Select Committee on Public Administration Appendices to the Minutes of Evidence

Memorandum by BUPA (PSR 25)


Statement of intent

  BUPA staff are dedicated to the provision of high quality treatment and care. BUPA wishes to contribute to the delivery of NHS services and believes that its staff provide the quality of service and dedication that patients, whether NHS or private, deserve.

About BUPA

  BUPA is a provident association. To ensure growth, and increase levels of reinvestment, it needs to make a return on services provided. All returns are reinvested into better health and care services. Currently, BUPA owns 235 care homes and 36 hospitals in the UK. Over the last two years BUPA has invested over £50 million in care services and hospitals.

The caring ethos

  BUPA treats all its patients and residents with equal care and respect, whether publicly funded (for example in our hospitals through the Concordat or in our care homes by the local authority) or privately funded, through insurance or self-pay.

  The ethic of public service is, as Alan Milburn has described it, essentially to contribute to serving the public regardless of wealth or worth. BUPA has been doing this for a number of years in the publicly funded work undertaken by its care homes and hospitals.

  The majority of residents in BUPA care homes receive funding from local authorities. All residents are treated with the same care and dignity, irrespective of funding source.

  Similarly, when a patient arrives at a BUPA Hospital they are immediately treated as a patient, not as a "Concordat" patient, a "self funding" patient or an "insurance patient". Care and treatment is administered according to need.

  Having a service ethos is not unique to the public sector. BUPA's vision is "Taking Care of the Lives in our Hands". This is a simple human expression of the dedication of our staff, and our corporate commitment to our patients and staff. A further commercial dimension also underpins our focus on the delivery of quality care. If a private company fails to provide the service its customers want it will not thrive.

Caring for our patients

  Patient care is top of BUPA's list of priorities.

  One only needs to look at the provision of care services to see how both the public and private sectors can work together to serve the interests of two of the most disadvantaged groups in our society—the elderly and mentally infirm.

  BUPA care homes operate on a commercial basis and like other BUPA businesses, BUPA Care Service aims to make a return on the services provided and the investments made. All surpluses made are reinvested into providing more and better health and care. Approximately 65 per cent of our residents receive support from their local authority to pay for their stay. Indeed, BUPA Care Services has even entered into agreements with local authorities such as Powys to manage their care homes on their behalf. The staff caring for our 16,000 residents care as much for their wards as those people who work for a publicly owned care home.

  All organisations need to make a surplus (or profit) if they are to invest and innovate. BUPA aims to make surpluses on its business activities on a scale that allows it to continue to keep pace with changes in demography, epidemiology, technology, real prices and consumer expectations. However, as our work with local authorities and NHS organisations demonstrates, this is not mutually exclusive to having a public service ethos. In actual fact, it has acted to stimulate value-for-money and quality in the public services we provide. This results in better service to patients, local authorities and NHS organisations alike.

Caring for our staff

  BUPA offers competitive salaries, flexible working conditions, and attractive benefits packages. For example, BUPA Hospitals employees are eligible for:

    —  corporate or stakeholder pension arrangements

    —  insurance and regular health assessments

    —  25 days holiday, increasing to 27 days (plus bank holidays)

    —  life insurance

    —  profit share scheme

  In our care homes, flexible working times allow those people who want or need to work part time (for example single mothers and the elderly) the ability to chose hours that suit them.

  Providing for our staff in this way has benefits for the patients and residents they care for because it can enable them to care for patients without being distracted by poor work conditions. Our staff, particularly our doctors and nurses would be deeply offended by any suggestion that they care less for their patients because they work in a profit-orientated organisation.

Caring for the future

  The current structure of the UK health system precludes independent providers from playing a widespread role in the health economy. In contrast, in some European countries, for example in Germany and France, independent providers play a more integrated role in the provision of health and care.

  The Institute for Health Economics and Policy (IHEP) found that in Germany, there was no institutional difference between public and private hospitals participating in state hospital programmes with respect to the provision of public subsidies and contracts. In other words, independent hospitals when operating public contracts are treated in the same way as public hospitals. Patients are cared for irrespective of funding method.

  In the case of France, profit-making hospitals are mainly established by small corporations, and they tend to specialise in fields such as surgery, obstetrics and gynaecology. No difference was found in the system between profit-making and non-profit hospitals with respect to medical fees and medical insurance contracts.

  It is clear from this research that it is possible for the health economy to make use of independent sector hospitals without loosing a "public service ethic" and benefit from the experience, management and specialisation of independent hospitals.


  There are differences between public and private sector organisations. There are also differences between people working within each sector. The public sector is not unique in having people who work for their love of caring. The private sector is not unique in having people that want a job that offers other, more personal, advantages.

  What is important is that care of the highest quality is given to those who need it. Whether as funders or providers, both the public and private sectors can work together towards this goal.

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