Hellenic Project Update

Health Insurance News reported that the private health sector has agreed to more transparency by being part of the new Hellenic Project which aims to gather information about the sector from various sources.

It seemed like a very good idea that private and health insurance customers could have information about what the private health sector had to offer compared to the NHS. It would also have been a good way for individual hospitals to have been compared to each other.

Unfortunately for consumers there are currently no plans to publish the results of the project. This is a great shame. Transparency is something that seems particularly important when it comes to health care. Its not like other consumer products. If you buy something and its not good you won't buy it again and you will tell your friends that you didn't like it too. What have you lost? A few pounds and a little inconvenience.

There is a great deal of evidence that suggests that people regularly use customer review sites to make their minds up about purchases but purchasing health care is a different kettle of fish. If you become unwell and something goes wrong with your health care there is a lot more to loose. So, if the statistics are there why can't we see them?

The Hellenic project is a good start and it is possible that consumer group pressure will eventually encourage the industry to reveal all. This can only be beneficial to the consumer who has the right to vote with their pound once they have all the information at their disposal.

New Bupa Select

Bupa Select is a new health insurance offering for small to medium sized businesses. It became fully available from 1st December and aims to offer flexible cover in these difficult financial times.

Director of business markets for Bupa, Ann Greenwood, said:

'High broker demand told us we needed a policy that was much more flexible and modular rather than simply opting for a ‘one size fits all’ approach with lots of features you pay for but may never use. When we tested BUPA Select in the run-up to the launch, brokers were impressed, particularly with the web-enabled functionality and the flexibility available to build bespoke cover.'

This private medical insurance cover enables companies to build a bespoke cover for their employees by enabling them to add or remove various cover options. The policy is available for companies with between 50 and 250 employees.

According to Bupa they have made all their administrative procedures more efficient and streamlined in order to provide a better customer experience. They are also offering a 30% discount for companies that sign up to the scheme before 31st December 2009.

Some of the main features of the product are:

• £1000 towards out-patient consultations, treatment and diagnostic tests
• £250 towards complementary medicine
• full refund for in-patient and day-patient hospital charges and accommodation in a Bupa Partnership Network hospital.
• Full cancer cover
• up to 45 days of psychiatric treatment
• private ambulance
• £50 NHS cash benefit to cover each night in an NHS hospital
• 24-hour Bupa HealthLine
• Free use of Positive Health

Reduction in Costs:
• Policy excesses of £100, £150 and £200
• reducing out-patient benefit to £750, £500 or £250
• excluding psychiatric treatment

Extra Cover:
• Including cash cover to help with optical, dental and prescription costs.
• increasing benefits for out-patient treatment to £1500
• removing the limit for complementary medicine
• increasing the range of hospitals available

Swine Flu Information

The H1N1 virus is back and after a slow start the private medical insurance companies are now giving clearer information about their position on cover for swine flu.

All the medical insurance companies direct you to the government helpline and offer guidelines on how to treat and prevent the virus.

Aviva says that they have 'robust plans in place to help ensure that we can continue to support our customers in the event of a pandemic.' They state that swine flu is not treated on either their International Private Healthcare or UK Private Healthcare products.

CS Healthcare Say that their first priority is to offer their members up to date and accurate information and advise customers to call their GP or NHS Direct if they have any concerns.

Bupa state that they do provide cover for swine flu but that

'The details of the cover will depend on your scheme and is subject to the standard terms of your scheme.'

They also direct people to their Bupa health and information service which is manned by fully qualified nurses. The also make it clear that they do not cover preventative medicine which includes the tamiflu vaccination.

The Association of British Insureres (ABI) are very quiet on the topic of swine flu and health insurance and although they do offer a lot of information about travel insurance and the H1N1 virus.

Overall there has been very little information offered by the health insurance companies over their position on swine flu. This is quite dissappointing considering the natural concern shown by the British public.

Luckily, so far the intensity of the virus has not been as serious as some sources predicted. There is no data available for the number of complications of swine flu that health insurance companies have had to deal with.

Accountability for the Private Health Sector

The private health sector has often been criticised for its lack of transparency. Since May the Hellenic project has been redressing this balance.

The NHS has to be accountable and the public have the right to see the statistics that they publish. Previously private organisations were only accountable to their shareholders. However, with more and more NHS patients choosing to have treatment in private hospitals as part of their NHS treatment plans it makes sense that the NHS want to see more transparency from the private health sector. More than 300,000 patients a year are being treated privately via the NHS.

The Hellenic project collects anonymous clinical and non-clinical data. Anonymous data is not ideal. Whereas in the NHS individual trusts and hospitals have their data exposed for comparison this does not yet apply to the private sector. It is however, a step forward.

The data collected comes from patients and hospitals as well as third party agencies such as the Health Protection Agency and the Care Quality Commission.

The information collected includes: mortality rates, MRSA and C.diff rates, and surgical site infections for knee and hip operations and day case rates.

Sally Taber, director of the Independent Health Advisory Services (IHAS), said:

'The Hellenic Project presents an exciting opportunity. For the first time independent sector providers will be able to accurately measure clinical quality at a national level, both within the sector and against the NHS. With the advent of patient choice, patients are increasingly able to tell us where healthcare is succeeding and where it is failing and the information we gather should help us fully assess that.'

The project is being run as a partnership between Dr Foster, the Independent Healthcare Advisory Services and the NHS Partners Network.

Currently there does not appear to be any readily available information about the Hellenic project. The Dr Foster website does have information about the whereabouts of private hospitals but that is all.

Infection Rate Differences

There are significant differences between infection rates in the NHS and that of the private sector. This is one of the main reasons why people choose to take out private health insurance rather than rely totally on the NHS. But why are there such differences?

The statistics are very telling. You are twelve times less likely to get a hospital-acquired infection (HAI) in a private hospital than in an NHS hospital. A recent report from Dr Foster which looked into the safety of patients in the NHS found that 5,024 people with low risk problems died in UK hospitals during 2009.

The NHS has done a lot to improve infection rates and much has been accomplished in the last three years. For example the Health Protection Agency reported that the rates of MRSA have fallen from 839 cases between April and June 2008 to 509 cases for the same period in 2009.

Despite improvements, public perceptions about NHS infection rates are still poor. Additionally the comparative figures show significant differences between the NHS and private sector rates.

One of the infection prevention measures used by private hospitals is the pre-screening of patients for infections. This ideas has been adopted by the NHS but the recent Dr Foster report found that one in five hospitals did not use this technique.

There are different levels of care in the NHS across the UK with some Trusts having very poor levels of infection control. This is one big difference between the NHS and private health institutions. Private hospitals tend to have very standardised levels of infection control across their networks.

Dr Andy Jones, group medical director of Nuffield Health claims that Nuffield hospital only had 6 cases of C-Diff (clostridium difficile) and one case of MRSA in 2008. During this time they performed 365,000 operations.

So why are there such differences? According to Spire Healthcare’s clinical director Dr JJ de Gorter it is about commitment and attention to detail. He said:

'The simple truth is that is achieved through blood sweat and tears. There are no reasons to suggest why working in private sector, would automatically mean that rates would be better. It’s attention to detail, a commitment and an obsession with infection control.

We respond to the market and consumers tells us that it’s important. We over-invest. Is it proportional to the actual harm caused? Potentially not. Is it proportionate to the patient’s perception? Yes it is.'

This shows the importance of consumer confidence. Feeling that everything possible is being done is very important to feeling safe and comfortable.

So, for the meantime the NHS has a long way to go not just before their HAI rates are more under control but also before the public have confidence in their abilities.