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

Kenneth Ewart Boulding

Kenneth Ewart Boulding (January 18, 1910 – March 18, 1993) was an economist, educator, peace activist, poet, religious mystic, devoted Quaker, systems scientist, and interdisciplinary philosopher. He was co-founder of General Systems Theory and founder of numerous ongoing intellectual projects in economics and social science.

Boulding observes that the date that divides human history into two equal parts is well within living memory. In effect, our century (20th) represents The Great Median Strip running down the centre of human history. Thus he asserts,

“The world of today … is as different from the world in which I was born as that world was from Julius Caesar’s. I was born in the middle of human history, to date, roughly. Almost as much has happened since I was born as happened before.”

This startling statement can be illustrated in a number of ways. It has been observed, for example, that if the last 50,000 years of man’s existence were divided into lifetimes of approximately sixty-two years each, there have been about 800 such lifetimes.

Of these 800, fully 650 were spent in caves.

Only during the last seventy lifetimes has it been possible to communicate effectively from one lifetime to another–as writing made it possible to do.

Only during the last six lifetimes did masses of men ever see a printed word.

Only during the last four has it been possible to measure time with any precision.

Only in the last two has anyone anywhere used an electric motor. And the overwhelming majority of all the material goods we use in daily life today have been developed within the present, the 800th, lifetime.

This 800th lifetime marks a sharp break with all past human experience because during this lifetime man’s relationship to resources has reversed itself. This is most evident in the field of economic development. Within a single lifetime, agriculture, the original basis of civilization, has lost its dominance in nation after nation. Today in a dozen major countries agriculture employs fewer than 15 percent of the economically active population.

It has been pointed out that if there is another world war we will be living in caves again.

And working the land.

Just saying………


I’ve some notion of what it is that can make a person have a fondness for a place or hold it in some sort of reverence. Take Moorends (near Doncaster) for example. Not quite my first home but the one I remember as first. I lived there until eight or nine years old, my dad worked at the mine, and so did his dad. That’s all on the plus side and I remember no negatives about the village. I later learned that at one time my great grandfather was assistant engineer at the pit and if that’s not enough I had my first beer at my Aunties wedding in Moorends Hotel. 2 bottles of Darley’s IPA at age 12 and I floated down the road afterwards. What a lovely feeling. My maternal grandfather died there in a shaft accident at the grand age of 21. One big fat negative but no slight on the village and a link nonetheless.
The mine was always fraught with difficulties, the shaft for example was designed by German Engineers but its building was held up as they went off to fight in WW1. It was plagued with water and geological faults and eventually closed altogether in 2004 after years of static maintenance, a mining population that had mainly dispersed and a fairy godmother who failed to appear and sprinkle her magic dust.
Today the village has a population of about 4500, about 500 of whom are teenagers about half being hooked on heroin. 1999 was a busy year for Moorends in the media for all the wrong reasons. The Heroin problem hit the headlines, ‘The Pied Piper has come to town and heroin is his tune …’  for example. A quick google of ‘Moorends and Heroin’ for example throws up all sorts of negative stuff.
In fact between newspapers and Wiki we discover that Moorends in 2011 had 5 drug dealers, 3 fish and chip shops, 2 pizza shops, 2 Indian restaurants and 2 Chinese takeaways and is home to one pub, and two private members clubs. I’m not entirely sure which of these can count as pluses but the next time I’m in the area I think I’ll keep on driving.