care. That represented a growth of almost 13 per cent over the previous year, a trend that looks set to continue.

Pay beds are offered through various arrangements: some hospitals directly manage them, others contract with external companies to run private wings. For example, Margate Hospital in Kent has 13 pay beds, which are managed by the private company Healthex. The company's profits are transferred to the hospital after keeping a proportion as a management fee.

A pounds 3m development is planned for Margate, to be run by Healthex, funded through the Private Finance Initiative. The new wing will offer an additional 18 to 20 beds and, unusually, provide a private out-patients and daycare facility. The Department of Health must give approval before the contracts can be finalised, but has informally welcomed the proposal.

Bill Nuttall is the private patients manager at Margate, employed by Healthex, having previously run pay beds at Leeds General Hospital. He argues: "We are helping to secure the future of the NHS." Mr Nuttall believes that as the number of pay beds grows, so private hospitals will close down, as is already happening in London. He predicts private healthcare suppliers will move away from running independent hospitals, instead developing partnerships to run private wings at NHS trusts.

Nuffield Hospitals, one of the country's leading private healthcare suppliers, says political uncertainty is holding it back from doing this, though it is leasing land from Hull trust hospital. Nuffield will run an entirely independent hospital, but expects to rent out some facilities while the NHS hospital is being refurbished.

Bupa has entered into two agreements, with Hastings and Bradford hospitals, to lease land from trust hospitals, with rental being a proportion of income. The hospitals will have their own operating theatres, and radiology and physiotherapy units. It is expected that the closeness of the private hospitals will assist the NHS trusts in retaining consultants who want to do some private work.

Ian Robertson, manager of St Mary's NHS trust, which has provided pay beds for 60 years, and last year generated a pounds 1.25m profit for the trust, argues that the retention of consultants is a key benefit from pay beds. "It keeps our medical staff, and enhances the reputation of St Mary's. We have got the consultants' loyalty," he says.

Mr Robertson believes that the market reforms are confusing traditional definitions. "The question of what is a private patient will be harder to define. GP fundholders' business is going to our private wing because of our package of prices. It may be that it will be in the NHS interest in some cases to close beds."

The independent sector argues that a hidden form of cross-subsidy is taking place, under which trusts protect private beds from the real commercial costs. Norwich Union has sponsored the National Economic Research Associates (Nera) to establish whether this is true, and a report will be published within the next month.

Nera's economics consultant, Keith Davies, says: "First, we have looked at the purely accounting side of things, to see whether [private beds] make a surplus, to see whether all the resources used are costed. Then we have looked at the wider issues of the cost of training, of consultants who don't look after NHS clients, and see whether they still make a surplus."

If the results support the complaints from the independent sector, the Government will be under enormous pressure to introduce stricter accounting regimes, which, independent providers say, would destroy the concept of pay beds.

If, though, the report shows that pay beds genuinely create additional income for the trusts, producing a subsidy for NHS patients, it could have important effects beyond the next election. Even an incoming Labour government might then accept the use of pay beds.

Independent Partners; request a free guide on NISAs from Hargreaves Lansdown

Suggested Topics
PROMOTED VIDEO
News
Buddy DeFranco
people
Arts and Entertainment
British actor Idris Elba is also a DJ and rapper who played Ibiza last summer
filmIdris Elba responds to James Bond rumours on Twitter
Arts and Entertainment
Lena Headey as Cersei Lannister in Game of Thrones
film
News
i100
Sport
Yaya Sanogo, Mats Hummels, Troy Deeney and Adnan Januzaj
footballMost Premier League sides are after a striker, but here's a full run down of the ins and outs that could happen over the next month
Finacial products from our partners
Property search
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

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

ES Rentals

    iJobs Job Widget
    iJobs Money & Business

    Selby Jennings: VP/SVP Credit Quant- NY- Investment Bank

    Not specified: Selby Jennings: VP/SVP Credit Quant Top tier investment bank i...

    Selby Jennings: Quantitative Research | Equity | New York

    Not specified: Selby Jennings: Quantitative Research | Global Equity | New Yor...

    Selby Jennings: SVP Model Validation

    Not specified: Selby Jennings: SVP Model Validation This top tiered investment...

    Selby Jennings: Oil Operations

    Highly Competitive: Selby Jennings: Our client, a leading European Oil trading...

    Day In a Page

    Ed Richards: Parting view of Ofcom chief. . . we hate jokes on the disabled

    Ed Richards: Parting view of Ofcom chief. . . we hate jokes on the disabled

    Bad language once got TV viewers irate, inciting calls to broadcasting switchboards. But now there is a worse offender, says retiring head of the media watchdog
    War with Isis: The West needs more than a White Knight

    The West needs more than a White Knight

    Despite billions spent on weapons, the US has not been able to counter Isis's gruesome tactics, says Patrick Cockburn
    Return to Helmand: Private Davey Graham recalls the day he was shot by the Taliban

    'The day I was shot by the Taliban'

    Private Davey Graham was shot five times during an ambush in 2007 - it was the first, controversial photograph to show the dangers our soldiers faced in Helmand province
    Revealed: the best and worst airlines for delays

    Revealed: the best and worst airlines for delays

    Many flyers are failing to claim compensation to which they are entitled, a new survey has found
    The stories that defined 2014: From the Scottish independence referendum to the Ice Bucket Challenge, our writers voice their opinions

    The stories that defined 2014

    From the Scottish independence referendum to the Ice Bucket Challenge, our writers voice their opinions
    Stoke-on-Trent becomes first British city to be classified as 'disaster resilient' by the United Nations

    Disaster looming? Now you know where to head...

    Which British city has become the first to be awarded special 'resilience' status by the UN?
    Finally, a diet that works: Californian pastor's wildly popular Daniel Plan has seen his congregation greatly reduced

    Finally, a diet that works

    Californian pastor's wildly popular Daniel Plan has seen his congregation greatly reduced
    Say it with... lyrics: The power of song was never greater, according to our internet searches

    Say it with... lyrics

    The power of song was never greater, according to our internet searches
    Professor Danielle George: On a mission to bring back the art of 'thinkering'

    The joys of 'thinkering'

    Professor Danielle George on why we have to nurture tomorrow's scientists today
    Monique Roffey: The author on father figures, the nation's narcissism and New Year reflections

    Monique Roffey interview

    The author on father figures, the nation's narcissism and New Year reflections
    Introducing my anti-heroes of 2014

    Introducing my anti-heroes of 2014

    Their outrageousness and originality makes the world a bit more interesting, says Ellen E Jones
    DJ Taylor: Good taste? It's all a matter of timing...

    Good taste? It's all a matter of timing...

    It has been hard to form generally accepted cultural standards since the middle of the 19th century – and the disintegration is only going to accelerate, says DJ Taylor
    Olivia Jacobs & Ben Caplan: 'Ben thought the play was called 'Christian Love'. It was 'Christie in Love' - about a necrophiliac serial killer'

    How we met

    Olivia Jacobs and Ben Caplan
    Bill Granger recipes: Our chef's breakfasts will revitalise you in time for the New Year

    Bill Granger's healthy breakfasts

    Our chef's healthy recipes are perfect if you've overindulged during the festive season
    Transfer guide: From Arsenal to West Ham - what does your club need in the January transfer window?

    Who does your club need in the transfer window?

    Most Premier League sides are after a striker, but here's a full run down of the ins and outs that could happen over the next month