Foundation trust hospitals will be able to take on an increasing amount of private work under new freedoms announced in the new white paper on health.
If the reforms are implemented the private patients income cap will be abolished, freeing foundation trusts to compete with the private sector for business.
The reforms will give foundation trusts scope to merge more easily and also to collaborate with private sector organisations.
The Foundation Trust Network has been lobbying for an end to the private patient income cap, set in 2002/03 to an average of 2% of revenue. This has restricted their ability to offer additional services and attract extra resources.
Health secretary Andrew Lansley told MPs that one of the best performing hospitals in Britain, the Royal Marsden, generated 25% of its income from private patients and this should be replicated across the country.
Sue Slipman, FTN director, said University College London Hospital was already providing their consultants with the opportunity to do private work. “Consultants benefit because they do not have to travel long distances to do their private work. The trust gains because their consultants on site if their NHS patients need them and helps them to attract high calibre doctors.”
Mental health trusts could offer talking therapies to business for their workforce health schemes. Liverpool Women’s Hospital was looking at a model to offer private fertility treatments, currently rationed by the NHS.
“Foundation trusts will play to their strengths. Some will provide the private treatment themselves, others will do the work in partnership with private sector providers and they earn money out of that,” she said.
Slipman said there would also be the opportunity for foundation trusts to exploit intellectual capital. “Clearly a lot of that is going to come from consultants and doctors - these reforms are incredibly motivating for everybody. It’s a way of saying now we can all get on with what we came in to the system to do. This very exciting.”
The government has said that all NHS trusts must become foundation trusts by 2013/14. Currently 130 of the 169 NHS trusts are foundation trusts.
But an analysis of the government’s proposals by Tribal, a private sector provider of public sector services, is pessimistic about the pace of growth of the private sector following the reforms.
“Over time the private sector will doubtless expand its currently tiny share of the market but organic growth will be comparatively slow. The major opportunity for the private sector would come if and when the current NHS incumbents fail to make the transition to the new regime. Under those circumstances government might well expect if not invite the private sector in.”
John Lister, director of the union-funded pressure group London Health Emergency, claimed the relaxation of the cap on private work was a step towards privatisation of the NHS. He complained that trusts might overstretch themselves in chasing private patients and could be driven by perverse incentives whereby they stood to make more money by getting patients into their private wings.
He also warned that doctors and other staff working for foundation trusts could also face the loss of national NHS pay and conditions as trust bosses cashed in on government plans to lift the cap on income from pay beds, private medicine, and deals with private companies.
“Andrew Lansley has made clear his wish to go further and make foundation trusts ‘off balance sheet’ as completely external providers to the NHS - meaning that their staff, too, would cease to be NHS employees,” he said.