Payments by Results could bankrupt hospitals, say doctors’ leaders
pharmafile | December 16, 2004 | News story | |Â Â Â
NHS hospitals that fail to attract patients could become bankrupt under the Payments by Results system, doctors' leaders have warned.
Due for introduction in April 2005, the system is intended to make the cost of treatment more transparent and stimulate greater competition between providers of care, new private providers such as Treatment Centres and primary care practices challenging acute trusts for the contracts.
The system is intended ultimately to create more capacity to cut waiting lists and provide greater choice for patients, but British Medical Association leaders have warned of other, potentially dire consequences.
BMA Chairman James Johnson, speaking at a conference on the NHS Improvement Plan, said there there was little benefit of granting patients a choice of extra hospitals for an operation.
He estimated that a hospital losing just a small proportion of its patients could be forced to close.
He said: "Under payment by results, if a hospital attracts patients, it attracts the money. But if it doesn't attract them in sufficient numbers then it goes bust."
Johnson also highlighted the problem of underperforming units within an NHS hospital.
He continued: "The real concern is that you have an underperforming surgical unit in an NHS hospital which is competing against a private hospital. What happens to the psychiatry and A&E unit when the NHS hospital become destabilised by the failure of its surgical unit? What will the government do to protect the other units in the hospital?"
The government plans that by 2008 patients will have the right to choose between any provider as long as they can provide the service at the agreed price and meet clear NHS standards.
The Payments By Results scheme was also levelled with the charge of creating an 'illusory Berlin wall' between primary and secondary care.
Dr Chaand Nagpaul, a member of the General Practitioners Committee, said: "Patients want to experience healthcare as a continuum. They see my colleagues and me as hospital partners. But the Improvement Plan creates vested interest for hospitals to generate income through increasing treatment volume by Payments by Results, and further generates vested interest for Primary Care not to refer, but instead to provide treatment at lower cost in Primary Care itself through the incentive to generate savings. I believe this divides clinicians across primary and secondary interface."
Paul Miller, chairman of the consultant committee, said there was uncertainty running through the medical industry as to the ramifications of the NHS Improvement plan.
He said: "It is like all the pieces of the NHS are being thrown up in the air and nobody knows where they will fall."
