There’s much debate and controversy about the continuing privatisation of the NHS. At a time when the UK population is growing older, just how much of a cash cow can the NHS be. As an old git who’s had a knee replacement I thought I’d look at what that operation cost and how it compares with charges abroad.


Knee Replacement Cost
Approximately 90,000 knee operations took place in NHS clinics and hospitals last year (2014) at an average cost of over £6,500 each.

Spire Healthcare www.spirehealthcare.com/ who run 39 private hospitals and take subcontract work from the NHS publish this on their website –

Primary Knee Replacement
Pricing detail £11,673.00

I would hope there’s some serious discount on that price to the NHS
But then –
Spire Healthcare sells 29.9pc stake to Johannesburg rival – http://www.telegraph.co.uk/finance/newsbysector/banksandfinance/privateequity/11690865/Spire-Healthcare-sells-29.9pc-stake-to-Johannesburg-rival.html

Cinven slashes stake in private hospital operator after agreeing £432m deal with South Africa’s Mediclinic.
Spire was floated last year by Cinven in a £842m listing after pricing shares in a public offering at 210p each. Since then, the shares have tracked almost 50pc higher as the company has allayed fears about its exposure to potential Government NHS policy changes.

In other words the Govn. has greenlighted private expansion. No surprises there then.

Looking elsewhere – An American website circa 2010
Price Estimates
Including room fee, nurse fee, food, pre-op tests, medical supplies,
medication, operating room fee, x-rays, and consultation.

Price (USD)
United States
$9,000 – $10,100
$7,000 – $11,200

That’s $45k to $60k. But then its blog from June 2012 –
Report underlines varying knee replacement costs in California
Posted by admin on Jul 31, 2012 in Knee Replacement Surgery.
A new report by California Public Interest Research Group (CALPIRG) emphasizes the variation in healthcare costs across the state, including the cost of knee replacement surgery.
The prices charged for surgery in California vary from one geographic region to another. We analysed hospital charge information provided in the California Common Surgery Cost Comparison database—a record of the prices charged for common, elective, inpatient surgeries performed at hospitals across the state—and created a charge index that can be used to compare charges for the 12 most common surgeries, such as Caesarean births, knee replacements and angioplasty. Though the database includes information on how much hospitals charged, not on how much they were ultimately paid, the observed variation in prices suggests important differences in surgery pricing.
The report observes that knee replacement costs in California were among the most variable, with prices ranging as high as $164,000:
“The typical knee replacement surgery performed in a Fresno-area hospital in 2010 was charged at $46,800, versus $127,500 in an Alameda-region hospital,” the report says, while “in the Alameda County area, which has high surgery charges,” prices “ranged from $59,800 at Alameda County Medical Center—Highland Campus to $164,400 at Washington Hospital—Fremont.”
So that’s a range of $45k to $164k that they know about. And going up.
What I found interesting was the Indian price range $7k to $11.2k. In other words the NHS costs are on a par with a third world country.

What about foreign investment into the UK’s healthcare?


This makes interesting reading showing some £2.3billion of foriegn capital looking for investment in the bricks and mortar of the health service providers.

The important thing to note here is that investment is in the property of healthcare providers.

‘UK Healthcare property continues to attract investors because of the sector’s characteristically long 25 to 35 year leases with RPI index-linked annual rental uplifts. Contrastingly, average lease lengths in
the core commercial property sectors have been falling steadily over the past decade and, in 2013, stood at just six years for UK All Property, according to IPD’s Lease Review.

The sector is benefiting from improving debt availability, with UK clearing banks increasing their lending exposure to Healthcare-fixed income deals during 2014. Subject to asset quality, business attributes and location, there is increasing evidence that banks and funds are prepared to invest and support established operators across the healthcare spectrum’.

Don’t you just love this gem –

Appetite for care homes in largely
local authority funded areas is
improving, with investors and
funds increasingly considering
UK regional cities.

Well, I’ve done my little bit of research and I’m even more convinced that the NHS is an enormous cash cow that investors across the globe are determined to grab a lot more of.
And what is it that’s being ripped off? A fantastic public service that knocks spots off the private service providers. What more can be said? In the era of austerity for the majority and rapidly increasing riches for the few I can only hope the health service workers who are marching and campaigning for the NHS are successful in their endeavours.
Long live the NHS