Tuesday, July 11, 2006

The wrong choice

I saw this story in Private Eye (1162; p30). Isle of Wight Primary Care Trust are being forced to pay Mercury Health £200K for 200 cataract operations: cash up front; no refunds. Mercury have, so far, only done four operations. No other trusts are wanting to buy these operations either. I had a look at this website and found that the situation is worse than the Eye states. It's 1650 operations a year, and up till March 2006, only 60 had been done instead of the expected 330, for which Mercury have been paid £335,412. Now a NHS cataract operation should cost £847. Sixty of them should cost £50,820!
I am not against independent providers coming in to perform operations, to help reduce waiting lists, and I'm fairly OK with the fact that the operations would only be done on patients with little medical history, who wouldn't require a general anaesthetic, with a low risk of complications. The hospital would be left with all the GAs, diabetics, frail elderly to treat of course.
The problem is that Mercury get paid for doing nothing. What's wrong with the Trust just paying for operations after they've been performed? That way, they can pay Mercury £50K for what they've done, and use the remaining money for the ophthalmic department in the hospital.
It's the patients' fault, of course. They've chosen the state-run hospital over the brand new private facility. The question is, why?
I assume they were given the choice; that, after all, is what the whole exercise is about.
Cataract surgery has a 95% success rate, or a 5% risk of complications. This would mean that of these 200 operations, you would expect to see about 10 of them going to the hospital for further treatment. Maybe the patients feel that if they should happen to be in the unlucky percentile, they'd be better off being in the hospital to start with where they might feel that the hospital ophthalmologists have more experience than the Mercury doctors.
Mercury do their operations at St Mary's Hospital in Portsmouth. No wonder patients on the Isle of Wight are put off by the Solent crossing.
These may be the reasons that patients prefer the Trust. If so, Mercury need to improve their PR drastically.

No comments: