Pay Beds (Hansard, 11 April 1978)

§ Mr. Ennals

Section 65 of the National Health Service Act 1977 lays down the384W method to be followed in determining new pay bed charges operative from 1st April each year. Under subsection (3) I have power to classify Heath Service hospitals and determine the charges to be made within each class for the accommodation and services provided at a hospital falling within each class. In determining the charges I am required to have regard to the total cost which, by reference to the facts known to me at the time of the determination, it is estimated will be incurred during the year commencing 1st April in the provision for resident patients of services at hospitals within each class. I also have power to include such amounts as appear to me proper and reasonable by way of a contribution to expenditure properly attributable to capital account.

The method for calculating charges for 1978–79, summarised in the schedule below, is as follows:

(a) The in-patient costs in 1976–77 for each hospital with pay beds were averaged for each of the six different classes of hospital. These average costs were increased to take account of administrative costs at district and board of governors level—which were not included in the hospital costing returns—movements in NHS pay and prices during 1977–78, provision for inflation in 1978–79 and planned increases in the real level of expenditure on the service. This produced an average cost basis for each class—item 1 of the schedule.
(b) An addition in respect of capital was calculated by reference to the average capital expenditure on hospital in-patient services for the years 1975–76 to 1978–79 (estimated) at 1978–79 prices. This expenditure is expressed as the cost per occupied bed per week at item 2. The full resulting amount of £20 per week was not included in the charges for long-stay and psychiatric hospitals since most capital expenditure is outside these classes, which attract very few private patients.
(c) Items 6.-9 of the schedule give details of the adjustments made in accordance with Section 65(4) and (5) of the Act, depending on whether the patient occupies a single room or other accommodation and whether he is paying the consultants separately for treatment. The daily charges are rounded to the nearest 10p.

385W

PRIVATE IN-PATIENT CHARGES 1978–79
				Long-Stay	Psychiatric	Acute and other (Non-Teaching)	Acute and other (London Teaching)	Acute and other (Provincial Teaching)	Postgraduate Boards of Governors
				A	B	C	D	E	F
				Week	Day	Week	Day	Week	Day	Week	Day	Week	Day	Week	Day
				£	£	£	£	£	£	£	£	£	£	£	£
1. Average cost basis 1978–79	169.77	—	99.67	—	266.01	—	423.41	—	312.71	—	432.52	—
2. Capital contribution	…	4.00	—	4.00	—	20.00	—	20.00	—	20.00	—	20.00	—
3. Total basic charge	…	173.77	—	103.67	—	286.01	—	443.41	—	332.71	—	452.52	—
4. Consultant's pay—
at 5.2 per cent. of 1 (classes A-C)	…	8.83	—	5.18	—	13.83	—	—	—	—	—	—	—
at 6.6 per cent. of 1 (classes D-F)	…	—	—	—	—	—	—	27.95	—	20.64	—	28.55	—
CHARGES
(a)Shared room or ward
Patient not paying separately for treatment (item 3)	173.77	24.80	103.67	14.80	286.01	40.90	443.41	63.30	332.71	47.50	452.52	64.70
6. Patient paying separately (item 5—item 4)	…	…	164.94	23.60	98.49	14.80	272.18	38.90	415.46	59.40	312.07	44.60	423.97	60.60
(b) Single room
7. 10 per cent. of item 6 addition for single room	…	16.49	—	9.85	—	27.22	—	41.55	—	31.21	—	42.40	—
8. Patient paying separately for treatment (item 6+7)	181.43	25.90	108.34	15.50	299.40	42.80	457.01	65.30	343.28	49.00	466.37	66.60
9. Patient not paying separately for treatment (items 8+4)	…	…	…	190.26	27.20	113.52	16.20	313.23	44.80	484.96	69.30	363.92	52.00	494.92	70.70

386W