Investigation of UK healthcare system and pathology market
By
Zhiwei (Jerry) Bao
London, United Kingdom
November 2006
After three years in medical equipment manufacture and nearly three years in couple of high reputable hospitals in United Kingdom, I do feel I have so much to share. Especially, being a witness to the rapid growth and success of Chinese medical devices industry, I feel so proud and wish to devote my experience to the motherland's splendid future and provide some valued information to the professional peers.
Required by friends in Mindray Company, I started this report in June 2006. Spending only my spare time, it is eventually finished in November 2006. After three years since last report for my Master project, this report did give me a good opportunity to reinforce my reading and writing skill and improve my data research ability. Therefore, I would like to give my gratitude to Mindray that initiated this report.
In the report, the United Kingdom’s healthcare system is investigated, and the National Health System and private health system are both analyzed. The British pathology service is also discussed with its recent development. More over, the Global, Europe and UK pathology instrumentation (mainly IVD equipment) markets are explored. In addition, relevant marketing information is reviewed for the Chinese companies that want to enter UK market.
Because of the individual limitation and my hospital background, the report is more from healthcare aspect and not very commercially valued. However, the report is incomplete, and more information will be updated.
Table of Contents
Abstract 2
Disclaimer 3
Table of Contents 5
Index of figures 9
Chapter One – UNITED KINGDOM 10
1.1 Country summary 10
1.2 Population 11
1.3 Economy 13
1.3.1 GDP 14
1.3.2 GDP Refined Table 16
1.3.3 GDP Growth 19
1.3.4 Inflation 20
1.4 Compare with other EU country 21
1.5 Heath care expenditure 23
Charter Two – National Health Service 26
2.1 Introduction 26
2.2 NHS structure 27
2.2.1 Strategic Health Authorities 28
2.2.2 Acute Trusts 31
2.2.3 Ambulance Trusts 32
2.2.4 Care Trusts 32
2.2.5 Mental Health Trusts 33
2.2.6 Primary Care Trusts 33
2.3 Funding the NHS 35
2.3.1 NHS spending 36
2.4 Hospital beds 37
2.5 Hospitals 38
2.5.1 Eastern 39
2.5.2 London 40
2.5.3 North East 43
2.5.3.1 Primary care organizations 43
2.5.3.2 Hospital trusts 47
2.5.3.3 Specialist Mental Health Trusts 49
2.5.3.4 Ambulance Trusts 50
2.5.4 North West & West Midlands 50
2.5.5 Southern 53
Charter Three – Pathology in NHS 56
3.1 Introduction 56
3.1.1 Categories of pathology laboratory services 56
3.1.2 At the heart of the health care services 57
3.1.3 Different models of service 57
3.2 Pathology services 58
3.2.1 Providers of pathology services 58
3.2.2 Process of pathology service 59
3.2.3 Point-of-care testing 59
3.2.4 Demand of pathology services 60
3.2.5 Laboratory in UK 60
3.2.6 Pathology instrumentation 61
3.2.7 In Vitro Diagnostic 61
3.3 Pathology service in USA 63
3.4 Expenditure of pathology 63
3.4.1 Cost of pathology services 64
3.4.2 Tariff of pathology test 64
3.4.3 Payment by Results 65
3.4.4 Per capita on in vitro diagnostics 66
3.4.5 Cost of routine chemistry and haematology tests 67
3.4.6 Service quality 67
3.5 Future of NHS pathology 68
3.5.1 Pathology – the essential service 68
3.5.2 Modernising pathology services 69
3.5.3 Review of Pathology 69
3.5.4 Response from BIVDA 71
3.6 Haematology analyser 72
3.5 Clinical Biochemistry instruments 74
Charter Four – Private healthcare in UK 76
4.1 Private Healthcare 76
4.1.1 Private healthcare market 77
4.1.2 Private health insurance 78
4.1.3 Subscribers of private health insurance 79
4.1.4 Regional variations 80
4.2 Private healthcare companies 82
4.2.1 Amicus Healthcare 82
4.2.2 Anglo-Canadian Clinics 82
4.2.3 Aspen Healthcare Ltd 83
4.2.4 Birkdale Clinic 83
4.2.5 BMI Healthcare 83
4.2.6 BUPA British United Provident Association Ltd 84
4.2.7 Capio Healthcare UK 85
4.2.8 Care UK 87
4.2.9 Life Healthcare 87
4.2.10 Care UK Afrox 87
4.2.11 Partnership Health Group (PHG) 88
4.2.12 HCA UK Holdings Ltd 89
4.2.13 General Healthcare Group (GHG) 90
4.2.14 Nations Healthcare 94
4.2.15 Netcare 94
4.2.16 New York Presbyterian Healthcare System 95
4.2.17 NHS Trusts 96
4.2.18 Nuffield Hospitals group 96
Charter Five – Medical device market 98
5.1 Global medical devices market 98
5.1.1 DTI May 2005 data 99
5.2 UK medical device market 101
5.2.1 Comparison of five countries 102
5.3 Key market facts in UK 104
5.3.1 Key Market Facts – In Vitro Diagnostics 105
5.3.2 Key Market Facts – Orthopaedics 107
5.3.3 Key Market Facts – Imaging 108
5.3.4 Key Market Facts – Advanced Wound Management 109
5.3.5 Key Market Facts – Respiratory/Anaesthetics 111
5.3.6 Key Market Facts – Radiotherapy 112
Charter Six – IVD equipment market 114
6.1 Definition of an IVD 114
6.2 Global laboratory equipment market 114
6.2.1 Lab equipment market 114
6.3 Euro IVD market 115
6.3.1 IVD market estimates by country 115
6.3.2 IVD market estimates by category of reagent 117
6.3.3 IVD market estimates by country and by category 118
6.3.4 Average growth by country 119
6.3.5 Average growth by category of reagent 120
6.3.6 Health Expenditures 124
6.3.7 IVD: The Cinderella of health care 125
6.4 Market in UK 126
6.4.1 UK diagnostics market 126
6.4.2 UK laboratory equipment market 127
6.4.3 UK IVD market 128
Charter Seven – Companies 131
7.1 Lab devices suppliers 131
7.2 Main IVD companies profile 146
7.2.1 Abbott Diagnostics 146
7.2.2 Bayer plc 147
7.2.3 Instrumentation Laboratory 147
7.2.4 Nova Biomedical Limited 148
7.2.5 Radiometer Ltd 148
7.2.6 Roche Diagnostics 149
7.3 Some IVD market leaders 149
7.4 Microplate washer and reader market leaders 150
7.5 Device Company Catalogue in Scotland 151
7.6 Some Pathology Companies in US 153
Charter Eight – Forecast 157
8.1 The Economy of UK 157
8.2 Lab equipment forecasts 2006 to 2010 158
Charter Nine – Miscellaneous 160
9.1 Privatisation of PASA and NHS logistics 160
9.1.1 Facts of NHS procurement 161
9.1.2 Diagnostic medical equipment team 161
9.2 Point of Care Test Devices 162
9.3 Organisation and association 163
9.5 Medical/IVD exhibition and conference 165
9.6 Medical/IVD magazines 168
9.7 Medical equipment 169
9.7.1 Instrument groups for Full Blood Count 169
9.7.2 Review of equipment from MHRA 170
A guide to blood gas analysers 170
HemoCue Glucose 201+ blood glucose analyser 170
Survey of fourteen blood gas analysers 171
Roche Diagnostics Accu-Chek Compact Plus blood glucose meter 171
The Horiba ABX Pentra 400 clinical biochemistry analyser 172
Nine troponin assays 172
Point of care devices for the quantitation of microalbuminuria 173
Automated pre-analytical sample processing systems 173
Six automated blood grouping systems 173
DiaMed ID-PNH kit for the detection of paroxysmal nocturnal haemoglobinuria 174
Sysmex XE-2100 haematology analyser 174
Eleven pallet-type urine pregnancy tests for professional use 174
Fifteen urine dipstick pregnancy tests for professional use 175
Nineteen urine and serum pregnancy test devices for professional use 176
Overview of pregnancy tests for professional use 176
Sixteen devices for the detection of drugs of abuse in urine 177
Charter Ten – REFERENCE 178
10.1 Reports 178
10.2 Internet resources 180
10.3 Book or research paper 186
GLOSSARY 188
Index of figures
Fig 1 Population in UK
Fig 2 Major cities and their populations: (Thousand)
Fig 3 GDP summary of UK
Fig 4 UK GDP current and annual price
Fig 5 GDP per capita
Fig 6 GDP in detail
Fig 7 GDP growth 2002 - 2006
Fig 8 GDP growth graph
Fig 9 Inflation Rate
Fig 10 Comparison with EU countries
Fig 11 Healthcare Expenditure
Fig 12 Expenditure THE & EMT
Fig 13 NHS structure
Fig 14 Strategic Health Authorities Map
Fig 15 Hospital Beds
Fig 16 geographical structure
Fig 17 Facts and Figures Eastern
Fig 18 Facts and Figures NW
Fig 19 Trust detail
Fig 20 Comparison of IVD spend per capita
Fig 21 Main suppliers of Clinical Biochemistry systems
Fig 22 Main suppliers of blood gas analysers
Fig 23 Public and private health expenditure
Fig 24 Private health insurance
Fig 25 Subscribers
Fig 26 Number of private hospitals/clinics by region
Fig 27 Market leaders
Fig 28 History of GHG
Fig 29 Global medical devices market by country
Fig 30 Global medical devices market by specialism
Fig 31 Global medtech market size per country Total Market (2002): $174 billion
Fig 32 GDP by Country, Medtech Market Size/GDP
Fig 33 Key Healthcare Expenditure and Trade Balance Statistics
Fig 34 US Medical Technology Industry Trade Statistics
Fig 35 UK Versus Global sector comparison
Fig 36 Market Structure and Size in IV Diagnostics
Fig 37 Market Structure and Size in Orthopaedics
Fig 38 Market Structure and Size in Imaging
Fig 39 Market Structure and Size in Advanced Wound Management
Fig 40 Market Structure and Size in Respiratory and Anaesthetics
Fig 41 Market Structure and Size in Radiotherapy Equipment
Fig 42 Global market for laboratory equipment by value (£bn), 2001-2005
Fig 43 IVD market estimates by country
Fig 44 Total IVD market (14 European countries) 7,366 Mio Euro
Fig 45 Total reagent market (14 European Countries) 6,491 Mio Euro
Fig 46 Total reagent market (14 European Countries) 6,491 Mio Euro (Table)
Fig 47 IVD market estimates by country and by category
Fig 48 IVD growth rates % by country (EDMA source)
Fig 49 Average growth by country
Fig 50 IVD growth rates % by category of reagent (EDMA source)
Fig 51 The total diagnostics and the total estimates for the 6 categories of reagents
Fig 52 The estimates for Laboratory Market (Instruments and reagents), Rapid Tests and Immunochemistry Groupings
Fig 53 Health Expenditures by countries
Fig 54 UK market for laboratory equipment by sector by value
Fig 55 UK imports and exports of instruments and appliances N.a. --- not available
Fig 56 Lab devices suppliers
Fig 57 Abbott Diagnostics
Fig 58 Bayer plc.
Fig 59 Instrumentation Laboratory
Fig 60 Some market leaders
Fig 61 Device Company Catalogue in Scotland
Fig 62 Forecast UK growth in gross domestic product
Fig 63 Forecast UK rate of inflation
Fig 64 The forecast UK laboratory equipment market
(Report has 194 pages, with many tables, diagrams and figures. Please email me if you are interesting in this report)
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