1. ANNEXE 6

2. United Kingdom: Establishing a mixed economy in healthcare 2005 Duncan Innes Head of Public Policy

3. UK healthcare - key points • The National Health Service is funded by tax not insurance - there are no charges to see a doctor or go into hospital • The State owns NHS hospitals, although there is some freedom for management • Private hospitals do not employ doctors • All referrals to both public and private hospitals come through General Practitioners • BUPA insurance pays all costs for treatment in any private hospital (not just those owned by BUPA)

4. 27,000 NHS patients in 2003 UK: 35 private hospitals Mainly surgical operations l

6. Long-term care of older people 250 care homes; 16,000 residents mixed private and State ownership and funding

7. The future • Prices fixed nationally - similar to DRGs • Choice - by December 2005 all patients in England will be offered four or five hospitals for surgery, booked at a time to ensure short waiting • Still no choice of doctor, or what treatment is given • Commission for Healthcare Audit and Inspection inspects standards in both public and private hospitals on a similar basis

8. 18 - week waiting timeand up to 15% of surgical operations in private hospitals by 2008 Government to spend £500m-£1bn more on imaging (MRI;CT;PET) and pathology

9. ‘Why use private hospitals and insurance in the UK?’ • Morecapacity to permanently reduce waiting times • Better productivity to treat more patients. • Utilisation of all the resources available in England • spread good practice and innovation