I would like to make it plain that BUPA Hospital Leeds does not charge a 'premium to tariff' when treating NHS patients under choose and book. It is understandable that the complex system you outlined (HSJ, 22 February) could leave readers thinking otherwise.

I would like to make it plain that BUPA Hospital Leeds does not charge a 'premium to tariff' when treating NHS patients under choose and book. It is understandable that the complex system you outlined (HSJ, 22 February) could leave readers thinking otherwise.

The issue arises because of the way the Department of Health funds trusts and deals with tariff fund flows. Tariff consists of bare tariff plus a local market forces factor (MFF)..

All trusts are paid the MFF independently by the DoH in a block and so they only charge primary care trusts.for each case at bare tariff..Private providers charge for the tariff plus MFF at the time of treatment. To the NHS as a whole the cost of the treatment is the same, but to PCTs it appears more expensive to pay the private provider.

BUPA would like to see this system reformed so that it is clearly seen that, far from the PCT losing out, the independent sector is paid the same rate as an NHS provider..The ECN contract has moved towards partially addressing this problem as PCTs will be refunded MFF at the end of the year but there will still be many other locally negotiated contracts for which a solution must be developed to ensure a level playing field.

Richard Jones, commercial director, BUPA Hospitals Ltd

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