Patient enthusiasm for private sector threatens hospitals

NHS hospitals across Birmingham and the Black Country strategic health authority may struggle to survive if they do not address the threat from the private sector, research has revealed. And the SHA has warned that other cities may face the same risks.

The MORI survey revealed that patients believed the private sector was superior to the NHS on 12 out of 14 factors, including cleanliness and the quality of management. Over 70 per cent of those surveyed said they would be 'fairly' or 'very' happy for their NHS care to be carried out in the private sector.

The survey asked people in each local authority within the SHA which local hospitals they would choose for an operation. HSJ has seen information published on three of the six authorities. It showed that private sector hospitals were first choice in one area and second choice in two. In two of these areas, six NHS hospitals were 'chosen' by less than 4 per cent of local populations.

As a result, the SHA has carried out modelling exercises which show that about £35m of annual income is in jeopardy across its seven non-specialist acute trusts.

The SHA commissioned the survey of 1,200 people in order to assess the potential impact on the NHS of choice, including the 'extended choice network' from next April. The sample was skewed towards those aged 45-74 to take account of those likely to access elective care. Under extended choice, patients will be given a choice of 40-50 hospitals from a menu of all foundation trusts, the private sector and local services.

The SHA stressed that it was making the findings public so that NHS services could adapt their strategies accordingly. SHA director of strategy Peter Spilsbury said: 'We are not sure every one in the NHS has clocked that from April 2006 we are going to move much quicker to a much wider range of choice. Choice is happening now; it's real.'

He said the rest of the NHS could learn from the SHA's research: 'Although the survey is based on findings from our area, they could well be replicated in many other urban areas across the country.'

Mr Spilsbury said the implications of the survey amounted to about £35m in potential lost NHS income, equating to 13 per cent of the area's £275m income: 'The seven trusts on our patch could lose £5m-£15m each. Choice is going to have a significant affect on everyone. It would be foolish to suggest otherwise.

'In every local authority, between 20 and 30 per cent [of those surveyed] would consistently choose the private sector,' added Mr Spilsbury.

MORI asked respondents what would make them more likely to use the private sector. The top reason - cited by 85 per cent of those surveyed - was if the private sector was 'MRSA-free'.

Mr Spilsbury said the survey demonstrated how drastic the impact of patient choice could be: 'If people do what they say they will, the independent sector could be the single biggest provider of elective surgery. Across the SHA the level of demand to use the independent sector will be 15-20 per cent of the population'.

SHA chief executive David Nicholson said the survey showed that 'introducing choice and contestability are the right policies; people clearly have an appetite for choice and are happy for the NHS to pay for private sector care'.

HOW MUCH MORE LIKELY WOULD YOU BE TO USE THE PRIVATE SECTOR THAN YOUR LOCAL HOSPITAL IF.....

It was MRSA free:
Much more likely: 73%
A little more likely: 12%
No more likely:11%
Don't know: 3%

Waiting times were shorter - half those for your local hospital:
Much more likely: 69%
A little more likely: 17%
No more likely:12%
Don't know: 3%

It was recommended to you by your GP:
Much more likely: 68%
A little more likely: 18%
No more likely:11%
Don't know: 2%

It provided free door-to-door transport for yourself:
Much more likely: 57%
A little more likely: 17%
No more likely: 24%
Don't know: 2%

It offered flexible appointment times:
Much more likely: 55%
A little more likely: 22%
No more likely: 21%
Don't know: 2%

It guaranteed car parking facilities:
Much more likely: 51%
A little more likely: 16%
No more likely: 31%
Don't know: 2%

It was recommended by your friends and family
Much more likely: 49%
A little more likely: 26%
No more likely: 22%
Don't know: 3%

It offered a private room for those that want it:
Much more likely: 48%
A little more likely: 23%
No more likely: 27%
Don't know: 2%

Base: 1,201 residents