PPUs pushing up in Northern Ireland
Northern Ireland’s NHS private patient services come under the spotlight in our monthly round-up of PPU progress. Philip Housden reports.
The NHS in Northern Ireland is organised into six health and social care trusts (HSCs), which manage all healthcare services in a single management structure.
The most recently published annual accounts of the five HSCs that provide hospital care – the sixth HSC is the NI Ambulance Service – have been used in this article.
In 2018-19, Northern Ireland total private patient revenues totalled an estimated £5.1m, up 6% and £0.3m from £4.8m the year before. The total spend of £5.1m represents a steady 0.11% of total HSCs expenditure in NHS Northern Ireland.
Belfast HSC Trust, accounts for nearly 75% of this total, with revenues in 2018-19 of £3,768,000. This is growth of 4.1% on 2017-18.
These results suggest that the trust has weathered the loss of Bupa recognition for services in late 2017. Significant revenues are earned from self-funded fertility services provided from the Regional Fertility Centre.
Total private patient revenues are 0.24% of total expenditure, which in equivalent terms would place the HSC 68th in the list of NHS trusts in England outside London.
Western HSC Trust has the highest volume of private activity after Belfast. Revenues were £638,000 and 25% up in 2018-19.
Maternity rooms
Income at Altnagelvin Hospital, Londonderry, appears to be linked to amenity payments for single rooms, particularly maternity, where the mother pays for private room but remains an NHS patient.
Earnings elsewhere in the three other remaining HSC trusts amounted to £683,000 in 2018-19. Overall, there are few if any signs of HSCs supporting growth in private patient services currently.
Therefore, the present overall earnings pattern can be expected to be maintained in 2019-20 accounts.
However, moving into 2020-21, private patient income may be substantially reduced.
When the independent sector restarts services for private patients, it will be the three main private hospitals in Northern Ireland that benefit, together with some providers in the Republic – particularly in Dublin – due to the geography and improved journey times.
How does Northern Ireland compare? Exact comparisons are difficult due to the differing income and expenditure patterns of NHS bodies across the UK, as both Northern Ireland and Scotland accounts include a wider range of services than just acute hospital care.
However, as can be seen from the comparison chart below, this total for Northern Ireland of 0.11% is well below that of Wales (0.17%) but significantly higher than in Scotland (0.03%). See our May and June issues, respectively, for the details on these countries.
All are below the 0.46% average for NHS trusts in England outside of London, although Wales is comparable to the lowest regional figure in England which is the North-east at 0.18%.
Philip Housden (right) is a director of Housden Group