Male Sterlisation (Vasectomy): Increase in charges

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A decision made on 24 April 2012:

Decision Reference: MD-HSS-2012-0010
Decision Summary Title :	Increase charges for male sterilisation (Vasectomy)		Date of Decision Summary:	20th April 2012
Decision Summary Author:	Director of Operations		Decision Summary: Public or Exempt? (State clauses from Code of Practice booklet)	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:
Written Report Title :	Increase charges for male sterilisation (Vasectomy)		Date of Written Report:	18th April 2012
Written Report Author:	Director of Operations		Written Report : Public or Exempt? (State clauses from Code of Practice booklet)	Public
Subject: Male sterilisation (Vasectomy)
Decision(s): The Minister for Health and Social Services Department has decided to seek approval from the Minister for Treasury and Resources to increase the current charge associated with male sterilisation (Vasectomy) in order to enable full cost recovery. This increase is in excess of the 2.5% and RPI.
Reason(s) for Decision: The existing charge, which has not been increased for over 7 years falls short of cost recovery for this non-essential procedure. The Minister approves the proposed increase in charge in order to fulfil the “user pays” principle in relation to this non-essential procedure.
Resource Implications: The proposed new charge will enable HSSD to recover costs associated with this non- essential procedure.
Action required: To seek approval from Minister for Treasury and Resources Director of Operations to increase charges
Signature:		Position: Minister for Health and Social Services
Date Signed:		Date of Decision (If different from Date Signed):

Male Sterlisation (Vasectomy): Increase in charges

Proposed Increased Charges for Male Sterilisation Surgery (Vasectomy)

– Briefing Paper

Purpose

The Minister for Health and Social Services has agreed in principle to the proposed increased charges to be made to service users who request the procedure of Sterilisation.

Background

At present, Health and Social Services (H&SS) charge the service user £95.00 for this procedure. The charge has not been increased for at least 7 years.The service continues to experience a high demand and needs to respond accordingly whilst remaining within the existing budget.

Male Sterilisation (Vasectomy) – Proposed Increase in Charge

The National Health Service provides this procedure at an approximate cost to the service user of £1,400.00.

If this service is provided privately, the charge currently levied by HSSD is £941.00. These charges are currently under review, and do not include pre and post surgery outpatient appointments, Theatre equipment and supplies, and Semen Analysis. Insurance companies do not cover this charge.

The table below provides a financial breakdown of the costs of this service to Jersey H&SS.

Initial outpatient appointment	£59.20
Semen Analysis x 2	£210.48
Surgery (In Day Surgery Unit)	£494.10
Total	£869.02

The proposed charge by H&SS for male Sterilisation is £869. Yearly increase should occur in line with inflation.

Scope

Sterilisation is a surgical procedure that permanently removes an individual’s fertility, normally involving transection of the vas deferens which carries sperm from the testes to the penis. This is carried out under General Anaesthetic usually as a day case. H&SS will fund in exceptional circumstances;

 Family in receipt of Income Support

 Certain life threatening medical conditions, which are hereditary (genetic conditions)

Estimated Financial Impact of Increased Charges

The aim is to introduce an increased charge to service users, reflecting the cost to H&SS. The financial objective for introducing this increased charge is to ensure the cost recovery of service provision to non-exempt service users.

H&SS provided this service to 56 patients in 2008, 46 in 2009 and 48 in 2010. If demand should reduce as a result of the proposed charge, other forms of contraception are available within H&SS. It is important to note that this charge will fall below the current charge of the National Health Service, so it is unlikely that the service user will choose to undergo the procedure outside Jersey. Very few General Practitioners now offer this service, with a cost of approximately £389.00.

Additional Information

H&SS policy for Male Sterilisation (Vasectomy) has been developed and is available on HSSNet.

Patient Information Leaflets have been produced and are in use in outpatient Urology clinics.

Recommendation

The proposed increased charge for Male Sterilisation (Vasectomy) should be introduced to meet HSS cost of providing the service.

Angela Body

Director of Operations