NHS Patients: Treatment Overseas (Hansard, 23 July 2002)

§ Lord Hunt of Kings Heath
My Lords, the cost of treating patients abroad will be met from existing local budgets. It is up to primary care trusts to commission treatment for their local populations within the resources that they have available.

§ Baroness Sharples
My Lords, I thank the Minister for that Answer. Can he say how many patients have been treated abroad so far and how many are expected to be treated abroad?

§ Lord Hunt of Kings Heath
My Lords, so far as concerns the test-bed scheme, as it is described, 190 patients received treatment in France or Germany between January and April at a cost of around £1.1 million. We do not have figures or estimates for such treatment in the future. That will depend on local decision-making within the National Health Service. We are evaluating the impact of the first pilot scheme and we will make that information available to the NHS. I hope that that will then inform future decisions.

§ Lord Clement-Jones
My Lords, the Government have prayed in aid commercial confidentiality when discussing the terms of these contracts with overseas providers. The outcome of the evaluation will be absolutely crucial. When will the results of the evaluation of the pilot schemes be available?

§ Lord Hunt of Kings Heath
My Lords, I cannot give a precise date because it has not yet been decided. It is the case that there are issues of commercial confidentiality. I have disclosed that the total cost of the January to April scheme was about £1.1 million. I understand that the costs of specific procedures are comparable to the costs of purchasing procedures in the UK private sector.

§ Lord Harrison
My Lords, given the need for savings in the costs of bureaucracy, is my noble friend advising PCTs to open euro accounts for transactions of this kind with others in the euro-zone countries?

§ Lord Hunt of Kings Heath
My Lords, I shall be happy to pass on my noble friend's advice to the NHS. I am sure that it will be very glad to receive it.

§ Earl Ferrers
My Lords, is the Minister aware that many people—including myself—admire the Government for taking the difficult decision to have patients treated overseas? Can he explain how other countries succeed in running their health services in such a way that they can look after their own patients and have room enough to spare to look after others when we do not seem to be able to look after our own?

§ Lord Hunt of Kings Heath
My Lords, the noble Earl should look no further than the record of his own government over 18 years, during which time there was consistent under-investment in the resources of the National Health Service. We have committed ourselves, over a five-year period, to raising the 187 amount of money spent on health in this country to 9.4 per cent of GDP. That will bring us up to roughly the level of spending in France. We will then be in a position to ensure that the targets we set will be met; that we will reduce waiting lists; and that we will have first-class services. In the mean time, it surely makes sense to use whatever capacity is available—whether in this country or abroad—to cut the amount of waiting that NHS patients have to deal with at the moment.

§ Baroness Noakes
My Lords, does the Minister accept that it is legitimate for the more than 1 million people waiting for treatment to ask that the NHS spends its money wisely? Will he answer the simple question posed by my noble friend Lady Sharples? What is the extra cost of treating NHS patients abroad compared with treating them in the NHS?

§ Lord Hunt of Kings Heath
My Lords, I thought I had answered that question. I said that the January to April pilot cost £1.1 million. I said also that the costs of specific procedures purchased abroad are comparable to the costs of purchasing procedures in the UK private sector. There are enormous variations in the costs of treatment in the National Health Service. It would be virtually impossible to give a two-line answer that out of those procedures some are worth more in relation to NHS costs. The noble Baroness was responsible for financial management in the NHS—she was a distinguished financial manager, if I may say so, for many years—and she will know that there are enormous variations in NHS costs. Of course we want to see value for money in using the private sector. We want to see comparability wherever commissioners purchase services—whether in the NHS or in the private sector—but, at the moment, it makes sense to use additional capacity to cut the number of people on waiting lists.

§ Lord McColl of Dulwich
My Lords, the Minister said that the continental costs were comparable to the private sector costs in this country. Did the purchasing go out to tender to the private sector in this country?

§ Lord Hunt of Kings Heath
My Lords, the NHS is using the private sector in this country to a great extent. Indeed, according to data made available to the department by the Independent Healthcare Association, between April 2000 and March 2002, at least 73,000 day cases, out-patient appointments and in-patient treatments were carried out for NHS patients in the independent sector. We are using the independent sector in this country, but we will also use other providers where it is appropriate to do so.

§ Baroness Howells of St Davids
My Lords, does the Minister agree that any money spent on ill patients is well spent? We know that there have been years of 188 neglect which have caused the NHS almost to pack up. We should all be pleased for patients who are having their hip operations abroad at whatever cost.

§ Lord Hunt of Kings Heath
My Lords, my noble friend has put the matter very well.

§ Baroness Knight of Collingtree
My Lords, bearing in mind the question directed to the Minister by my noble friend Lord McColl, did the purchasing go out to tender?

§ Lord Hunt of Kings Heath
My Lords, the NHS is using the independent sector and is reaching agreement around the country. Many different contracts have been agreed between the NHS and the independent private healthcare sector in this country. I have described a pilot scheme under which agreements have been reached with hospitals in France and Germany to provide even more capacity in addition to that being bought from the independent private care sector in this country. So the question of tendering simply does not arise.