Private medical cover for ‘top-up’ treatment must integrate
AXA PPP healthcare, has warned of conflicts of interest and clinical apartheid in its response to the Department of Health's consultation on allowing NHS patients to buy for top up treatment.
Axa said communication of patients' NHS entitlement also gave cause for concern.
AXA said it understood the government's concern that NHS and privately funded care should be kept separate to avoid inappropriate cross subsidy. But it warned that too rigid adherence to the principle of “clinical apartheid” could result in patients having to have separate infusion lines for their NHS and their privately funded drugs or to-ing and fro-ing from bed to bed. Needless duplication (and cost) of blood tests and scans to monitor patient progress should also be avoided, and care providers allowed to share tests results irrespective of whether they were NHS or privately funded.
AXA is calling for primary care trusts (PCTs) and hospital trusts to publish, in a readily accessible form, which treatments they will pay for and which ones patients will have to pay for themselves.
To give the new policy teeth, implementation and monitoring should be overseen by the NHS' strategic health authorities (SHAs), AXA believes, and findings published to enable patients to see for themselves whether it is being fairly and effectively applied. SHAs should also be tasked with enforcement to ensure that PCTs that fail to implement the guidance are obliged to remedy their shortcomings.
Main recommendations:
To avoid conflicts of interest patients should be given access to second opinions and to the findings of independent expert reports to help them to make informed decisions about their treatment.
Patients must not drawn into paying for care to which they are entitled under the NHS.
The Department of Health should inctroduce a national tariff for NHS private care (including specialists' charges and drug costs) based on the cost of provision - not at what the market would bear.
Fergus Craig concluded ‘We welcome the Department of Health's decision to allow patients to complement their NHS treatment and privately funded care. It's a big step in the right direction of giving patients greater choice over their healthcare provision and I am confident that the obstacles highlighted above, whilst challenging, can be successfully overcome.'
