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Hospital specialists' private practice and its impact on the number of NHS patients treated and on the delay for elective surgery

Author

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  • Antonia Morga
  • Ana Xavier

Abstract

This paper analyses UK NHS waiting times and waiting lists for elective surgery looking at the hospital specialists' behaviour and the conflict of interest these may face when allowed to practice privately. We look at the relationship between the government as the health care purchaser and principal of a two-tier hierarchy, and two hospital specialists, the agents, that deal with elective and emergency treatement. Specialists are organised in a separated structure, each responsible for only one type of surgery (either elective or emergency). We formalise specialists' preferences when dealing with the two activities. We see how specialists' interest in the income obtained with private practice (and altruism) affects negatively (positively) the optimal NHS numbers treated and increases the waiting time for elective surgery. Asymmetry of information also has a negative impact on the NHS leading to fewer patients treated or higher transfers paid. If remuneration is based on performance, transfers have to take private practice into account. As a result, there may be benefits from extra investment so as to improve information systems as well as seeking out instruments for nurturing more altruistic behaviour on the part of the specialists

Suggested Citation

  • Antonia Morga & Ana Xavier, "undated". "Hospital specialists' private practice and its impact on the number of NHS patients treated and on the delay for elective surgery," Discussion Papers 01/01, Department of Economics, University of York.
    • Handle: RePEc:yor:yorken:01/01
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    References listed on IDEAS

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    Citations

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    Cited by:

    1. Sherry A. Glied, 2008. "Universal Public Health Insurance and Private Coverage: Externalities in Health Care Consumption," NBER Working Papers 13885, National Bureau of Economic Research, Inc.
    2. Jacqueline O'Reilly & Miriam M. Wiley, 2007. "The Public/Private Mix in Irish Acute Public Hospitals: Trends and Implications," Papers WP218, Economic and Social Research Institute (ESRI).
    3. Siciliani, Luigi & Hurst, Jeremy, 2005. "Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries," Health Policy, Elsevier, vol. 72(2), pages 201-215, May.
    4. Sherry Glied, 2008. "Universal Public Health Insurance and Private Coverage: Externalities in Health Care Consumption," Canadian Public Policy, University of Toronto Press, vol. 34(3), pages 345-358, September.
    5. Olivella, Pau, 2003. "Shifting public-health-sector waiting lists to the private sector," European Journal of Political Economy, Elsevier, vol. 19(1), pages 103-132, March.
    6. Socha, Karolina, 2010. "Physician dual practice and the public health care provision. Review of the literature," DaCHE discussion papers 2010:4, University of Southern Denmark, Dache - Danish Centre for Health Economics.

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    More about this item

    Keywords

    waiting times and lists; elective surgery; hospital specialists;
    All these keywords.

    JEL classification:

    • H0 - Public Economics - - General
    • I1 - Health, Education, and Welfare - - Health
    • L2 - Industrial Organization - - Firm Objectives, Organization, and Behavior
    • L5 - Industrial Organization - - Regulation and Industrial Policy

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