As a general election gets closer, parties are fighting to be ‘protector of the NHS'. Jill Davies explores the possibility of NHS spending cuts and how health cash plans might change as a result
When the NHS was introduced in 1948, hospitals, doctors, nurses, pharmacists, opticians and dentists were all brought together under one healthcare umbrella. For the first time, services were provided which were free for all at the point of delivery.
Initially it was feared that offering free medical services would render health cash plans largely irrelevant and it did indeed lead to a fall in income for some contributory schemes, with some ceasing to operate.
But while some policyholders withdrew their membership, thousands of others were unsure that all the required and desirable healthcare would be included in the NHS offering. They were proved right when, in 1951, NHS charges were introduced for prescriptions, dental services and glasses.
As the years have passed, the NHS has changed beyond recognition to reflect advances in healthcare, knowledge and treatments. This has led to the public adapting to the changing services available to them and cash plan providers have had to continue to evolve to maintain their relevance.
The past year’s economic downturn has resulted in an unprecedented government deficit which must be tackled. Any new government will be looking to make cuts and it seems unlikely that the NHS will escape. The media are already speculating about how much this crisis will affect the NHS. According to media reports, health budgets will not be spared from the inevitable cuts to public spending that will follow an election.
Current Secretary of State for Health, Andy Burnham, has laid out Labour’s vision for the future of the NHS, which focuses on policies of prevention and shifting the emphasis of the NHS from being an illness service, to a wellness service.
A new prevention strategy is being proposed on Alzheimer’s, dementia, mental health and heart disease. Burnham has also elaborated on Gordon Brown’s announcement regarding cancer services, which involved pledging new rights for cancer patients to obtain results within a week, and direct GP access to MRI scans and ultrasounds.
But the Prime Minister has reported to G20 Finance Ministers that Labour would cut the Government’s deficit by half through a mixture of tax rises and spending cuts, a promise first made in the April budget. As a result, other parties seem to be bending over backwards to defend NHS spending cuts.
The Conservatives’ policy statements so far report a determination to protect the service. Shadow Health Secretary Andrew Lansley has pledged that, if elected, the Tories would continue to invest in the NHS, driven by patient needs, with savings made in administrative areas. A particular focus for the Tories is NHS dentistry. They want to bring more dentists back to the NHS and claim that a million more people will have an NHS dentist, with school check-ups for every child being put into practice.
The Liberal Democrat Shadow Health Secretary, Norman Lamb, has stated that there is a fundamental need to change the way the NHS currently works. He feels this can be achieved by devolving accountability and financial responsibility to a local level, empowering patients and the NHS workforce.
QUASHING THE QUANGOS
The Liberal Democrats are proposing to cut the amount spent on Quangos by a fifth, scrapping many of them completely. Lamb says he will also cut the bureaucracy of the Department of Health by half. Lamb forecasts that these, and other changes, would result in huge savings, over £1/2 billion a year, not only in central costs but in every hospital.
But whatever the political colour of the new Government, the reality is that it seems inevitable that the NHS will face cutbacks. Health cash plan providers are already working to anticipate and respond to changing health and wellbeing needs, offering a range of different plans with benefits to meet the evolving UK healthcare environment for both individual and corporate policyholders.
As a result of the recession, healthcare needs are changing, with the credit crunch having a definite impact on people’s health as they struggle to cope financially or with the worry of possible redundancy.
CONSIDER AND ANALYSE
Cash plan providers have to consider this and must continually analyse the healthcare environment to help identify where NHS provision and availability is diminishing. This leads them to develop new, innovative benefits in those areas where the NHS may need support, particularly helping to deliver the fast access to diagnosis and treatment that a patient needs and wants.
For example, Westfield Health realised there was a need in the market to assist with NHS waiting times for scans, which can crucially detect serious conditions such as heart disease, brain disorders and cancer early, potentially at a treatable stage. Westfield therefore introduced a scanning benefit to provide fast access to MRI, CT and PET scanning facilities.
Surgical cover for procedures normally classed as ‘non-urgent’ by the NHS is another benefit to enjoy popularity in the cash plan industry. These give employees the opportunity to access treatment quickly. It is different to PMI, however, as it covers non-urgent operations, such as those for gallstones, varicose veins and hip replacements, which often have longer waiting periods on the NHS.
The opportunities for cash plans to continue to ‘plug’ the NHS gap are likely to be many. And, as providers respond with new and improved benefits, an increasing number of employers and intermediaries will now be considering the comparative benefits of health cash plans and PMI, or looking at how the two can work together.
Rather than just being considered a lower-cost alternative form of health insurance, cash plans are now being recognised as a progressive business tool in their own right.
The new Laing & Buisson report, Health & Care Cover 2009, reflects this, showing sales of corporate-paid plans have increased by nearly 30%, building on already strong growth of 27% in 2007.
One of the reasons for this is companies recognising the role that cash plans can play in absence management.
The CIPD Absence Management Survey Report 2009 states that the average cost of absence has increased to £692 per employee, per year, with the most common cause of long-term absence in non-manual workers being stress, followed by acute medical conditions, mental ill health such as anxiety and depression and musculoskeletal conditions.
In addition, almost four in 10 employers say that the recession has increased their organisation’s focus on reducing absence levels and costs. And one in five said there had been an increase in reported mental health problems such as anxiety and depression in the last 12 months.
The appeal of HCPs is that they don’t just help employers to tackle absenteeism. They also offer staff, who may be struggling to budget during the recession, extra help with the costs of everyday healthcare, which can help to prevent health problems, increase morale and reduce stress – in itself a major cause of absence.
In the current climate, Employee Assistance Programmes (EAPs) with 24-hour counselling lines and face-to-face counselling can be a welcome employee benefit for many. The health of a workforce can have a significant impact on the health of a company – which in broader terms can impact on the economy.
EAPs have been found to help reduce absence in the workplace and lower employee stress levels. They cannot only play a valuable role in helping employees on long-term sick leave to get back to work, but can also improve staff health and wellbeing in general.
In addition, many cash plan providers offer therapy treatment benefits, giving employees the opportunity to tackle specific musculoskeletal problems without having to join an NHS waiting list. Many cash plans provide money back towards the cost of physiotherapy, osteopathy, acupuncture and chiropractic treatment, which helps people to treat their conditions and get back to fitness sooner.
To sum up, while cash plan providers may be developing new benefits far beyond traditional dental and optical, politicians are still looking at what is discretionary in the NHS and will increasingly review funding in other healthcare areas.
Cash plan providers therefore have a big role to play to help keep the health and wellbeing agenda on track. While we await the general election, we will keep a close eye on what Health Ministers are proposing, to anticipate changes and to continue to support the NHS services in the best possible way.
Jill Davies is chief executive at Westfield Health
