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NHS v Private healthcare: who's the victor?

Much has been made recently of the perceived state of the National Health Service (NHS). Scandals of dying patients being left for hours on end and A&E departments grossly understaffed and overworked. This leaves the question - does this reflect a true picture of the NHS and is private healthcare a legitimate alternative?

The NHS

The NHS was founded in 1948 to implement the recommendations of the Beveridge Report of 1942, which endorsed the creation of a ‘comprehensive health and rehabilitation service for prevention and cure of disease.’

The services are funded through general taxation and National Insurance, and therefore the vast majority of services are free for people that legally reside in the United Kingdom. Like free market economies the world over, the discerning and the financially able seek out higher quality services this is especially true when seeking the relevant healthcare. Many decide to opt for private services, and if one finds themself in the position to afford this, it’s understandable that you would invest in it.

The choice of opting for National Healthcare Services as opposed to Private Healthcare is a rather subjective matter and experiences and opinions on this topical issue will always vary.

Private healthcare

Private healthcare requires a significant investment. Globally speaking the price of good healthcare has become a costly enterprise especially so as it pertains to long term care - particularly concerning nursing and palliative care.

It is very likely that individuals may end up spending their retirement funds or life savings to cover the costs of the different degrees of care that they may require as they grow older. They may in fact even run out of funds in some cases, depending on the extent of care that is needed. This, inevitably, may cause consternation and bitterness, having contributed to tax and National Insurance all of their working lives.

However, in terms of diagnoses involving lifelong disease and life limiting conditions, the government has finally come through with the reform of the long term care act, now making provisions for individuals that require extensive care. The Continuing Healthcare subsidy really can come in handy when you find yourself in a position where you are no longer able to afford the costs of the extra care that you may require for yourself or your dependents.

Long term care reform

The NHS is the pride of the welfare state and introduced the national framework for its Continuing Healthcare subsidy in 2007 (revised in 2009 and 2012). NHS Continuing Healthcare gives dignity back to individuals with complex healthcare needs, allowing them to be cared for in their own homes or care homes free of charge.

To be eligible, a patient must be over 18 years of age and have a complex medical condition and ongoing care needs. The NHS will pay for healthcare, such as services from a community nurse or specialist therapist, and personal care, i.e. help with bathing, dressing and laundry.

The Continuing Care scheme not only benefits the patient, but also alleviates the pressure on children looking after their parents or spouses looking after their dependents, lessening the financial burden of elderly care.

If eligible, this would be the favourable option when considering the immense cost of living in a private care home. Despite the anticipated costs of private healthcare, the benefits of the supposed superior services and facilities can make the decision to go this route worthwhile.

The weekly cost of living in a private care home can be exorbitant, but the idea is that a premium is paid for the quality of medical services provided. According to a 2012 report by healthcare specialists Laing & Buisson, a residential care home can cost up to £37,500 per year if nursing is required. Bupa charges between £550 and £1200 per week, depending on the level of care a senior citizen may require.

Facilities can be extensive for top of the range care (i.e. more towards the £1200 per week than £550).The cost of care fees would essentially be determined by the extent of care allocated to individuals, in relation to their care needs. The facilities that luxury care homes normally make provision for can include:

• 24 hour personalised care
• private and furnished bedrooms
• home-cooked meals and refreshments
• activities and events
• laundry services
• daily cleaning services
• bed linen and towels
• utility bills
• physiotherapy
• chiropody
• speech therapy
• occupational therapy
• hairdressing and aromatherapy.

Many people would argue that the feeling of security that a loved one is being well looked after is worth more than the costs it may involve. Independence is key.

The alternative to funding such private care through savings is to invest substantially in a good health insurance policy. Insurance premiums are likely to increase over the course of one’s life, and the cost thereof will depend largely on the health status of the individual at the time.

Comprehensive medical insurance has often been deemed a luxury product, the high price tag of which means it is only bought by the affluent and those lucky enough to get it through their employer.

Effectively, it enables people to jump the queue to get a private consultation after a referral by a GP and then treatment in a hospital of their choice at a time which suits them. But it doesn’t come cheap. For example, a 45 year old healthy man, living in Twickenham, south London, would pay close to £100 per month for a comprehensive health insurance plan.

Growing concerns: NHS

Yet, news reports constantly mention that public health is in disarray, that health professionals are overworked and hospitals rarely have enough beds. So you find yourself in a bit of a catch 22 when making a definitive decision as to whether you should opt for private or public healthcare.

A 2012 survey found one in three NHS staff said there are not enough people in their department to get their work done. The Royal College of Nursing also warned that one in three nurses working on older people’s wards are too busy to help patients with eating or going to the lavatory, which goes some way to explaining the allegations of the levels of negligible care in the NHS.

A survey last year of NHS bosses showed that finances, Accident and Emergency (A&E) waiting times and bed shortages are all worsening. The Department of Health, though, said ministers were taking “bold and radical steps to transform the manner in which hospital care is delivered” in an effort to relieve pressure on the NHS, including placing a GP in charge of every elderly patient’s care.

The NHS is already outsourcing some operations to private hospitals, and has been doing so since 2011, in an effort to save £20 billion. It was revealed in October 2010 that GP’s were being asked to limit the number of people they send to hospital because of growing deficits facing frontline health organisations. Inevitably, this will lead to longer waiting lists.

As is the case in any country, optimal care is not always guaranteed when one goes through public channels, which is why individuals that can afford private care would generally opt to invest in it regardless of the cost.

Whatever the outcome of a decision, there is no denying that healthcare on offer in the UK - particularly the NHS system - is envied the world over.

This was posted in Bdaily's Members' News section by Graham Vincent .