ANNEXE 6

United Kingdom: Establishing a mixed economy in healthcare

2005

Duncan Innes

Head of Public Policy

UK healthcare - key points

• The National Health Service is funded by tax not insurance - there are no charges to see a doctor or go into hospital

• The State owns NHS hospitals, although there is some freedom for management

• Private hospitals do not employ doctors

• All referrals to both public and private hospitals come through General Practitioners

• BUPA insurance pays all costs for treatment in any private hospital (not just those owned by BUPA)

Mainly surgical operations

l

UK: 35 private

hospitals

27,000 NHS patients in 2003

Coronary artery by-pass graft episodes split by major payor group

200

100

0

VOLU

ME

Insured

Self Funding

NHS

250 care homes;

16,000 residents

mixed private and State ownership and funding

Long-term care of older people

The future

• Prices fixed nationally - similar to DRGs

• Choice - by December 2005 all patients in England will be offered four or five hospitals for surgery, booked at a time to ensure short waiting

• Still no choice of doctor, or what treatment is given

• Commission for Healthcare Audit and Inspection inspects standards in both public and private hospitals on a similar basis

18 - week waiting time and up to 15% of surgical operations in private hospitals by 2008

Government to spend £500m-£1bn more on imaging (MRI;CT;PET) and pathology

‘Why use private hospitals and insurance in the UK?’

• More capacity to permanently reduce waiting times

• Better productivity to treat more patients.

• Utilisation of all the resources available in England

• spread good practice and innovation