UK Surgeons fees - the highest in the world?

According to a recently published study, the answer to this question seems to be a definite "yes"!

The study was carried out by the independent consultancy, National Economic Research Associates, and was commissioned jointly by Norwich Union Healthcare and the "Financial Times." It found that UK Consultants charge on average between 22% and 59% higher than their colleagues in other developed democracies and that this difference is as much as 400% for some procedures. The study looked at charges in the U.S.A., Australia, Canada, Germany and Spain and reports that the higher charging was most marked for cataract removal, tonsil removal and for heart bypass surgery.

While the study is interesting, it only confirms the findings of other similar studies done previously. It comes at a time, however, when the private sector's costs are under particular scrutiny. For the past two years private hospitals have been in partnership with the NHS to help clear waiting lists with the help of large amounts of extra funding from the Government. The Government is now looking seriously at what it has to pay to get operations done in the private sector and decided that it is too much. As reported in a previous Mellon Corporate Health Update, this has resulted in future contracts for NHS work being given to organisations other than the traditional UK private hospital operators. These are mostly foreign companies whose cost cutting plans include the use of surgeons from abroad who will not be tied to the UK fee charging structure.

To be fair to British surgeons, it is the existence of the NHS that partly explains the high private charges. For the great majority of surgeons in the UK, private practice is done, or should be done, outside of their normal NHS working hours. Most of their time is spent working for the NHS at a salary which is well below the level of remuneration that colleagues in many other countries enjoy. UK surgeons would probably claim, therefore, that a comparison done on the basis of total earnings rather than just private income would show them as being no better off than their foreign colleagues.


Fixed prices for NHS operations:

The NHS has announced that over the next three years it intends to move towards paying a fixed fee for regularly performed procedures.

As explained above, this is part of the Government's new policy of tightening up on what it pays to deliver reduced waiting lists following the realisation that it has had to pay around 40% more on average to have an operation carried out in a private hospital as compared to the cost in Trust or other NHS facilities.

The new schedule of fixed charges will apply to NHS hospitals as well as private and is something of a bold move. If it can find enough takers for the new charges then the Government will succeed in having more cash to spare to reduce waiting lists further or for other developments in the NHS. Furthermore, the existence of rates declared in advance and not for negotiation will remove much of the time and effort involved in contracting that goes on now.

Some hospitals, private and public, are already saying, however, that the new tariffs do not begin to cover their costs. On the face of it, £10,199 for a heart bypass or £786 for removing a cataract does not seem unreasonable; but much depends on whether organisations considering these rates are expecting to pay UK traditional fees to the surgeon or something less generous. There are also other considerations. Costs vary in different parts of the country, especially in London, and some hospitals have to bear costs that others do not. Teaching hospitals, for instance, have always been recognised as having higher costs because of the demands of training the future medical profession while at the same time allowing the present generation to function.