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Lookup NU author(s): Graham Kirkwood, Professor Allyson PollockORCiD, Peter Roderick
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© 2024Parliament has imposed duties on the government and NHS in England aimed at reducing health inequalities. Aim: to understand the effect on inequalities of government policies, which require the NHS in England to outsource elective surgery to the private sector. We analysed the numbers of admissions for hip and knee replacement surgery from the least and most deprived population quintiles in three time periods: before the introduction of the policies (1997/98–2002/03); following the implementation of the independent sector treatment centre programme (2003/04–2006/07); and after the extension of 'choice at referral’ (2007/08–2018/19). Results: despite admission rates doubling and trebling for hip and knee replacements, respectively, between 1997/98 and 2018/19, inequality grew to the detriment of the most deprived. Inequality grew at the fastest rate during period 3; admission rates to the NHS fell while admissions to the private sector continued to rise. By 2018/19 almost a third of NHS funded procedures were provided privately. In 1997/98, for every 10 patients admitted for hip and knee surgery from the most deprived quintile, 13 and 9, respectively were admitted from the least deprived, by 2018/19 the gap had widened to 19 and 15, respectively. Socio-economic inequalities for hip and knee replacement have widened as outsourcing of NHS treatment to the private sector has increased. The NHS must rebuild in-house capacity and provision instead of outsourcing care.
Author(s): Kirkwood G, Pollock AM, Roderick P
Publication type: Article
Publication status: Published
Journal: Health Policy
Year: 2024
Volume: 146
Print publication date: 01/08/2024
Online publication date: 22/06/2024
Acceptance date: 21/06/2024
Date deposited: 08/07/2024
ISSN (print): 0168-8510
ISSN (electronic): 1872-6054
Publisher: Elsevier Ireland Ltd
URL: https://doi.org/10.1016/j.healthpol.2024.105118
DOI: 10.1016/j.healthpol.2024.105118
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