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In the USA, hospitals have been buying up private practices to provide
integrated care.
Harvard has done a study on the effects - which seem to be increased costs
and also increased use of out-patient facilities.
http://hms.harvard.edu/news/unintended-costs-health-care-integration#.Vi0tJX
vpj1Q.twitter
I appreciate that the situation is different here, but friends who are in
private medical practice in the US tell me that what happens is that there
are other consequences as well:-
1. the physicians owning the private practice (which is a big financial
investment) are offered employment for 3-5 years: at the end of that time
they are dismissed because they are too expensive and are replaced by newly
qualified - and cheaper - staff.
2. there is no longer a supply of practices available for purchase - and as
the hospitals control who has admitting rights, no real possibility of
starting up new practices without hospital agreement (which won't be given)
3. performance targets are set to the highest possible volume - which may
not be safe if the patient has a complex condition - and patients have no
choice of provider supposing a different hospital has a better service for
their particular problem.
Will the same (apart from the purchase of practices) happen here in vertical
integration models?
Mary Hawking
Committee member BCS PHCSG
Retired from NHS on 31.3.13 because of the Health and Social Care Act 2012
"thinking - independent thinking - is to humans as swimming is to cats: we
can do it if we really have to." Mark Earles on Radio 4
http://primaryhealthinfo.wordpress.com/2014/12/01/can-integrated-care-satisf
y-all-of-freds-needs-including-patient-empowerment/