Professor Field: We talked about it a little bit, and we did not put as much in our report as perhaps we could have done. In fact, it was one area, having re-read the paper at the end, that we might have been stronger on, but, because the feedback was so mixed, I did not feel that we could actually make a strong recommendation.
On one hand, many of the foundations trusts were saying that the private patient cap was unreasonable. One strong representation was from University hospital Birmingham, which is capped at around 1%, whereas the Royal Marsden is capped at around 30%, so University hospital Birmingham could not bring money in that would actually help its NHS services. On the other hand, if you opened the cap, it made you more likely to be under attack from EU law, competition and Monitor, so when we weighed up the proposals and the problems that might arise, we chose not to go into any great detail.
If you wanted a gut feeling for what was happening in the listening, the feeling was that the private cap should actually stay, because people felt that that would provide a protection. However, it should be reviewed and set at a reasonable level, whereas it is unreasonable in some areas at the moment. We felt that that probably was not worth putting in the document, because it was divided.