Memorandum submitted by Standard Life
Healthcare (CP 10)
1.1.1 Standard Life Healthcare is one of
the UK's leading private medical insurers with around 440,000
lives covered. We provide a range of healthcare solutions focusing
not only on ensuring prompt treatment when our customers are ill
but also a range of tools to promote good health.
1.1.2 We have a track record of collaborative
working to promote good health having been prominent in the debate
on improving health at work. We also want to contribute to our
debate by offering some conclusions drawn from our experience
of a business centred around private payments for healthcare.
1.2 Whether charges for treatments, including
prescriptions, dentistry and optical services; and hospital services
(such as telephone and TV use and car parking) are equitable and
1.2.1 It is Standard Life Healthcare's view
that it is fundamentally appropriate to levy charges for aspects
of healthcare so long as they are transparent and fair. We have
heard recently that the NHS may be facing a deficit of around
£620 million for 2005 and healthcare costs are increasing
rapidly leading to cost pressures in both the public and private
sector. In this environment it is appropriate and necessary to
continue to levy charges. This is not to say that the system cannot
be improved but it should not be scrapped altogether.
1.2.2 We argue that the current system of
charges is inappropriate in that it is incoherent and lacking
a proper framework to decide what should be provided free at the
point of delivery and what should be subject to charging. This
is unhelpful for patients who are uncertain about where they will
have to pay charges as well as helping to prevent a proper public
debate about the value of healthcare.
1.2.3 We should ask whether patients would
consider charges to be more appropriate if there was greater public
understanding of the costs of healthcare and the funding pressures
on the NHS and other providers.
1.3 Whether the system of charges is sufficiently
1.3.1 The system of charges is not at all
transparent. There is no logic behind the current regime of charging.
Why do we pay a prescription charge but make no contribution to
the cost of drugs supplied as part of in-patient treatment? Why
do we pay for car-parking but not for the hotel cost of a hospital
bed? Why are optical services subject to charging but GP appointments
are not? This is not to draw conclusions about any of these specific
examples but to make the point that the current system of charges
is confusing and incoherent. Funding pressures on health services
mean that charges are inevitable but it does not serve patients
to maintain the current, unclear system. We need a proper public
debate about the need for co-payments in health services.
1.4 Whether charges should be abolished
1.4.1 In a perfect world we would all prefer
that healthcare was provided entirely free at the point of need
for patients. However soon after the foundation of the NHS it
became clear that some charges were necessary to cope with the
extraordinary demand for "free" health services. This
is a pattern that has not altered in the decades since. Ideally
charges should be abolished but in actuality this is not a realistic
1.5.1 The government should open a public
consultation on charges; where they should be levied and at what
level. One aim of this should be to explain to patients and the
public why, with the high costs of modern healthcare, charges
1.5.2 There should be greater recognition
from government that people are willing to pay for healthcare.
We see this in the booming market for health related products,
particularly those focusing on diet and fitness as well as research
that demonstrates that 58% of people would pay up to £1000
for medical treatment. Only 24% would not be prepared to pay for
treatment. (Standard Life Healthcare Attitudes to Healthcare Survey
1.5.3 The government should encourage those
who can afford to contribute more towards the cost of their healthcare
by considering ideas such as Health Savings Accounts which could
work along the same principles as an ISAtax free savings
hypothecated for spending on healthcare.
Standard Life Healthcare