Public inaccuracy; habitual self-interest; a substantial cost for the NHS

Benenden National Health Report 2015 reveals public perceptions about the cost of NHS care.

The UK public routinely underestimates the costs of many common NHS procedures and habitually prioritises its own needs when it comes to treatment, the National Health Report 2015 reveals.
The report, compiled by mutual health and wellbeing provider Benenden, questioned 4,000 people across the UK asking them to put a cost to some common procedures and treatments – ranging from natural child birth to liver transplants, while at the same time enquiring if they believe some of those treatments should be funded, at least in part, by the individuals on the receiving end. It also explored attitudes surrounding the public’s prerogative to those same NHS treatments, revealing disproportionality between what people believe others are entitled to and their own entitlement.
When it came to judging the cost of procedures and treatments, liver transplants were estimated to cost £12,279 per operation, when in fact the true cost is £70,000; abdominal hernia surgery, of which 7,489 low risk ones were carried out last year, were thought to cost £1,609 rather than the £2,281 in reality; almost half (48%) of respondents thought less than 2,500 gastric bands, gastric by-passes and gastric balloons procedures were carried out by the NHS each year, far shy of the real figure, which is double that at 5,443, costing the NHS in excess of £25m in 2014.
IVF comes low on the list of NHS priorities as far as the public is concerned, with more than three-quarters of those questioned stating that people should either contribute towards the cost of IVF or foot the bill entirely, with only 22% of recipients believing it is a treatment that the NHS should offer. One round of IVF treatment on the NHS costs between £1,287 and £6,000, with women under 30 years of age being offered up to three rounds, and women over 40 given just one round on the NHS. The younger the recipient, the more likely they are to believe that IVF should be funded by public money: 28% of 25-34 year olds think the NHS should pay in entirety for the treatments, while only 15% of 65-74 think the same.
Keeping to the topic of pregnancy, it is apparent that the public is naive when it comes to the cost childbirth, with almost half of people (47%) thinking it costs less than £500 for women to have a natural birth in hospital, without any complications. Even taking all survey respondents into account, the average cost of a natural birth is estimated to be £1,288 by our respondents, which is more than £500 short of the true figure of £1,824.
Commenting on the findings of the report, Medical Director of Benenden, Dr John Giles, said: “The issues surrounding NHS funding is an extremely contentious subject and disparity between the actual and perceived costs of treatments on the NHS needs to be addressed. As a nation we have lost touch with the role we should play in our own health and wellbeing, with a large proportion of the population relying on the NHS to maintain our health even if our own lifestyles are detrimental. This has led to a damaging culture whereby we are happy to point the finger when it comes to saying who doesn’t deserve treatment, but we take little responsibility on the individual impact we are all having on the NHS.”
Despite being naive when it comes to certain treatments, the public is accurate when judging the cost of cosmetic procedures on the NHS. The average cost of a ‘nose job’ is £2,498 for adults over the age of 18 and slightly more for teenagers at £2,582, which the public estimated quite accurately. The younger the respondent, the more accepting they were of cosmetic produces on the NHS to help those suffering from self-esteem issues: 38% of 16-24 year olds thought it was acceptable, while just 25% of 55-64-year olds thought cosmetic surgery courtesy of the NHS was OK, with the percentage dropping to just 18% in the 75-84-category. Shockingly, nearly one in 10 admitted to either lying to their doctor or knowing someone who’d lied about being depressed or suffering from low self-esteem in a bid to get free cosmetic surgery, with this trend much more common in the younger respondents.
The survey revealed that the public will take a hard line when it comes to treatments needed as a result of excessive lifestyle choices. The number of people who believed making poor health choices, including, obesity, drugs or alcohol, should result in not being treated by the NHS hovered around 51%-53% in each case.
Last year more than 1.4m people used NHS drug and alcohol services, including rehabilitation, at a total cost to the NHS of £136m – and Benenden’s survey respondents were unforgiving: just 15% thought treatment for alcohol abuse should be offered free-of-charge on the NHS, while 85% of respondents believed patients should either pay for their own treatment or make a contribution towards it. Similarly, one in 10 Brits think that if you need a liver transplant as a result of abusing alcohol, then the NHS shouldn’t provide it and a further 23% believe alcoholics should contribute towards the transplant. A more generous 43% thought they should get liver transplants for free providing they are alcohol free for three or more months prior to the operation.
When it came to looking at their own attitude to the NHS and what they feel they are entitled to, the public was more relaxed. Three-quarters (75%) of those questioned admitted they didn’t consider the cost of a procedure or worry that the free treatment they were receiving could be taking treatment away from someone in greater need, despite 62% expressing concerns that the NHS was under strain.
Another area where views on cost proved to split opinion is prescriptions. Currently in Scotland, Wales and Northern Ireland, prescriptions are free to all citizens. However, in England, unless you fall under certain exemptions then you are expected to pay for prescriptions. The Benenden report reveals that almost four in 10 (37%) thought the current system was unfair and that people in England should get their prescriptions for free, with an almost identical number believing it is the systems in Scotland, Wales and Northern Ireland that should change and start charging.
Dr John Giles commented: “These findings are somewhat worrying as they offer a perturbing insight into the sense of entitlement of the British public. This manifests itself in an enormous cost to the NHS, which is not helped when people abuse the system. Yet, unfortunately the burden often rests with healthcare professionals and the NHS itself.
The selfishness displayed by the public when it comes to looking at their own attitude to the NHS and what they feel they are entitled to is contributing considerably to the strain the NHS is currently under. If the public was more aware of the cost of appointments, treatments, operations and prescriptions, and really took responsibility for their own health, using the NHS only when absolutely necessary, the crisis the service finds itself in today would be significantly lessened.”

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