In the final article in our series on private hospitals, Angela Faherty looks at the factors providers consider when pricing different treatments
As the Government continues to shout about the importance of the NHS and free health care services for all, there is one factor that is continually brought to the fore. Cost.
Each year, the Government continues to plough money into the service in the hope that waiting lists will fall and that the NHS will eventually become an exemplary public offering and the model to which all other public healthcare services should aspire.
As a result, there has been a split in public perception and an almost unnecessary battle between the public and private healthcare sectors. However, this is changing.
An increasing number of individuals are acknowledging the private sector and using the facilities for one-off treatments - recognising that having a public and private partnership to enable patients to utilise both services is, perhaps, not a bad idea.
Despite the divide between both sectors, a common theme is the increasing cost of healthcare and its provision. Modern day developments in medical science are warmly welcomed, but on the other hand, advances also mean prices will continue to escalate.
For those opting to fund elements of their own healthcare in the private sector, it is important to know the likely cost of treatment and how it varies throughout the UK. While the type of treatment required is the dominating factor in the overall cost, geography, the patient's standard of health and economic and social issues also play a part.
Varying costs
The cost of treatment also varies between each of the main five independent hospital providers: BMI Healthcare, BUPA, Nuffield Hospitals, Capio Healthcare UK and HCA International. However, the main factors affecting cost will be dominated by the needs of each individual.
What is worth noting however, is that some of these establishments specialise in certain areas of healthcare and as a result, may not be comparable to those providing more common procedures such as hip replacements and cataract surgery.
But the problem with giving average prices for treatment is that no two procedures are the same. There is always a different element that needs to be taken into account, and this is why prices can vary widely.
BMI Healthcare does not actually publish a standard list of guide prices, but fee quotations are available by contacting individual hospitals directly. Capio Healthcare UK hospitals do publish individual rates for the procedures offered, but prices vary between hospitals.
Nuffield Hospitals offers a Fixed Price Direct package, which guarantees that should any complications arise within 30 days of leaving hospital, no further charges will be made - provided the patient has followed the medical advice they were given.
In terms of cost for the actual procedure a patient is undergoing, a number of factors influence the price of treatment, as Katy Evans, spokesperson for Nuffield Hospitals, points out.
"Self-pay prices are determined on a case-by-case basis. The patient's age, physical condition and the procedure they are undergoing are all taken into account. The vast majority of self-pay business is conducted on a fixed price basis where the patient is given an all-inclusive price following a consultation," she says.
Hospital charges
To establish the cost of treatment, a number of elements are taken into account. First, each hospital will have a 'hospital stay' charge incorporating nursing care, an on-site doctor, support facilities and catering requirements. There is no set price for this as it varies widely between each patient. However, someone undergoing a more complex and care intensive procedure will inevitably require more attention, which will be reflected in the eventual cost.
In addition, each procedure will have an expected length of hospital stay. This will increase the cost for those needing to remain in hospital for a few days to recover compared to day-case patients. Necessary specialist care, such as physiotherapy appointments and treatment while the patient is in the hospital for a hip or knee replacement operation for example, will also serve to bump up the cost.
Similarly, an elderly person with slightly faltering health who requires a hip replacement is more likely to need greater time and attention to recuperate than a person in their early 40s with an excellent bill of health.
Each hospital also has a theatre charge that is calculated on the time needed to undertake the procedure as well as staffing costs. Similarly, drugs, dressings and other clinical materials required by the patient during their stay in hospital, as well as the type and volume of drugs to be taken home, also have to be factored into the cost.
Perhaps one of the most notable variants in costing the price of healthcare is the prosthesis selected by the consultant for those patients requiring a hip or knee replacement procedure. These can vary enormously and could be a factor in the £2,000 differential between procedures from the same provider.
Another factor when determining the cost of treatment, says Carol Friend, spokesperson for BMI Hospitals, is the consultant who carries out the procedure.
"The consultant surgeon and the consultant anaesthetist charges do vary, but this is not necessarily a regional issue. There is more variation based on the eminence of the consultant than on the location," she says.
However, the location of the hospital in which a patient receives treatment does go some way to influence the overall cost. All prices are agreed locally, therefore this can reflect variations in underlying costs.
As a general rule, because salaries and property costs are greater in the south of the UK - particularly in London and the South East where many of the specialist teaching hospitals are located - the cost of treatment is likely to be more than in the north of the country.
However, social factors such as a higher concentration of elderly people or those requiring a similar type of surgery in a certain part of the country can also influence cost.
"In the case of cataracts for example," says Friend, "one of the less expensive places for the operation it seems, is along the South Coast.
"The reason for this is the high volume of patients in the area helping to keep costs and charges down."
Bearing in mind the way the cost of treatment is priced, it is interesting to see that while some providers seem more expensive than others, generally figures are in the same region.
BUPA for example, gives an approximate cost of £1,750 to £2,800 for the removal of cataracts. The price range for the same procedure is quoted as being in the region of £1,800 to £2,200 by BMI Healthcare, and £2,150 to £2,300 for Nuffield Hospitals. Capio Healthcare UK also quotes its cataract removal procedure to be between £1,650 and £2,604.
The price bands quoted by each provider shows differentials of a few thousand pounds to reflect all the factors that culminate to affect the total cost of treatment. However, while prices do vary regionally, generally, this may only be by a few hundred pounds.
For example, the difference in the cost of cataract treatment in a Nuffield hospital varies only slightly. The average price reflects the percentage of patients who will require an overnight stay, despite the fact that most cataract procedures are carried out as day-cases.
As expected, it is in the South East of England where the procedure would cost the greatest, around £2,300. However, in the South of the country and in the Midlands, it is only £100 less at £2,200, while in the North of England, the average cost is £2,150.
Similar cost differentials can be seen from Capio Healthcare UK. Guideline costs from the provider show that treatment to remove cataracts at its hospital in Bingley, West Yorkshire can range from £1,999 to £2,174, whereas the cost in Peterborough is quoted as being between £1,900 and £2,200.
What is surprising however, is that it is slightly more expensive to receive treatment in Cornwall than it is in the Home Counties. At Capio Healthcare's Rivers Hospital in Sawbridgeworth, Hertfordshire, the average price for treatment is stated to be £2,060. In contrast, at the Duchy Hospital, which is based in Truro, Cornwall; the cost of the same procedure is almost £200 more, with the guideline price quoted as being £2,259.
When pricing the cost of treatment, there are a number of factors providers need to take into consideration. As each procedure is judged on a case-by-case basis, gaining an exact figure is difficult, therefore prices quoted are often guideline figures. However, as a general rule, the cost of treatment in the South East of England is slightly more expensive than in the northern half of the country. However, the main factors affecting cost are ultimately the procedure being undertaken and the physical condition and age of the patient.
COVER notes
• A patient's age, physical condition and procedure are taken into account when pricing the treatment.
• Social factors such as a higher concentration of elderly people requiring similar surgery in a certain part of the country can also influence cost.
• Because salaries and property costs are greater in the South of the UK, the cost of treatment is likely to be more than in the North.
