After the break …..
Remedy UK have been busy with a new statement released over the holidays. The Review Group is also due to detail its programme this week.
The Financial Times analyses the probable strategy behind the suggested sale of BUPA’s hospitals division with a look at what it might mean for the state of the health insurance market.
BUPA has long faced charges that its position as both the biggest health insurer in the UK and one of the biggest hospital providers amounts to a conflict of interest.
That could potentially leave subscribers uncertain whether BUPA, as an insurer, is acting entirely in their best interests - in spite of the Chinese wall between the hospital and insurance businesses.
BUPA’s hospitals business has been unable to expand as fast as it would like, being blocked by the competition authorities from buying Community Hospitals at the turn of the decade. It has sought to win NHS business, for example by providing treatment centres.
At the same time, the insurance business has marketed itself as the quicker alternative to the NHS and has recently published a study arguing that the current NHS funding model will come under severe pressure in the next few years.
A sale of the hospital business would raise cash for further expansion, possibly overseas.
But it would also allow the insurance side to be seen to be acting unequivocally in the interests of its customers. It has already been seeking to drive down doctors’ and diagnostic fees, with the aim of lowering the cost of private medical insurance (PMI). Following a sale, it could do so without being hampered by the impact such measures would have on the hospital side of the business.
“Choice” in the NHS gets more attention in the Telegraph with the scheduled launch of the “NHS Choices” website discussed yesterday.
NHS Choices will give statistics on hospital times, MRSA rates and cleanliness. It will also allow patients to look up conditions and treatments in an online medical library.
However, the National Patient Choice survey of 57,000 patients found that only 41 per cent referred to hospitals by GPs could recall being offered a choice. Of those, 28 per cent were offered a copy of Choosing your Hospital, the Government guide giving patients information on how to make their choice. Most - 59 per cent - gave location or transport considerations as the most important factor.
GPs have complained that they do not have enough information about private healthcare providers and hospitals outside their region to be able to help patients make meaningful choices.
Dodgy surveys aside, patients do not know the relative merits of different treatment approaches & rely on the judgement of their GP. There is an expectation that all variations on a procedure are created identical but medicine does not work like that. Meaningful choice is a difficult objective to fulfil.
Isoft seems to be under further pressure with a lawsuit against it in New Zealand.
ISoft acquired i-Health, which had been making an operating loss, in January 2004 with most of the amount paid staggered over a five-year period, depending on revenues generated by the business. Under this “earnout” agreement, the vendors of i-Health and a related company called Galen were to receive NZ$9.9m if the business performed to expectations over the five years and up to NZ$24.9m if it outperformed expectations.
A statement of claim filed at the high court in Auckland alleged iSoft had failed to market i-Health’s HealthViews software globally and, where the product had been licensed, it had been sold at well below market price. The claim said iSoft also “knowingly and deliberately sought to replace HealthViews in major reference and other sites with another of the iSoft Group’s products, Lorenzo.”
Though I am unsure just how much room there might be in the contract for Galen to succeed with this approach, the legal distraction (and expense) at-least is unlikely to be welcome to Isoft.
There is a warning that HIV care is slipping down the list of priorities with cuts to funding, though admittedly not as savage as elsewhere.
Ten years after drugs were made available that will keep people alive, HIV does not have a high priority and funding disappears into the general NHS pot, says the report. Its survey of HIV service providers and commissioners concludes there is no national strategic vision.
The report, from a group of charities called the Aids Funders Forum, which includes the Elton John Aids Foundation and Crusaid, says the NHS is not putting in place the right services to deal with the changing face of the condition in the UK, and is failing to focus on keeping people well. There are no government targets on HIV prevention, social care or provision of information, it says, and it has disappeared from the political agenda and public consciousness.
More than 47,000 people are HIV positive in the UK and the number has grown by around 6,500 to 7,000 every year for the past three years. Just over half are white and predominantly gay men, 43% are black and 6% are of other ethnicities.