Chain store prices are far from the biggest rip-off in our hospitals

http://www.theguardian.com/commentisfree/2015/aug/28/hospital-phone-television-charges

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Is there something about the British mentality that inclines us to see everything as a shopping opportunity? Revelations this week that chain stores in hospitals charge higher prices – almost twice as much in some instances – than they charge for the same items in the high street have attracted more attention for the cynical rip-off factor than for the more shocking concept of having shops in hospitals at all.

The strangeness of this often occurs to me when I visit hospitals, as – because of family, friends and a fracture a couple of years ago – I have been doing rather more often than I would like. If you go into a hospital in France or Germany or Italy, you go into a hospital. There might be a flower stall outside, or a coffee kiosk, but the only quasi-commerce you will generally find inside the actual establishment will be a pharmacy. It is clear that the single business of the hospital is medical.

I cannot quite remember when I first noticed that you might confuse the reception area of a British hospital with a mini-shopping mall (albeit with higher prices), but it was probably some five years or so ago. And while part of me embraced the convenience, a much bigger part searched nostalgically for the good ladies of the Women’s Voluntary Service, with their reasonably priced basic coffee and sympathy (both commodities available on-site or to take away). Now, if they survive at all, they are exiled to the backwoods, in hospital terms, far away from the Costas and the M&S “Simply food”.

You can regard higher prices in such “outlets” as a rip-off or market forces. Doubling the price is unambiguously a rip-off. But prices even in chain stores are variable. I discovered recently that ground coffee at my local mini-Tesco was 30p more than at the prime-site Tesco in London’s St James’s. When I asked why, they cited “policy”. M&S charges more for snacks and much else at its branches by Tube stations than it does on the high street. You might say “captive audience”; they will say – as they said this week – longer hours, running costs, higher rent.

Who on earth thought it a good idea to mix NHS maternity wards and business?

Charging more in hospital outlets, of course, has a particular whiff of exploiting the weak and the sick. But there are other aspects of the British hospital that are at least as worthy of indignation, and to my mind somewhat more.

Start with the obvious – parking charges. The structure is often weighted to extract the most – given that it’s a hospital – from the vulnerable. For instance, there may be only an extortionate day rate, or an hourly rate paid in advance, so you gamble on your appointment being on time or risk a hefty fine. Why drive? Because public transport to many newer hospitals leaves much to be desired.

Then there are the “baby packs”, “free gifts” to new mothers. They may be convenient – that word again – but they are actually advertising promotions, designed to tie mothers to particular brands. They used to be distributed by company reps. Who on earth thought it a good idea to mix NHS maternity wards and business?

My pet hates, though, are the charges for phones and television. Phone charges are mercifully in decline, as most hospitals now recognise that patients with mobiles are going to use them. So unless there is a medical reason – the signal would interfere with equipment – they are generally permitted. There was a time, though, when charges to make a phone call were iniquitous.

Perhaps the TV cost has been increased to compensate? There is no doubt that having a personal TV is a million times preferable to the blaring set at the end of the ward. But what a performance, and an expensive one, to make it work. You need a card or a code; if the machine (in the corridor) doesn’t work, you have to phone an automated system to get one. If you move wards, you discover that the charge cannot be transferred. Plus, if you are bedbound, you have to get someone to buy your card, and if your hands or ears or eyes aren’t working too well – you are in hospital, remember – the complicated controls are likely to defy your best efforts.

So high street stores may be making a mint on the cards and the flowers they sell at hospitals, but there are even bigger rip-off artists out there. After all, with a bit of planning, you could buy your Get Well card elsewhere, but you are not going to lug in your own television set, even though – for me, at least – a bit of entertainment might be just what the doctor ordered.