http://www.bbc.co.uk/news/business-23860805

Ah yes, competition. If it's not the government shouting about it and then giving the job to their friends anyway, it's a spot of price-fixing that when fined doesn't match the profit made, or...

It does sort of kill the idea that private hospitals offer better value for money.

That they can, that they must, that they always, or that there are any circumstances under which they could?


Obviously the idea that private hospitals always offer better value would never have been entertained by anyone.
Equally, nobody in possession of a mind worth inhabiting would be so stupid as to infer from this story that private hospitals cannot offer better value.

And better value than what? Surely it goes without saying that some must offer better value than others?
Any hospital that doesn't kill too many patients is better value than one that does - a category which has often included non private hospitals.

I'm struggling to see what idea has been killed here.

On iphone so might not address all points or do so properly.

1. I agree that private hospitals charge loads. They can charge whatever they want. It is up to the insurance companies to accept them or not. Insurance companies can also decline private work. I've seen insurance companies turn down varicose veins and hernia operations because of cost effectiveness - the same reasons they're no longer routinely done on the NHS!

2. Agree that private hospitals will overcharge. Two things here - the first is income. A patient of mine was worried about throat cancer so he saw the specialist directly. The specialist did a CT scan and a nasendoscopy. The patient was charged for the initial consultation + investigations + report of investigations + follow up consultation. Can't remember the final sum but it was near £1000 or so. After being told he didn't have throat cancer, he came and saw me. I diagnosed it acid reflux, put him on medication and saw him again a while later. His symptoms had completely resolved. Out of his taxes, £68 would come to me irrespective of how many times I saw him in a year. The second thing is litigation. If they had said there's no throat cancer, he would be more likely to sue because he had paid privately. This is part of the reason why you'll have a billion tests in America for a simple viral throat infection. In case they miss a tumour.

3. Comment on GPs being paid to do pre-op assessments. Nothing new essentially. As always, it's far cheaper for the GP to do something than the specialist or the hospital. Mainly because it comes out of the GP's pocket. A patient might be on medication under a specialist. Specialist needs bloods to be monitored. Instead of patient going all the way to the hospital for blood tests and the specialist looking at the bloods, they ask the GP to do it. Largely, GPs have done it through goodwill because it's best for the patient. A surgery will be charged something like £1.50 for a blood test but reimbursed only £1. As more of this scut work has been passed on to GPs, more have refused to do it - it takes up time, effort and money. So now there agreements in place via the PCT (now CCG) - along the lines of "we will pay you £10 per patient whose blood monitoring you do on behalf of specialists". It's still less reimbursement but you're not as much out of pocket so most GPs would sign up to it. As I recall, my local surgery is signed up for doing pre-op assessments for NHS patients. The private hospital paying the GP to do it is nothing new and the private hospital will still make money because it will cost the GP less than it would cost the hospital and hence more profit.