Public sector union Unison yesterday sounded the alarm bells over a move from NHS foundation trust bosses to lift the cap on the number of private patients they are allowed to treat.
A Unison 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 Foundation 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 in the House of Lords this week.
Hospitals in England with foundation trust status claimed they may be forced to refuse patients who want to top up their care under the new ‘co-payments’ rules because they fear they could be breaching NHS rules on private patients.
NHS managers have warned that unless the limit is scrapped they will have to send top-up patients elsewhere.
A British Medical Association spokesperson said: ‘This story illustrates the huge risks that lay before us with the decision to allow a limited form of co-payments.
‘While it was wrong that some patients were denied the opportunity to pay for treatments they needed, we need to avoid the creation of a two-tier system where some NHS patients receive inferior treatment to others.
‘We have to guard against a move towards a system where top-up payments are routine, and where patients could potentially be exploited by those seeking to make a profit.’
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.
It was only last November that the government agreed to allow co-payments, or top-ups – where patients pay privately for care not available on the health service while continuing to receive their NHS treatment.
Now foundation trusts have said this policy could come unstuck because of the long-standing rule on private patient income.
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 differs for each trust and is based on their private patient income in 2003.
There are 83 foundation trusts. Baroness Meacher, who is moving the amendment on their behalf said: ‘The cap just does not make sense anymore. NHS trusts do not have it so there is not a level playing field.’
Commenting on the Bill allowing direct payments to patients, Karen Jennings, UNISON Head of Health said: ‘There is a world of difference between giving patients greater say over their treatment, which we support, and giving them money to buy-in their own healthcare.
‘We are in real danger of creating a situation where patients use their personal budget ineffectively and then, like Oliver Twist, go back for more.
‘Or, patients will be persuaded to top up their budgets from their own savings undermining the very founding principle of free healthcare for all.’
She expressed concern over ‘NHS budgets, a two-tier NHS, staff training and development, and the possibility of greater rationing’.