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Women are being urged to attend tests to assess the risk of cervical cancer, as figures emerged this week suggesting that almost a third of the female population have never been for any type of health screening.
Almost a third (29%) of more than 1,000 women surveyed for Bupa by Ipsos MORI say they have never been for any type of health screening. Bupa, which released the figures to mark Cervical Cancer Prevention Week, said that this suggests that many women are foregoing tests which could prove vital in detecting abnormal, pre-cancerous cells which may lead to cervical cancer.
At present, women between the ages of 25 and 64 are eligible for a free cervical screening test, paid for by the NHS, every three to five years. Meanwhile, a cervical smear test is also one of the tests included in Bupa’s female health assessment.
While around 2,900 women in the UK are diagnosed with cervical cancer every year, deaths from the disease having fallen over the last 25 years, precisely because of large numbers of women undergoing cervical screenings, Bupa said.
However, the provider warned that many women are put off going for a screening owing to a lack of information on what it involves and anxiety about dealing with abnormal results. Dr Katrina Herren, medical director, Bupa Health and Wellbeing, said early detection of pre-cancerous cells is “vitally important” in preventing cervical cancer.
Last year, a survey for Jo’s Trust, a charity, suggested that young women are missing the potentially life-saving cancer test because they find it difficult to take time off work.
 Almost a third (32%) of women have missed or delayed a cervical screening appointment, according to the poll of 2,467 women. More than a third of those eligible for cervical cancer screening who work and have missed or delayed appointments said that they did not find it easy to leave work in order to attend the appointment. More than a quarter (26%) said they would be more encouraged to attend if their company was more flexible and they did not have to take holiday for an appointment. More than a third (35%) said that if their GP surgery opening times had been more flexible it would have encouraged them or even ensured they attended those appointments.
Almost one in three (30%) of women aged 25-34 that have missed or delayed appointments and work said they always book holiday to attend appointments because they are too embarrassed to talk to their employers.
Meanwhile, a report released towards the end of last year by the US-based think tank the Commonwealth Fund suggested that five-year survival rates for cervical cancer is lower in the UK than in developed countries and that care varies across the country.
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Arrangement could help to settle disputes over financial responsibility
A national insurance scheme could be introduced to protect consumers in the wake of the breast implant scandal.
NHS medical director Professor Sir Bruce Keogh told the BBC that the introduction of a scheme similar to the Abta (Association of British Travel Agents) arrangement is currently under consideration.
Around 40,000 women in the UK received implants manufactured by French company Poly Implant Prostheses (PIP), which were filled with non-medical grade silicone, resulting in a dispute over who should pay to have potential problems fixed.
Sir Bruce, who is leading a government review into the risks from faulty breast implants, said an Abta-style insurance model “captured the flavour of where we want to go”.
Under the Abta arrangement, companies pay a subscription to become members of the scheme, which provides a fund for people to fall back on if something goes wrong.
He told BBC Radio 4′s The Report: “One of the things that my review will be looking at will be something rather like the Abta arrangement that travel agents have, which means that if an organisation runs into trouble the consumer is covered.”
 There is no clear evidence PIP implants cause harm but the Government has said patients who had their surgery on the NHS will be able to have the implants removed and replaced free of charge. For patients who had the procedure done privately, the NHS has also agreed to pay to remove, but not replace, implants if their clinic refuses to do so or no longer exists.
If you have concerns about your medical care talk to Private Healthcare Bureau to put your mind at rest
AXA PPP healthcare have followed Aviva UK Health’s lead by removing limits on its cancer cover.
The moves come in the wake of changes made last year by Bupa, the largest private medical insurance (PMI) provider in the UK, which announced that it would no longer sell corporate health insurance schemes which feature overall cost or time limits for cancer treatment.
Here we present a comparison of the policies now offered by the AXA PPP and Aviva UK Health, the second and third biggest PMI providers respectively.
Radiotherapy and chemotherapy
Both providers offer full cover for these treatments, commonly prescribed for patients.
Targeted drug therapy
Both providers offer full cover for targeted drug therapy, a rapidly growing field of medicine including drugs such as Herceptin and Avastin. The NHS does not always fund these drugs. Both providers previously put time limits on such treatments.
Side effects and sickness drugs
Cancer treatment can result in side effects including nausea. Both providers cover treatments prescribed to counter such effects in full.
Bisphosphonates and bone scans
Bisphosphonates are drugs that can help to protect a patient’s bones against some of the effects of cancer, such as pain and weakness. They may also be used to reduce a raised calcium level in the blood. Both providers will cover drugs and scans in full. Aviva UK Health will cover them for as long as the specialist says they are needed, regardless of the stage of the treatment. Private Healthcare Bureau has previously highlighted this as an area of cancer treatment not routinely covered by insurers.
Hormone treatments used to manage cancer
Hormone treatments are prescribed to alter the production or activity of particular hormones in the body and are most commonly used to treat breast and prostate cancer. AXA PPP healthcare will cover the cost of injectable hormone treatments used to manage cancer while the patient is undergoing eligible chemotherapy for cancer. Aviva will cover hormone therapy if it is required to shrink a tumour before surgery or radiotherapy.
 Outpatient consultations and tests
In addition to inpatient care, cancer patients may need to have consultations and tests such as blood tests in an outpatient setting. AXA PPP healthcare previously did not cover this on all its policies, but all limits on out-patient diagnostic tests and consultations when directly related to cancer treatment have now been removed. Aviva UK Health will cover them in full if the policy includes full out-patient cover. However, even if the member has chosen a reduced out-patient option, it will still cover consultations and tests in full while he or she is having chemotherapy or radiotherapy.
Stem cell and bone marrow transplants
A stem cell transplant may enable a cancer patient to undergo a much higher dose of chemotherapy than usual which can help to improve the chances of curing some types of cancer, leukaemia, lymphoma or myeloma, or of prolonging a remission. Both AXA PPP healthcare and Aviva UK Health will cover this in full.
Unlicensed treatments
Generally, doctors prescribe treatments that have been licensed for use in the UK. However, not all cancer treatments have a license, particularly those used for rare cancers. Doctors may also wish to try a drug outside the use of its license (for example, to treat a rare cancer rather than a more common cancer for which the drug is licensed). Aviva UK Health has said that it will fund unlicensed treatments provided that sufficient information is made available to its decision makers while AXA PPP healthcare will fund them if they are prescribed as part of an ethical clinical trial, subject to approval by the insurer beforehand.
Prostheses
Following surgery to remove cancer, patients may use a prosthesis such as a breast prosthesis. Both AXA PPP healthcare and Aviva UK Health will pay up to £5,000 towards the cost of this.
Wigs
A side effect of some cancer treatment is hair loss. Both AXA PPP healthcare and Aviva UK Health will pay £100 towards the cost of a wig.
End of life care
 Aviva UK Health will now fund every stage of cancer treatment, including palliative care, for as long as it is recommended by the specialist. AXA PPP healthcare says that it will now fund chemotherapy and/or biological drug treatment given to prevent a recurrence of a cancer or for maintenance of remission (previously excluded) and treatment to relieve pain. It will also pay up to £100 per night towards hospice care. Aviva UK Health will pay up to £100 per day up to £10,000.
Monitoring
Once cancer care is complete, patients will return to their specialist for regular check-ups to monitor their health. AXA PPP healthcare has removed all limits and will cover this monitoring for as long as required while Aviva UK Health has extended its cover from five to 10 years.
To ensure you have the best Private Medical Care available at the best possible price contact Private Healthcare Bureau for a free review.
Employee time off work may have doubled since the introduction of the fit note, the replacement system for the traditional sick note introduced in 2010, according to the UK’s largest absence management specialist.
A study carried out by FirstCare suggests that workers who went to their GP for a fit note were absent from work for 48 days on average, compared to 20 days for those who did not apply for one.
 FirstCare said it has carried out an analysis of 22,086 employee records which found that the majority of GPs continue to sign off employees sick for lengthy periods of time. The fit note had been introduced in order to enable doctors to say what an employee is well enough to perform, as opposed to simply saying whether they can be at work or not at all.
James Arquette, a director at FirstCare, said the system “causes employees to be off work for longer without reducing the likelihood of repeated absence”.
FirstCare’s analysis chimes with findings from a survey carried out last year by the Chartered Institute of Personnel and Development and Simplyhealth which suggested that just 11% of business said the fit note had cut absence. The CIPD/Simplyhealth survey of 592 organisations also found that just under a third (31%) agreed that the fit note helps line managers to manage absence more effectively.
Have a chat to Private Healthcare Bureau about ways of managing your staff absence
British businesses may need to work harder to ensure that the employee benefits they offer are both relevant and properly communicated over the next twelve months, as staff dissatisfaction with pay and bonuses soared in 2011.
Figures published today by the Chartered Institute of Personnel & Development (CIPD) suggest that the majority of employees felt poorly rewarded last year as companies tightened their purse strings amid the economic downturn.
 The CIPD’s annual Employee Attitudes to Pay survey suggests that 48% of staff saw their pay frozen during 2011, while 5% actually saw their pay cut. Just 18% received a cash bonus.
The main explanations given by employees for dissatisfaction with their employer’s pay decisions are: it did not keep pace with the increases in the cost of living (up from 53% in 2010 to 63% in 2011); it did not reflect how well I performed at work (22%); and my pay is below what I could get elsewhere for doing the same job (18%).
Even satisfaction levels among those who did receive a pay rise in 2011 dipped compared to the year before, although only slightly. The main explanation given by employees for being satisfied with their pay rise is that it reflected the state of the economy. Just 19% felt that their pay rise had reflected how well they worked.
The report also found that since 2008, the proportion of employees receiving a pay rise has fallen from 67% to 45% in 2011, down slightly on the 46% recorded in 2010.
By sector, 51% of private sector employees have had a pay rise since the start of 2011, 45% did likewise in the voluntary sector, but just 24% of those in the public sector have received an increase.
Is it time to offer your staff a greater benefits package ? Contact Private Healthcare Bureau for your FREE company review !
Simplyhealth has published guidance for employers about the tax implications of providing health benefits to staff.
“Taxation implications for company paid healthcare” provides information for SMEs providing healthcare benefits including cash plans.
It explains the tax implications for both employers and employees and covers insurance premium tax (IPT), national insurance contributions (NIC), income tax (IT), corporation tax (CT) and value added tax (VAT).
 Howard Hughes, head of business marketing for Simplyhealth [pictured], said the publication had been produced “to cut through the jargon surrounding tax and provide clear and simple guidance”. However, he cautioned that it was not intended to provide tax advice to firms.
Dame Carol Black recently recommended changes to the taxation of employer-funded healthcare in order to incentivise more employers to play a role in the rehabilitation of employees on sick leave.
The fact sheet is available at www.simplyhealth.co.uk/business We can help you introduce this into your company please contact Private Healthcare Bureau for a free review.
Bupa has announced that it will take further steps to reduce its use of BMI Healthcare hospitals in 2012.
The insurer has already confirmed that 12 BMI Healthcare hospitals will not be recognised from 1 January next year but has now warned intermediaries that another 24 hospitals are likely to be removed when its contract with BMI Healthcare expires at the end of this month. BMI Healthcare has 72 hospitals and clinics in total, making it the largest private hospital group in the country.
Bupa claims that BMI Healthcare has requested prices for treating members that are more than 20% more expensive than at least one other national hospital group. The insurer argues that this price increase has been proposed “despite, in our view, offering no better quality or service”.
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In a letter to intermediaries, Linda Wallace, head of intermediary sales at Bupa, writes: “Unfortunately, we see no realistic alternative to this course of action. If we had to include all BMI hospitals in our recognised lists, regardless of price, this would completely undermine our ability to negotiate good value on behalf of Bupa members. We feel these actions are needed to secure affordable, high-quality hospital arrangements for your clients.”
The letter confirms that Bupa will continue to recognise “some” BMI Healthcare hospitals if there is no convenient alternative for members nearby. A group of outer London hospitals are also likely to be included, given that the main alternatives in central London may be more expensive.
Bupa has also said that it will not fund treatment at de-listed hospitals for members of the trusts that it administrates.
Bupa is now contacting individual members in the catchment area of potentially affected hospitals, who have pre-authorised treatment between 1 September and 30 November this year, “to ensure they are fully informed and reassured of our commitment to continue to fund their ongoing diagnosis and/or treatment in the affected hospital”.
Last month Dr Natalie Jane Macdonald, managing director of Bupa Health and Wellbeing, criticised BMI Health for sending an “inaccurate” letter to a patient at one of the 12 de-listed hospitals warning that she may be liable for the costs of her care if her bill was not settled by Bupa by January.
In an exclusive piece for Health Insurance published last month, John Von Klemperer, managing director, hospital operations for BMI Healthcare, challenged the claim that the prices charged by private hospital groups was the cause of rising private medical insurance premiums.
“Based on our historic experience, even if our prices to Bupa reduced steeply to the levels they want, it is unlikely that any reduction in premiums would be passed on to customers and even if it was, the change would not be material for customers,” he wrote. “From our point of view, a steep reduction in our rates could compromise the level of care we were able to offer. It is interesting that while insurance premiums have risen 10% every year, this figure bears no resemblance to the price increases afforded to private hospitals and consultants which are significantly less, and for some services, have even reduced.”
BMI Healthcare has also pointed out that its facilities score highly in patient satisfaction, quality, and clinical governance statistics. Contact us to review your options
Drug extends life for patients with lymphoma
The National Institute for Health and Clinical Excellence (NICE) has approved a drug for people with a common type of lymphoma.
Rituximab (marketed as MabThera by Roche) is a targeted therapy prescribed to people with follicular lymphoma, in combination with chemotherapy treatments. Evidence shows that it helps people to live longer and improves their quality of life while NICE’s calculations indicate that is also represents value for money for the NHS. The average cost per cycle of rituximab is £1,222 and NICE estimates a cost of £10,800 for every year of life gained (using rituximab in combination with one form of chemotherapy). In contrast, the breast cancer drug eribulin, recently rejected by NICE, was estimated to cost £68,000 for every year of life gained.
Follicular lymphoma is a common type of lymphoma (cancer of the lymphatic system). The average age at diagnosis is 60 and most people are diagnosed when the disease has already spread, at which point it is not curable. Around 1,869 people in England and Wales have follicular lymphoma.
NICE has already approved the use of rituximab in combination with one type of chemotherapy but the new guidance widens the options for prescribing the drug in combination with various forms of chemotherapy.
Certain private medical insurance (PMI) policies will not fund targeted cancer drugs readily available on the NHS, including those offered by WPA and Bupa’s NHS Cancer Cover Plus, which is designed to fund access to treatments not available on the NHS. Let us do a free analysis of your policy- Private Healthcare Bureau is a whole of market broker with some amazing results. Contact us for your review
The Government is using a new set of international statistics to justify its controversial health reforms.
The report from the Organisation for Economic Co-operation and Development (OECD) shows that, although the NHS is performing well in many areas, outcomes for diseases including cancer and stroke lag behind those of other countries.
The good
The data shows that the UK has achieved a “remarkable” decline in deaths from heart disease by more than two-thirds, partly as a result of smoking cessation.
The heart disease mortality rate for women is 50 per 100,000 women, below the OECD average of 60 but still higher than in 16 other countries (out of a total of 34). For men, it is 110, below the average of 117 but still higher than in 18 other countries.
The UK has also achieved “substantial” improvements in survival rates for breast cancer. Today, 81.3% of women survive for at least five years, compared to 75% in 1997-2002. However, this remains below the OECD average of 83.5%. The UK is ranked 12 out of 16 countries. In the US it is 89.3%
Three-quarters (76%) of people in the UK report being in good health, above an OECD average of 69.1% but below 13 countries. In the US it is 90%
Waiting times in the UK have fallen significantly. In 2005, 60% of people waited more than four weeks to see a specialist. Today it is just 28%. Although this is higher than in Germany, Switzerland and the US, the UK formerly had by far the highest percentage and has overtaken other countries including the Netherlands and Canada.
Today, 21% of people wait more than four months for elective surgery, compared to 41% in 2005. Although this is a higher percentage than in other seven out of 11 countries listed, the UK formerly led this table.
These gains have been achieved following significant increases in expenditure on health but the UK still spends less on health as a proportion of GDP than other countries – 9.8% (compared to an OECD average of 9.6%) compared to 17.4% in the US and more than 11% in France and Germany.
 The bad
When it comes to premature mortality (people dying before the age of 70) the UK is just above the OECD average for women, placing it 22 out of 34 countries and higher than most other European countries. It is ranked 12 for male premature mortality.
Cancer mortality rates remain higher than in other countries. For women, there are 141 deaths from cancer per 100,000 women, above the average of 124 and higher than in 26 other countries. For men it is 199, below the average of 208 but higher than in 14 other countries.
Deaths from lung cancer in women are a particular issue, with 30 per 100,000 women, compared to an average of 20 and higher than in 27 other countries.
For breast cancer, the rate is 23.2 deaths per 100,000 women, above the average of 20.1 and higher than in 25 other countries while for prostate cancer it is 23.3 per 100,000 men, compared to an average of 22.4 and higher than in 21 other countries.
Why take a gamble with your healthcare policy ? – Contact Private Healthcare Bureau for a free review
It’s often said that a company’s workforce is its biggest asset. And at a time when pay increases are minimal, there’s never been a greater need for employers to enhance the employee benefits package they offer to their staff.
 Corporate paid health cash plans work as stand alone low cost healthcare products, or as a complement to existing PMI schemes, and are a cost-effective employee benefit that can help to improve staff recruitment, retention and morale and support a company’s sickness absence strategy.
Health cash plans (corporate paid and voluntary) covered an estimated 3,960,000 persons throughout the UK at the start of 2011, equivalent to 6.4% of the population*. And corporate paid health cash plans have seen continued growth, increasing by 11.2% in 2010*.
This increase in growth has been driven by a number of factors. According to the Datamonitor UK Healthcare Cash Plans 2011 report, as well as ehancing employees’ benefits, employers are also looking to ensure disruption at work is minimised, by guaranteeing that employees have access to health support services.
In 2010, a staggering 190 million days were lost to absence, costing the UK economy over £17 billion**! Mental health and musculoskeletal disorders were among the most widespread cause of long-term absence, whilst minor illness, acute back pain, other musculoskeletal disorders and non-work related anxiety/stress/depression were among the main causes of short-term absence**.
This is where introducing a corporate paid health cash plan can help. As well as providing the benefits most popular with employees such as money back towards dental and optical treatments, health cash plans can also provide money back towards therapy treatments including physio and chiropractic, diagnostic consultations, access to MRI, CT and PET Scanning Facilities, Employee Assistance Programmes and much more.
Find out more…
Please contact Private Healthcare Bureau for more information and to see how we can help your business and your employees.
* Laing & Buisson 2011 ** CBI Healthy Returns? Absence and workplace health survey 2011
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Almost a third (32%) of women have missed or delayed a cervical screening appointment, according to the poll of 2,467 women. More than a third of those eligible for cervical cancer screening who work and have missed or delayed appointments said that they did not find it easy to leave work in order to attend the appointment. More than a quarter (26%) said they would be more encouraged to attend if their company was more flexible and they did not have to take holiday for an appointment. More than a third (35%) said that if their GP surgery opening times had been more flexible it would have encouraged them or even ensured they attended those appointments.
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