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Hospitals 'may say no to top-ups' Hospitals 'may say no to top-ups'
(about 11 hours later)
Leading hospitals in England say they may be forced to refuse patients who want to top up their care because they fear they could be breaching NHS rules.Leading hospitals in England say they may be forced to refuse patients who want to top up their care because they fear they could be breaching NHS rules.
Elite hospitals with foundation trust status have a cap on the number of patients they can treat privately.Elite hospitals with foundation trust status have a cap on the number of patients they can treat privately.
And NHS managers have warned that unless the limit is scrapped they will have to send top-up patients elsewhere.And NHS managers have warned that unless the limit is scrapped they will have to send top-up patients elsewhere.
The House of Lords is due to debate scrapping the cap, but unions have said such a move could harm NHS care.The House of Lords is due to debate scrapping the cap, but unions have said such a move could harm NHS care.
It was only in November that the government agreed to allow top-ups - where patients pay privately for care not available on the health service while continuing to received their basic package of NHS treatment. It was only in November that the government agreed to allow top-ups - where patients pay privately for care not available on the health service while continuing to receive their basic package of NHS treatment.
Our fear is that it will allow these hospitals, with all their freedoms, to effectively become private facilities. That is not in the interests of NHS patients Unison spokeswomanOur fear is that it will allow these hospitals, with all their freedoms, to effectively become private facilities. That is not in the interests of NHS patients Unison spokeswoman
The move came after several high profile cases where cancer patients had been denied NHS services after paying for drugs themselves.The move came after several high profile cases where cancer patients had been denied NHS services after paying for drugs themselves.
But now foundation trusts have said the policy could unravel because of the long-standing rule on private patient income.But now foundation trusts have said the policy could unravel because of the long-standing rule on private patient income.
Sue Slipman, director of the Foundation Trust Network, said: "Hospitals are worried that because they are close to the cap they will have to send patients to other centres.Sue Slipman, director of the Foundation Trust Network, said: "Hospitals are worried that because they are close to the cap they will have to send patients to other centres.
"Top-ups is still bedding in, but in the future it could be a serious problem.""Top-ups is still bedding in, but in the future it could be a serious problem."
Such a scenario would be a blow to patients, as many of the 83 foundation trusts - such as the Royal Marsden, a specialist cancer centre in London - are among the best performing centres in the country.Such a scenario would be a blow to patients, as many of the 83 foundation trusts - such as the Royal Marsden, a specialist cancer centre in London - are among the best performing centres in the country.
Ms Slipman also said mental health trusts which have foundation status, of which there are 32, are also facing problems.Ms Slipman also said mental health trusts which have foundation status, of which there are 32, are also facing problems.
She said she knew of one trust which was struggling to build a mother and baby unit because it needed space for private patients to make it financially viable.She said she knew of one trust which was struggling to build a mother and baby unit because it needed space for private patients to make it financially viable.
DebateDebate
The network is backing an amendment to the Health Bill proposing that the cap be scrapped.The network is backing an amendment to the Health Bill proposing that the cap be scrapped.
It has been put forward by Baroness Meacher, who is chairman of a foundation trust in London, and is likely to be debated this week.It has been put forward by Baroness Meacher, who is chairman of a foundation trust in London, and is likely to be debated this week.
Baroness Meacher, a crossbencher, said: "The cap just does not make sense anymore. NHS trusts do not have it so there is not a level playing field.Baroness Meacher, a crossbencher, said: "The cap just does not make sense anymore. NHS trusts do not have it so there is not a level playing field.
"Of course, we don't want to see hospitals treating just private patients, so the amendment requires that any money made be reinvested back into NHS care.""Of course, we don't want to see hospitals treating just private patients, so the amendment requires that any money made be reinvested back into NHS care."
The cap was proposed by the then health secretary Alan Milburn, in an attempt to convince backbench Labour MPs in 2002 to back the bill, paving the way for foundation trusts to be free from central government control.The cap was proposed by the then health secretary Alan Milburn, in an attempt to convince backbench Labour MPs in 2002 to back the bill, paving the way for foundation trusts to be free from central government control.
It differs for each trust and is based on their private patient income in 2003.It differs for each trust and is based on their private patient income in 2003.
However, Unison is opposed to scrapping the cap.However, Unison is opposed to scrapping the cap.
A spokeswoman said: "Our fear is that it will allow these hospitals, with all their freedoms, to effectively become private facilities. That is not in the interests of NHS patients."A spokeswoman said: "Our fear is that it will allow these hospitals, with all their freedoms, to effectively become private facilities. That is not in the interests of NHS patients."
The Department of Health said the government would respond to the amendment through the parliamentary process in due course.The Department of Health said the government would respond to the amendment through the parliamentary process in due course.
But a spokeswoman also added that officials were carrying out a national audit of demand for unfunded drugs "to help inform our consideration of policy on the private patient cap in the future".But a spokeswoman also added that officials were carrying out a national audit of demand for unfunded drugs "to help inform our consideration of policy on the private patient cap in the future".