Government abandons plans to use payments to prevent private providers selecting simplest cases

The Department of Health for England has dropped plans to use the NHS Payment by Results tariff to prevent “cherry picking” of patients by private sector providers.

Last November the department promised to use the price mechanism, under which hospitals are paid for the particular services they provide, to ensure that lower prices were paid to providers who tackled only the simpler cases. The undertaking was a response to fears expressed during the passage of the Health and Social Care Act that private providers would skim off the most profitable patients, leaving NHS hospitals with more difficult cases whose costs would not be fully covered by the tariff.1

David Flory, NHS deputy chief executive, told the Health Service Journal at the time: “This isn’t about poking the independent sector providers in the eye, it’s about being really clear about transparency and fairness.” But on 20 September the Financial Times disclosed that Flory wrote to NHS managers saying that the health department no longer planned to tackle the issue through changes to the tariff.

A department spokesman told the BMJ, “We are committed …