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Private enterprise

The private sector needs to play a greater role in influencing the debate on future healthcare funding, says Bupa Insurance managing director Fergus Kee

About 7.5 million people in the country have private medical insurance – about 13 per cent of the UK population. Although this figure rose slightly in 2004 compared with the previous year, there is still no room for complacency in private healthcare.

If the private sector is to grow the market, it needs to offer high-quality, affordable healthcare which is truly different from public provision and meets the changing needs and expectations of customers.

One of the biggest challenges the industry faces is the need to better demonstrate the differences between what private healthcare offers and what the NHS offers.

In a recent survey, Bupa asked people to name the most important things for patients. They said: The quality of medical treatment; good nursing care; clean, comfortable surroundings; being kept well informed and involved; and fast treatment at a time to suit them. On four out of five of these measures, they said the independent sector was better able to deliver. On the standard of medical treatment, they said the NHS and the independent sector were equal.

Corporate customers also value the private sect-or’s contribution. More companies are focusing on the broader contribution private healthcare makes to productivity and profitability through services which manage sickness absence, support employ- ees and help get them back to work quickly.

So there are key differences between the NHS and the private sector which are highly valued by customers but medical insurers are not making these clear enough. The industry needs to better demonstrate the differences in areas that are important to patients, such as speed of access and quality and where the standard of treatment in the private sector is higher.

Another challenge for the industry is the need to deliver affordable health-care. Private medical insur-ers need to offer customers the best healthcare cover possible while maintaining affordable premiums. Slow-ing the rate of premium inflation will not be easy and the only way to address this issue is for insurers and providers, hospitals and consultants to work together to make improve-ments that will benefit premiums without affecting the quality of care.

One way to do this is for private medical insurers to contract with hospitals and doctors to provide a standard delivery of care to give the best possible outcome for patients at a cost-effective price.

This will involve taking a different approach to the purchasing of healthcare with hospitals and new ways of working with doctors. It is important that all providers demonstrate that they can meet defined evidence-based quality criteria. Insurers need to work with hospitals and consultants to review how care is delivered and identify opportunities where, together, we can improve efficiency and effectiveness.

As well as slowing the rate of future premium inflation, the industry needs to develop new products which better meet the existing and emerging healthcare needs of today’s and tomorrow’s customers.

More clients are looking for a broad range of serv- ices to help them manage health and health-related productivity issues across the entire workforce, from stress through sickness absence, EAPs, occupational health as well as traditional acute elective surgery. The industry must be able to offer these services and show companies the economic benefits they bring.

In the personal market, the product trends are less clear. Some customers are more focused on positive health, wellness and fitness while others are more concerned with the health issues of the elderly. But what is clear is that the private sector needs to work harder on product development and be genuinely guided by what customers want.

Brokers and IFAs have an important role to play in helping to grow and develop the market. Advice and guidance for customers is important – not all health cover is the same. There is no such thing as “quality medical insurance at half the price”. There is a difference between policies which offer comprehensive cancer cover and those which provide no cancer cover at all and customers need to under-stand what they are buying.

We strongly believe the private sector needs to play a greater role in influencing the debate on future health-care funding. In Ireland and Australia, for example, about 50 per cent of the population have private cover. People there have more choice, are more involved in their healthcare and in doing so reduce the strain on the state system and the public purse. It is important that the private sector is able to influence the debate to explore if there might be a better way to bring public and private funding of healthcare closer together.

As an industry, we need to make private medical insurance more affordable and attractive by stemming the rise in premium increases and demonstrating the adv- antages for customers. This is not a simple agenda and will not happen overnight. But if insurers, hospitals, doctors, brokers and IFAs all work together, we can develop and grow the industry, deliver better and more affordable products and services to our customers and improve healthcare in this country for the benefit of all.

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