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Health payment guidance
12/12/2008
Draft revised guidance to assist Scotland's NHS Boards to manage arrangements for NHS patients also receiving private healthcare has been issued for consultation today.
Health Secretary Nicola Sturgeon announced in September the Scottish Government's intention to revise current guidance in order to provide greater clarity for NHS Boards when patients wish to pay for private treatment while receiving NHS care.
The provision of revised guidance responds to a recommendation from Scottish Parliament Public Petitions Committee following its inquiry into access to medicines.
Building on the strengths of the existing Scottish system and taking account of the issues raised by Professor Mike Richards' Review into improving access to medicines in England published in November, it seeks to combine the rights of the individual with robust clinical governance and the founding NHS principle that: treatment should be based on clinical need, not on the ability to pay, with NHS care free at the point of access.
Designed to be used by NHS Boards, the new guidance will outline key principles and requirements, in-line with the core principles of the NHS. The key requirements which should apply in circumstances where NHS patients can obtain private healthcare in addition to their NHS care are:
- the primary purpose of any NHS organisation is to provide NHS care
- NHS and private care should be kept as clearly separate as possible
- in all cases, it must be clearly understood by all parties involved whether an individual procedure or treatment is privately funded or NHS funded
- the NHS should never subsidise private care with public money, which would breach core NHS principles
- private care should be carried out at a different time and place to the NHS care being provided. This could include the facilities of a private healthcare provider, or part of an NHS organisation which has been designated for private care, including amenity beds
- the fact that some NHS patients also receive private care separately must not be used as a means of downgrading the level of services that the NHS offers
Health Secretary Nicola Sturgeon said:
"Earlier this year I announced that we would be revising current guidance in order to address concerns which had arisen over the complex issue of concurrent NHS and private treatment - also referred to as 'co-payments'.
"In this, the 60th anniversary year of the NHS, it is essential we uphold and protect the founding principles of the NHS. These principles quite righty continue to underpin the healthcare designed and delivered to meet the needs of patients in a modern NHS.
"Nothing in the new draft guidance should distract us from the priority of making sure that where a patient can genuinely benefit from a drug they are able to access it on the NHS. We must aim to ensure that decisions on "co-payments" are the exception not the norm.
"However, it is also clear that NHS Boards can be faced with complicated circumstances where a patient may wish to pay for treatment not provided on the NHS.
"We took the decision that a new framework with revised guidance would be helpful in assisting NHS Boards with the management of such circumstances.
"The revised guidance is underpinned by the premise that where, as part of their care a patient wishes to include elements of NHS care and private healthcare in combination and where this does not compromise patient safety; clinical accountability; probity; and existing treatment arrangements, NHS Boards should have arrangements in place to enable this to happen and in doing so, should keep NHS and private care elements clearly separate.
"We are some way forward already in ensuring that we can improve arrangements here in Scotland. I believe the policy in Scotland is right for patients and this revised guidance will help Boards, clinicians and patients understand the framework in which such care can be delivered.
"I encourage all those with an interest to respond to the request for views on the revised draft guidance so that the new framework can be put in place as soon as is possible."
The draft revised guidance has been issued to NHS Boards and other key stakeholders. The deadline for responses is January 12, 2009.