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Non-NHS Income Cap

The BBC Continues to Paint a Misleading Picture

A blog that I wrote for the think tank 2020Health on 18th January 2012 discussed misleading, biased reporting on the Health and Social Care Bill in the media. A story carried by the BBC was cited as an example. I have great respect for the BBC. They were selected as an example partly out of respect to illustrate how deep-rooted the problem is. My aim is not to criticise the BBC but rather to set the record straight and in some small way to encourage better reporting.

I am saddened to say that the BBC has again today (19th January 2012) repeated comments that are likely to prejudice their audience. In a news story published today the BBC say:

“ One of the key developments was the news, which emerged just after Christmas, that NHS hospitals would be allowed to do 49% of their work in the private sector - something which could potentially mean eight in 10 increasing their private work 25-fold.”

The facts, not opinions, are:

1.       1..    The news was announced n 15th December, when it was extensively discussed in a House of Lords Committee.

2.      2.   Very few, if any, NHS hospitals will be allowed to reach the 49% cap because other statutory obligations would prevent this and because there are not enough private patients available. The 49% cap is viewed as a “belt and braces” safeguard.

3.      3.  It is literally ludicrous to suggest that 8 out of 10 hospitals could increase their private work 25-fold.

4.       4. Without the Government amendment on 15th December the cap would have been lifted entirely. If therefore the announcement is regarded as a key negative development, people must misunderstand.

Additional thoughts can be found in my relevant 2020Health blog, in my comment posted with it in reply to a critic and in my tweets at @barbararesearch. You are now viewing my website where you can find information about me and my other healthcare views.

Quote from Lord Howe on 15 December 2011

Lord Howe, Minister of State, said in a House of Lords Committee debate on 15th December 2011:-

"My Lords, this is an important issue and one that I recognise is of considerable interest to the Committee. To start at the beginning, the Government are clear that NHS providers should always focus on the provision of care to NHS patients. However, we cannot ignore the fact that the private patient income cap, which Clause 162 would remove, is damaging to the NHS and to patients' interests. We think that there is a very strong case for removing the cap, because doing so will allow NHS patients to derive even greater benefits from foundation trusts. At the same time, we understand the sensitivities. The key to addressing those sensitivities is to have adequate safeguards to ensure that NHS patients and resources continue to be prioritised and protected. I reassure the Committee that we believe we can achieve that through the Bill and through the government amendments, and I shall explain why and how in a moment.

The words "private patient" in the cap's title may have unfortunately given the wrong impression about the substance of the argument. My noble friend Lady Noakes was quite right in what she said. The cap's scope goes far wider than just private patients. It captures income from activities such as innovations involving research, joint ventures and the sale of medicines and intellectual property to private healthcare providers in the UK and abroad. This means that innovative partnerships of the kind that the noble Lord, Lord Warner, indicated might happen are being hampered, and the ability of foundation trusts to earn more income to help to bring in leading-edge technology to the NHS faster-for example, for cancer treatment-is unnecessarily restricted.

Foundation trusts have told us that the cap is detrimental to care offered to NHS patients. They have welcomed our move to remove what they and we see as an outdated, unnecessary and arbitrary legal instrument that locks them into maintaining income from private charges below the levels that applied in 2002-03.

Perhaps I may remind noble Lords of the compelling reasons for removing the cap. As I am sure the Committee will agree, the rule itself is unfair. Some foundation trusts have much higher caps, and hence much more flexibility, than the majority. In 2010-11, around 75 per cent of foundation trusts were severely restricted with caps of 1.5 per cent or less. Meanwhile, the Royal Marsden benefits from a 31 per cent cap and is the country's highest private patient income earner. It has also been consistently rated as a highly-performing NHS provider."