NHS doubles pay-bed income: Hospitals treating more private patients to compensate for under-funding

NATIONAL Health Service income from private patients has more than doubled over five years as hospitals look for new ways to raise money.

Earnings last year topped pounds 140m, compared with pounds 67m in 1987, when the market-style reorganisation of the NHS was still on Whitehall drawing boards. The biggest expansion of private treatment by NHS hospitals was seen in London and the South-east, Oxford, East Anglia and Wessex. Only Mersey experienced no increase in private patient income of the 14 English regions. Over the same period, the number of people on NHS waiting lists rose by 18 per cent.

The NHS, now with a 13 per cent stake in the commercial acute health care market, is becoming an increasingly powerful competitor to the private hospital sector.

Most NHS trust hospitals either operate, or are planning to open, private wings or wards to help generate income. Some trusts are seeking to persuade their consultants to treat all their private patients 'in-house' in return for higher salaries.

However, such efforts are being resisted by large numbers of doctors, who fear a gradual erosion of their traditional freedoms under the NHS overhaul. There is no statutory limit on the amount of private work that can be carried out in the NHS.

The latest figures came in replies from Tom Sackville, Under-Secretary of State for Health, to a series of parliamentary questions from Alan Milburn, Labour MP for Darlington.

NHS hospitals trying to clear, or stave off, deficits are turning more to the private patients as sources of income to plug the gap caused by under-funding, Mr Milburn said.

'The Trojan horse of private treatment is threatening to make the NHS a pay-as-you-go service. These figures suggest that patients who are desperate for treatment are having to pay through the nose to avoid lengthening waiting lists.'

The Department of Health collects statistics both on the number of NHS pay-beds and the cash they generate, but not on how they are used. It is therefore virtually impossible to assess whether they represent a cost-effective use of taxpayers' money.

The key Department of Health measure of hospital activity does not distinguish between NHS and private patients. Labour MPs on the health select committee were surprised to learn that figures used to support government claims about the NHS treating ever more patients included both state-funded and privately funded patients.

Under close questioning from Hugh Bayley, Labour MP for York, Virginia Bottomley, Secretary of State for Health, acknowledged that some of the 407,000 extra patients she claimed last month had been treated by the NHS over the past year could have involved readmissions of the same patients.

Responding to Mr Milburn's claims, Brian Mawhinney, Minister of State for Health, insisted the rising private income to the NHS reflected rising costs. He added: 'It is the time people wait that matters, not the numbers waiting - 75 per cent are treated within three months.'

----------------------------------------------------------------- INCOME FROM PRIVATE PATIENTS - pounds 000 (CASH) ----------------------------------------------------------------- 1987-88 1991-92 Northern 1,504 1,877 Yorkshire 3,425 4,542 Trent 2,385 3,465 East Anglian 3,093 7,319 NW Thames 8,150 13,984 NE Thames 8,791 11,158 SE Thames 6,828 11,692 SW Thames 2,702 3,528 Wessex 1,665 4,383 Oxford 4,849 9,725 South Western 2,627 2,112 W Midlands 3,439 6,327 Mersey 2,055 2,006 North Western 4,094 4,950 *SHAs 11,287 21,513 NHS Trusts - 32,254 TOTAL 66,893 140,834 ----------------------------------------------------------------- Source: Hansard 20 May 1993. *SHAs = Special health authorities for London postgraduate teaching hospitals. -----------------------------------------------------------------