Forum Topic

Kingston Private Health

Rather disturbing to find, not that Kingston Private Health (KPH) exists – after all, the private health sector has existed alongside the NHS for its entire existence – but that it is actually located within Kingston Hospital itself and benefits from that location. KPH offers, it says, “affordable private healthcare” “at highly competitive prices. That sounds impressive, but you have to turn to a report in today's Observer to find that the treatments include hip replacements for a not-very-affordable £10,100 and that patients are cared for by “experienced NHS nursing staff.” And KPH itself boasts that its location within Kingston Hospital “allows us to keep costs down” and “ means you will benefit from peace of mind in the knowledge that immediate access to Intensive Care and High Dependency Unit beds is available.”The usual justification attempted for private health care is that it relieves pressure on the NHS, but it seems to me that, on the contrary, by locating itself in an NHS site and having access to NHS nurses and to NHS emergency care if things go wrong, KPH is leaching on the health service, and that’s plain wrong.

Richard Carter ● 889d56 Comments

The accounts state somewhere that the private part was closed during COVID so perhaps not representative of what the income might have been.But yes the income was small compared to the overall budget.PFI on the other hand is not small. Looking at various parliamentary reports and independent reports it is basically expensive debt that will take 30 years to pay off.I cycled through our local PFI hospital, Queen Mary's the weekend and you can smell the diesel smell the diesel from the generators used by the outbuildings.Just as well they do not have wheels on them otherwise XR etc will be gluing themselves to the car park. Oh I forgot they don't do that anymore having helped the government secure draconian legislation they ceased. Job done I guess!

Ed Robinson ● 881d

We certainly could do with a clarification from someone who actually understands accounts. The Kingston accounts for 2021-22 don't seem to help at all, whilst according to the NHS England accounts for 2018-19 which you also cite, Kingston Hospital Trust received a total of £247,703,000 in the year from Patient Care Activities, of which £515,000 (0.21% of the total) was from private patients (I've left aside the £51,614,000 of Other Operating Income, though this would have reduced the private contribution share even further).Have I got this right, that private health care contributed only one fifth of a percent of the income of Kingston Hospital Trust? If so - and I hope someone will correct me if I'm wrong - this doesn't, to put it mildly, seem overly impressive or a great deal to be grateful for. But a fuller cost benefit analysis on this, would be helpful, if anyone could provide one.

Richard Carter ● 881d

Sorry probably put this on before.

Barbara Stevens ● 881d

I believe Kingston Private Health was taken in house in 2019 according to the 2018/19 accounts p30:"The BMI contract ended on 31st March 2019 with the provision of private health services transferring back to the Trust under the name Kingston Private Health."https://www.england.nhs.uk/wp-content/uploads/2019/09/Kingston_Hospital_NHS_Foundation_Trust_Annual_Report_and_Accounts_2018-19.pdfLatest accounts are belowhttps://kingstonhospital.nhs.uk/wp-content/uploads/2022/09/KHFT-Annual-Report-Accounts-2021-22-01.07.22.pdfProbably need an accountants view but I think PFI is a bigger wider issue but let's not discuss that as that isn't the issue that the main parties want to address!

Ed Robinson ● 882d

Yet you still state outdated views as if we were back in the 70's ignoring international recruitment and student loans/tuition fees. As if staff belong to the NHS through some form of modern slavery, using the private sector as an excuse for low public sector wages and conditions."leeches on the NHS by employing staff who have been trained at public expense"

Ed Robinson ● 882d

Well when I was in Kingston Hos 9 yrs ago for 10 days, the staff that worked for Hosp were fine, but agency staff that came on in the evenings, wish I could say the same they were rude to the other staff who were going home. I could write a book. One elderly lady in my small ward was 98 I felt so sorry for, she was really tall and very slim. a nurse that came on in the evening grabbed her arm really tight, I was so glad when the elderly lady kicked her leg out of the bed and kicked her. All this young nurse did was keep shouting she kicked me, she kicked me, I wrote a report when I came out regarding this and the way the Agency staff talk to the other nurses. When I was due to leave on a Sunday the nurse that was on didn't appear to know I was allowed to go home as the doctor forgot to tell her, so I went and asked the doctor sitting outside the ward on the computer and she contacted him, he said yes I could go home. But the nurse still refused take away my canular. With that I started to get upset. As everybody who has been in Hospital knows you feel like you want to run out. Any way the lady in the next beds daughters stood in front of their mother and said to the nurse, your not toughing my mother till you have removed her drip. Home at last. I'm sorry to say but the nurses were not white.  But this March I was in for 4 days and you could not fault the nurses male and female, who seem to be all Philippians.

Barbara Stevens ● 882d

"Nothing would be done at all if one waited until one could do it so well that no one could find fault with it."John Henry Newman

David Ainsworth ● 882d

Once again, in your tiresome attempts to be contrary, you've picked the wrong target. Of course it's not "OK for the NHS to leech trained staff from other countries," a point I've argued here before. The answer is to train more staff in the UK, as any fule kno.

Richard Carter ● 882d

But let's not forget that the NHS only pays for part of the training for doctors."The NHS does not pay for medical school in the UK. Medical students have to get a student loan (or self-fund) in the same way as any other student. However, the NHS does offer a bursary for the final year’s tuition fees as well as a £1000 grant to all medical students.https://medicalschoolexpert.co.uk/medical-school-debt

Ed Robinson ● 883d

It is NOT OK for the UK to be depending on overseas staff because they have not allowed for enough training places here, and are not ensuring that the pay and conditions are good enough here to retain the staff trained here.

Philippa Bond ● 883d

"And in any case, it doesn't change the facts both that the private sector leeches on the NHS by employing staff who have been trained at public expense whilst making no contribution to this training itself"But it is OK for the NHS to leech trained staff from other countries? And what about the staff expenses? Tuition fees, student loans etc?This really is a dated point you are trying to make. Just below 50% of NHS nurses registered last year were from outside the UK.https://www.health.org.uk/news-and-comment/charts-and-infographics/how-reliant-is-the-nhs-in-england-on-international-nurse-recruitment

Ed Robinson ● 883d

Shouldn't there be full transparency of the costs and financial benefits to the NHS so that we, the taxpayers, assess these arrangements. Unfortunately to often these are obfuscated because of claims of non disclosure agreement. Perhaps such NDAs should be banned?

Michael Ixer ● 883d

"Thank you Tina.You have answered the question I asked earlier in the string. It's very easy for the OP to make a one sided argument very much as the press do to suit their agenda."And have you decided with which side's agenda you agree?

David Ainsworth ● 883d

"The key point is that the private units in the NHS  provide income that allows more NHS patients to be treated."But as I mentioned earlier, the key point is whether the resources used by KPH justify this assertion. And in any case, it doesn't change the facts both that the private sector leeches on the NHS by employing staff who have been trained at public expense whilst making no contribution to this training itself, and that when things go wrong, it is able freely to offload the problem for the NHS to handle.

Richard Carter ● 883d

"About a third of the gross income from NHS private practice is profit which all goes back into NHS services," your husband informs you. Are you (or he) saying that Kingston Private Health is a charity and keeps no profit for itself? If so, it'll be the first private company to do so...And you (or he) claims that "doing private practice within the NHS benefits all patients." It may provide some benefit, but the real question is whether this benefit wouldn't be larger if the resources used were devoted to the NHS.All this underlines, as Ivonne has suggested, that rather more information on KPH is needed.

Richard Carter ● 883d

"It's very easy for the OP to make a one sided argument"Strange comment: this is a discussion forum, not an academic exercise, and people put their own views - as you do, usually negatively, but you're as free to do that as anyone else.

Richard Carter ● 883d

There is the long standing argument about the private sector profiting from the public sector investment in staff etc.Of course that was a bit stronger before tuitions fees and graduate loans not to mention the NHS recruiting staff from poor countries around the world and basically doing the same.But the real NHS issues are vacancies not being filed, poor pay and conditions and newly qualified staff being lumped with debt. Add in the housing and standard of living issues the UK has - is it any wonder that more doctors are emigrating and staff leaving?It is not as if we have the best weather on the planet with lovely golden clean sandy beaches."St George’s Hospital A&E chaos as 60 nurses resign"https://www.wandsworthguardian.co.uk/news/23246781.st-georges-hospital-e-chaos-60-nurses-resign/"Meanwhile, a third (33%) of the 4,500 junior doctors in England surveyed said they were planning to work in another country in the next year."https://uk.news.yahoo.com/nhs-not-able-cope-poll-095226328.htmlhttps://www.mylondon.news/news/south-london-news/south-london-hospital-chaos-60-25962711

Ed Robinson ● 884d

Thank you Tina.You have answered the question I asked earlier in the string. It's very easy for the OP to make a one sided argument very much as the press do to suit their agenda.

Andy Pike ● 884d

1. Private NHS Beds are often used to support NHS patients and function as a safety valve2. The other 2/3rds is the cost of running the private service, this does not include doctors fees that are dealt with between patient/ insurer and the doctors.3. The key point is that the private units in the NHS  provide income that allows more NHS patients to be treated.

Tina Caroline Ainley ● 884d

Thank you for your post, Tina.I would dearly love to have more information on this arrangement.With the crisis at the NHS hospitals, it would be helpful to know if the beds used by the NHS private practice can be opened to non-private patients.  I am aware that some private hospitals do take NHS patients and the NHS is charged accordingly.It would also be of great help if you could let us know if NHS facilities are used for fee-paying patients. You mention that about a third of the gross income from NHS private practice is profit which goes back to the NHS services.  Could you give us an idea as to what happens to the other 2/3s?  Is it consultancy fees?As I said before, with the crisis in the NHS at the moment, a more robust explanation on how it works would be of great help.Thank you!

Ivonne Holliday ● 884d

My husband informs me, that the money raised by doing private practice in an NHS facility makes money for the NHS, that keeps NHS wards and theatres open etc. About a third of the gross income from NHS private practice is profit which all goes back into NHS services.I would respectfully suggest that you know the facts before making inappropriate comments. Hence doing private practice within the NHS benefits all patients.

Tina Caroline Ainley ● 884d

Very well informed but has been going this way for some time.Kings! Guys Chelsea Etc etc .Too many sleeping voters, as Labour did Nothing to stop!

David Thompson ● 884d

The Thames View  15th Floor of Charing Cross Hospital is private.

Philippa Bond ● 886d

The Royal Marsden also has private health wards.

Karen Taylor ● 887d

Philippa, what are your credentials, only you seem to answer on any subject.

Barbara Stevens ● 887d

With the pandemic I know that they tried to separate covid and non-covid wards at the very beginning but that they found this pretty unsatisfactory to start off with because they were not able to tell who had the virus and who didn't.  As time progressed this became clearer and testing that worked (well certainly most of the time) is still used before planned hospital procedures to try and protect the vulnerable both working in and visiting or admitted to hospital. Test and trace was an expensive disaster AFAI understand.

Philippa Bond ● 887d

Ed, that must have been upsetting being there so long as a child. The Porters used to take my son for a ride down there, he took a load of his toy cars there when he got older for the children. They also had the fete's in the grounds in the summer.

Barbara Stevens ● 888d

Yes Ed, 8 yrs I worked there at weekends in the Four Seasons Cafe, I used to take my son as well when he got a little older. The Porters took him on a ride down the corridor on their trolleys. I also worked in an office in the week somewhere else, must have liked working. Everything has changed so much.

Barbara Stevens ● 888d

I wish it was Barbara, I remember those corridors.I spent months in QM as a kid and probably had the occasional jam donut from your canteen.Most of the wards used to open out onto the wonderful grounds and had excellent light too. It's a shame it was lost. Closing QM caused chaos as Kingston A&E could not cope and took years to expand. Once A&E goes you lose all the other critical care services. QM building seems largely empty now, including the huge car park. I assume they need to still pay for the used space? Possibly until 2035!https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310020/

Ed Robinson ● 888d

Probably well before your time Ed, but I had my son in the old Queen Mary's Hospital, the corridors seemed to go on for ever. I was in M Ward and the wards were really large, I was kept in for a month with high blood pressure  on bed rest. I did 2 oil paintings by numbers while I was in there to pass the time.  A day or so after I had finished them, my blood pressure shot up so I then had to have my baby. But I must say even with the large wards, they were all really efficient.

Barbara Stevens ● 888d

I'm not sure what the health tourism loss is to the NHS, I could not find any recent stats. Possibly because it is either very low now or having a Conservative government in power for the last decade it may be politically embarrassing.There are certainly private patients either individually or through their government that pay. Crown dependencies being a good example.Incidentally crown dependencies seem to have a fair better service than the UK!But there is the opposite to health tourism and that is the NHS recruiting and financially benefitting from countries that can least afford it."NHS recruiting from ‘red list’ countries after Brexit loss of EU staff, says reporthttps://www.theguardian.com/politics/2023/jan/06/nhs-trusts-recruit-from-red-list-countries-brexit-eu-staff-loss

Ed Robinson ● 888d

One could argue that with PFI, you effectively have a NHS hospital in a private building.If some of that space is sublet to private health care then things do get complicated but no doubt less efficient.A quick reminder that Queen Mary's Hospital was closed under Labour despite a manifesto commitment not to close anymore hospitals. I asked the Labour MP at the time about this and he had no answer.

Ed Robinson ● 888d

Don't really understand what the query is. People pay insurance for their animals. You pay insurance on your property. People pay private if they want to for a hospital. If you look up a Consultant at Kingston Hospital, he might also work at Parkside. I've heard you can pay for a private room, even if you are having NHS work done. You pay if you abroad insurance. What does get on my nerves is people who come hear from other countries and haven't paid anything, just to get our health service and disapear with out paying.

Barbara Stevens ● 889d

But we dont know what they mean by keep costs down.Perhaps the business model is to rent space, share maintenance costs  etc rather than the expensive set up costs of building a hospital from scratch and purchasing land in central London.

Andy Pike ● 889d

According to KPH itself,"Our location within Kingston Hospital allows us to keep costs down," which rather suggests they're getting a pretty modest deal at least.  Other than that, there doesn't seem to be any data available.

Richard Carter ● 889d

No, I thought that as you said it was on gge cheap you would know the answer.So the fact is you do not know whether it's on the cheap or not.Half a story

Andy Pike ● 889d

Hospital beds were reduced over the years - and not always a bad thing.Much better to look at spending, outcomes & efficiency etc.I think the consensus from various reports is that the NHS is quite efficient but spending per population is low and many outcomes are poor.Lack of staff is a key issue and this will continue to be the case until policies are implemented to address the issue. The main two parties do not have any policies to address this.As with most things, looking at past spending decades ago is not necessarily an indication of what will happen in the future. Especially when both parties have shifted so far right. Compare Dobson to Streeting for example. https://www.kingsfund.org.uk/publications/nhs-hospital-bed-numbers"The total number of NHS hospital beds in England has more than halved over the past 30 years, from around 299,000 in 1987/88 to 141,000 in 2019/20, while the number of patients treated has increased significantly.'

Ed Robinson ● 889d

No idea, Andy; do you know?

Richard Carter ● 889d

But yes from print-screen!!

Ivonne Holliday ● 889d

Apologies for the double posting!!!I cannot copy-paste the table successfully, but the text states:The NHS has a shortage of hospital beds, with occupancy rates consistently exceeding safe levels. As the health system faces unprecedented pressures due to rising demand and the burden of COVID-19, bed capacity will remain a critical limiting factor in the ability of the NHS to recover.This page provides analysis on the availability and occupancy of beds in the English NHS and is updated regularly with new data.Last updated: 20 December 2022The UK has fewer hospital beds than comparable nationsCompared to other nations, the UK has a very low total number of hospital beds relative to its population. The average number of beds per 1,000 people in OECD EU nations is 5, but the UK has just 2.4. Germany, by contrast, has 7.8.Combined with staffing shortages, an insufficient core bed stock means that hospitals are less able to cope with large influxes of patients, for example during winter or periods of high demand.This has ultimately impacted hospitals’ ability to provide safe and timely care and remains a major factor in growing backlogs.

Ivonne Holliday ● 889d

Thank you Richard.  I Googled your suggestion and this is what is what I found but cannot copy-paste it successfully.  This is the link with information of number of beds. https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-hospital-beds-data-analysisIt certainly is very demoralizing!

Ivonne Holliday ● 889d

Richard can you advise what it is paying the NHS for accommodation at Kingston ?

Andy Pike ● 889d

Thank you Richard.  I Googled your suggestion and this is what is what I found but cannot copy it successfully.  This is the link with information of number of beds.  https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-hospital-beds-data-analysis It certainly is very demoralizing!
GermanyGermanyAustriaAustriaHungaryHungaryCzech RepublicCzech RepublicLithuaniaLithuaniaPolandPolandFranceFranceSlovak RepublicSlovak RepublicBelgiumBelgiumLatviaLatviaAverageAverageEstoniaEstoniaSloveniaSloveniaLuxembourgLuxembourgGreeceGreecePortugalPortugalFinlandFinlandItalyItalyNetherlandsNetherlandsSpainSpainIrelandIrelandDenmarkDenmarkUnited KingdomUnited KingdomSwedenSweden OECD Data • Total hospital beds refers to number of beds that are maintained, staffed and immediately available for use. Total hospital beds includes acute care beds, rehabilitative care beds, long-term care beds and other beds in hospitals.

Ivonne Holliday ● 889d

Re: social care, I think if people want to pay for a private, deluxe carehome, then that is their choice, as it is paying for private medical care.  However,  paying £1,000 + a week for a really basic carehome isn’t justified, where is the money going?

Martine Guy ● 889d

Thank you, Ivonne, those are significant and helpful figures - and you could also have added that the UK lags seriously behind almost every country in Europe in its hospital bed provision. There's also the issue if social care, which is possibly more serious than all the others.

Richard Carter ● 889d

The Chelsea & Westminster has a private maternity wing.

Martine Guy ● 889d

You're right that "for some time that the Private sector and the NHS have worked closely together," but having their own ward(s) in Kingston Hospital seems a step further. And the real issue is that the private sector in this case (as in others) is parasitic on the NHS in three ways:* it's getting accommodation more cheaply than in its own premises;* it's benefitting from the use of nurses  when it has made no contribution to their training - and, in the process, robbing the NHS of at least part of their time when it is already seriously short-staffed; and* when anything goes wrong,  it weasels out of any expensive difficulties by simply dumping the problem on to NHS emergency care.

Richard Carter ● 889d

And, in the same article:

Ivonne Holliday ● 889d

Hello Richard,
Thank you for your post and it is rather unsettling, to put it diplomatically! I was aware that there were private rooms, at a cost, available at NHS hospitals.  What I was not aware, that private medical healthcare was being carried out in NHS hospitals using qualified staff!  Grrrrrrrr But, as published in the BBC website yesterday, it is not surprising that "private care" is infiltrating the NHS.  Being really horrible, is that not what the conservatives have been after for some time?  Imitating the US healthcare? https://www.bbc.co.uk/news/health-64190440

Ivonne Holliday ● 889d

Hello Richard,
Thank you for your post and it is rather unsettling, to put it diplomatically! I was aware that there were private rooms, at a cost, available at NHS hospitals.  What I was not aware, that private medical healthcare was being carried out in NHS hospitals using qualified staff!  Grrrrrrrr But, as published in the BBC website yesterday, it is not surprising that "private care" is infiltrating the NHS.  Being really horrible, is that not what the conservatives have been after for some time?  Imitating the US healthcare? https://www.bbc.co.uk/news/health-64190440

Ivonne Holliday ● 889d

David,That is indeed the question especially considering the recent Labour announcements not to mention previous part privatisations and PFI.The Greens are clear (see below) but can they be trusted???As people say this has been going on for decades just more explicit.What makes absolutely no sense is diesel powered heaters for temporary or not so temporary outbuildings in Queen Mary's car park. They have been there since Covid and we're still there a month ago. Possibly to get around a PFI cost but would still need planning permission I assume.https://policy.greenparty.org.uk/home/archive/general-election-2019/public-nhs.html"We will:Fight for a publicly funded, publicly provided health service free at the point of use.End the creeping privatisation of the NHS and repeal the Health and Social Care Act 2012.Make mental health a much higher priority with resources to match this status.

Ed Robinson ● 889d

Katrina, I agree, I used to get Private Health with a company I worked for in the 80's. I had my wisdom teeth out at Parkside and stayed in overnight. Also Brompton had a floor for Heart Surgery that was Private. If you had Private Health you could have these done and your own room. My cousin in North London had to have her knee done last year as it was done 2 years previous but went wrong. Doesn't mean Private is any better than NHS because I have heard some awful things. All your really doing is getting a Private room and it done quicker. When I was in Parkside my face was really swollen after, but in the night a foreign lady was screaming for help along the corridor nobody was going to help her, I got out of bed to see if she was OK and went and found somebody to help.I prefer to be in a small ward so you have somebody else to talk to.

Barbara Stevens ● 889d

For Richard Carter.I think it has been the case  for some time that the Private sector and the NHS have worked closely together. I paid for a private operation out of desperation at the waiting time, in the 1980's. That was at Kingston, in a private room on a NHS ward. The surgeon said he preferred there, as the nursing staff were better than elsewhere.Since then and many NHS operations later at St Thomas's hospital, I found that floors of the hospital were allocated for private patients.At Chelsea and Westminster on a recent stay it was made known that private rooms were available to NHS patients for a fee. I think the NHS makes money where it can, but the largest holes in the budget still seem to be that  paid for agency staff. I think that was around £6million but could be wrong.

Katrina Black ● 889d

"I take it your not voting Labour at the next election then?"As Toots sang:-"It's a perfect ponder".

David Ainsworth ● 889d

Do we know how much they pay the NHS in rent, staff costs etc etc. You never know with the full story we might find it works for both sides.

Andy Pike ● 889d

I take it your not voting Labour at the next election then?

Ed Robinson ● 889d