Alison Platt's Powerpoint presen

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					   British American
   Chamber of Commerce

   October 2009

Alison Platt – Group Development Director
The three things I will cover today……

• A little bit about Bupa.

• Some perspectives on healthcare from “across the pond”.

• The changing face of the Foreign and Commonwealth Office.
About Bupa…
                    We commenced operations in 1947 and our founding principles
    60 years of     remain core to our success and growth over 60 years and into the

                    Bupa’s core purpose is to prevent, relieve and cure sickness and ill
  …only in health   health of every kind, across all of Bupa’s businesses and geographies.
  and care…         Our aim is to provide our customers with high quality health and care
                    products and services.
                    We are a private company with no shareholders – Our primary
                    concern is for our customers. All our profits are reinvested in the
  … no
                    company to provide more and better health and care to our increasing
                    number of customers around the world. In all cases, we aim to treat and
                    care for our customers as individuals.
                    Our size and geographical focus has shifted, allowing us to exercise
    … scale…        the benefits of scale and geographical diversity… we take care of lives in
                    more countries than any one of our competitors.

                    Our vision ‘to take care of the lives in our hands’ reflects what we
                    do, and represents our guiding principles. We recently gave more focus
     … vision       to this by articulating our mission ‘to help people live longer, healthier
                    and happier lives’.
Our values are reflected in everything we do….
  … to benefit our customers around the world
                                  United Kingdom
                                  Bupa UK Membership                             India
                                  Bupa Health Assurance                          Max Bupa
 Sanitas Hospitals
                                  Bupa Wellness
                                  Bupa Care Services UK
                                  Bupa Home Healthcare
                                  Bupa Cromwell Hospital
                                  Bupa Health Dialog

 US                                                                                            Office Beijing
 Health Dialog

                                                                                             Hong Kong
                                                                                             Bupa Hong Kong

                                                                                                 Bupa Thailand

Bupa International:
Offices in Brighton, England;                                                               New Zealand
Copenhagen, Denmark;
                                                                                            Bupa Care Services
Miami, US; Dubai, UAE;
                                Saudi Arabia                                                New Zealand
Cairo, Egypt; and Hong
Kong                            Bupa Arabia                Australia
                                                           Bupa Australia/ MBF
                                                           Bupa Care Services
       Bupa has unique knowledge across healthcare

                    Private Medical    PMI businesses in the UK, Spain, Australia, Thailand, Hong Kong, Saudi Arabia,
                    Insurance (PMI)    India*, China* and internationally.

                                       Wellness and occupational health services in the UK, delivered through 50
                       Wellness &      Wellness Centres
                       Workplace       Health Protection Products, UK
                       Health          Chronic Disease Management through Health Dialog, United States

                                       Hospitals and Primary Care Centres in Spain
                        Hospitals      Bupa Cromwell Hospital, Central London

                                       301 Care homes in the UK
                                       40 Care Homes in Spain
                       Aged Care
                                       48 Care homes in Australia
                                       46 Care homes and Retirement villages in New Zealand

                     Public/ private   More on this later…

*yet to commence operations
        Growth in Revenue and Customers
                                                                                                              A further 20
               Revenue (£bn)                                                               Lives Covered      million lives
                                                            Rest of World                                     covered by
                                                                                                              Health Dialog

                CAGR 13%
                                          5.9                                              CAGR 12%

                                                                 Spain                                10.3m

                                                             Bupa Intl (UK)

                      2.4                                          UK                        4.7m

                      2001              2008                     2008                         2001    2008
                                      Post M&A                 Post M&A

                 There has been a significant shift towards a more international set of businesses:

                        In 2001, 26% of revenue originated from BUPA’s non-UK businesses

                        In 2008, 51% of revenue originated from BUPA’s non-UK businesses

Source: Management Accounts 2001 , 2008 (excluding Hospitals and Bupa Ireland); AOP 2008
NHS v US health reforms: Debate obscured the real issue
My perspective on the debate
• Heated rhetoric and selective use of statistics is unhelpful
• UK and US citizens value different things in healthcare:
    • US: Value choice – you have the most advanced treatments in the
    • UK: Value equality and universality – healthcare “free at the point
      of use”
    But overall, US health outcomes are no better than in the UK

• Obama is not proposing a British-style NHS – he is principally focused
  on broadening health insurance
• The NHS improved over the last 7 years, but:
    • 230,000 people are still waiting 18 weeks or more for treatment
    • Productivity has fallen 4% over the last decade
    • The gap in life expectancy between rich and poor is widening
The real issue: Funding the escalating costs of healthcare

US – „A Crisis of Costs‟               NHS – „A Crisis of Provision‟
• US spends 16% of its GDP on          • State forced to take decisions
  healthcare - twice that of Britain     over which drugs and
  – but not everyone is covered.         treatments to fund on financial
• The rising price of new drugs          grounds.
  and treatments has seen health       • Funding gap will be £15bn by
  insurance premiums double in           2010, according to The King‟s
  the last decade.                       Fund.
• Significant bureaucracy – for        • Banking crisis and government
  every two doctors, there is one        rescue packages have increased
  administrator.                         the state‟s debt position and
• Healthcare costs are crippling         are squeezing public spending
  US companies – 60 percent of           even further.
  bankruptcies are related to
  healthcare costs.
  Finding a solution
      The most successful health systems – the ones that deliver the best outcomes
         for patients – are those that have a strong core public health provision
       supplemented and enhanced by a dynamic and competitive private market.
The private health sector can partner with public health systems in a number of ways:

            UK: Working with the NHS to offer health coaching services to
            improve health outcomes, patient satisfaction and provide
            support for time-pressured GPs.

            UK: Providing out of hospital care to 12,000 NHS patients –
            freeing up bed space, reducing waiting times and improving
            patient satisfaction.

            France: Providing health coaching services to 138,000 diabetics
            and looking to roll this service out to entire diabetic population in
            France (c. 1.4 million).

            Spain: Operating a new 300 bed hospital in a 15 year partnership
            to provide for the healthcare needs of 140,000 people in the
            Manises region of Valencia.

            Australia: Bupa Australia‟s Chief Medical Officer is chairing the
            National Health and Hospitals Review for the Government
The way forward

   The US or the UK could learn lessons from the health systems
   of other countries:

      Switzerland and the Netherlands: Every person must have
      health insurance, but the state will step in for those who
      can‟t afford it.
      France: Compulsory health insurance. Ranked as the most
      efficient health service in the world by WHO. Spends 11%
      GDP on health, but better life expectancy than US & UK.

      A European-style combination of private insurance backed by
      a core government safety net may be the best outcome.

    The private sector‟s expertise can be leveraged on both sides
            of the Atlantic to address the funding crises.
The changing face of the FCO

• The change journey in the last five years.

• The challenges currently in play.

• Potential for radical reform 2010 and beyond.