Annex III
FUNDING
1. The vast majority of acute mental health
care in the UK is provided and financed by the NHS or local authorities.
Laing (1998) estimates that about 9 per cent of all acute psychiatric
beds are provided by the independent sector: 6 per cent privately
financed via self-pay or PMI and the remaining 3 per cent financed
by the NHS. The NHS funds about 30 per cent of independent sector
acute psychiatric beds. These are probably underestimates due
to uncertainty about the numbers of acute NHS mental health beds
and differences in classifying what constitutes acute (as opposed
to non-acute) mental health care. Further, significant numbers
of substance misuse providers are registered by local authorities
as residential care homes. A report commissioned by the Department
of Health and the IHA from the Sainsbury Centre for Mental Health
(1995), now somewhat outdated, estimated then that 17 per cent
of total acute provision was provided by the independent sector.
Industry sources would put the figure as high as 20 per cent.
The majority of long-term care for mental illness is financed
by the NHS, local authority and/or income support.
2. IHA estimates that the total turnover
of a broadly defined UK independent health and social care sector
is nearly £17 billion (see Exhibit 2, compiled from various
sources). With all the complexities of the health and social care
sector this figure can only be a rough estimate, but it represents
about 25 per cent of all UK health and social care spending.
Exhibit 2: Total UK independent health
and social care supplied, 1997-98
| | £m
| £m |
| £m | £m
|
| Acute medical/surgical | 1,250
| | Dentistry
| 230 |
|
| Acute mental health | 94
| | Ophthalmics
| 790 |
|
| Other | 81 |
| Private GP services
| 315 |
|
| Independent hospital revenue |
| 1,425 | Complementary medicine
| 570 |
|
| Specialist fees | 631
| 631 | Pharmaceuticals etc
| 3,120 |
|
| Total acute healthcare |
| 2,056 | Total other direct healthcare
| | 5,025
|
| Nursing and care homes | 6,917
| 6,917 | Independent medical research
| 2,500 | 2,500
|
| Total Independent Health and Social Care16,498
|
|
