Private health insurance doesn’t cover A & E!!

Posted by Mike Gold on Monday, January 30, 2017 · Leave a Comment

“That’s the standard technique of privatisation: defund, make sure things don’t work, people get angry, you hand it over to private capital.” Noam Chomsky

Top of the range private medical insurance is no good to you if you are involved in an accident and need urgent treatment. Private hospitals do not have Accident and Emergency (A & E) departments so you will be taken to an NHS hospital with an A & E.

Up and down England A & Es are being threatened with closure as figures from NHS Improvement (the new combined name for Monitor and part of the old NHS England) show a 6.3%¹ increase in attendances at A & Es in the first quarter of 2016/17 (1st April – 30th June) compared with the first quarter of 2015/16.

A & E is a hospital’s front line; it’s the part of the hospital most visited by the public, yet the cost of A & E was less than 3% of the total Department of Health budget of £116.4 billion²in 2015/16. In 2014/15 the cost of A & E was £2.5³ billion but closer inspection of the figures tells a more frightening story. It is not as simple as an increase in population and/or a lack of available GP appointments overwhelming A & Es. The truth is England’s A & E departments are being deliberately underfunded and this is the real cause of the pressure on A & E departments.

To try and understand this we enter a world of secrecy where the NHS suits and the politicians are economical with the truth or tell outright lies. There were 156 NHS Foundation Trusts and 82 NHS trusts in England operating in England at the first quarter 2016/17 and they are known as providers. NHS Commissioners pays a tariff price for each of the provider’s activities and the attendance of one person at A & E has an average tariff of £100⁴. However, the actual average cost to the hospital is £132, some 32%⁵ higher than the amount they are paid by the NHS Commissioners. No A & E can treat its patients in a timely and efficient manner when its funding is totally inadequate. In round figures the total underfunding of all the A & Es is £600 million.

Do the politicians and the NHS suits want to dramatise the funding problems in the NHS? Will this allow them to justify taking ‘urgent’ transformative action, avoiding normal consultation procedures, in order to solve the ‘crisis’?

The truth is the A & E ‘crisis’ can be solved simply by correcting the tariff price per attendance. But the question is whether there is the political will to solve the ‘crisis’ or is there an ulterior, more sinister, motive.

Michael Gold,

November 2016

¹^{https://improvement.nhs.uk/uploads/documents/Q1_2016-17_Supplementary_Performance_Paper.pdf}^{Para 5}

²^{http://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget?gclid=CJHA5ffajs8CFYgK0wodnJ4Oxw}

^{3 2014/15 reference costs (Department of Health 2015)}

^{4 NHS England tariffs 2014}

^{5 A Comparison of tariffs with per capita reference costs 2014}