More Pressure on Employers to Pay

In their briefing on the Health and Social Care Bill which is being debated by MPs today, the Royal College of Surgeons (RCS) indicates that already, certain surgical procedures are no longer being commissioned by PCTs in some parts of the country because ‘they are incorrectly deemed to be of limited clinical value’. It highlights hernia surgery and hip and knee operations in particular. If this becomes widespread, the implications for employers could be serious.

There are going to be many cases where employees are away from work because of the conditions highlighted by the RCS. If the NHS is not going to fund their surgery, then who is?

Of course the counter argument is that there could be more cost effective ways of treating each individual other than surgery. I’m not a clinician, but available evidence and my own experience tells me that this is no doubt true in certain circumstances.

It’s hard not to see vested interests on both sides. Surgeons will lose business as a result, whilst PCTs and in the future, GPs who commission services will be looking to make the most of their available budget.

This leaves employers in a bit of a no man’s land when it comes to understanding what the best way might be to get an affected employee back to work. If they already provide private access to treatment then GPs will be more likey to refer for surgery as it is ‘off their books’. If employers solely rely on the NHS, then the non-surgical option will have more GP appeal.

I’m anticipating employers needing to spend more money on occupational health and second opinion services to see where they should be investing in their employees’ recovery and return to work. This need will grow in line with any deepening division between those who commission healthcare and those who deliver it.