The Great Hospital Car Parking Rip Off

Robert Halfon MP
Introduction:
Throughout the last four years as Harlows MP, I have been contacted on multiple occasions by
constituents with concerns about hospital car parking. Some of these issues have involved problems
such as fines, a lack of security, and what one man reported as chaos whilst trying to find a parking
space. However, by far the most common complaint in my postbag is in regards to the cost of parking at
hospitals, either as a patient, or having to pay to visit a loved one.
One Harlow resident wrote:
Why do we have to pay such extortionate prices to visit our loved ones who are sick in hospital or to
simply pick someone up who is coming home? I was there early this morning for a blood test and as the
car park was virtually empty, I concluded that I would only have been parked for a very short time, and
yet the Car Park fee is 3 minimum. I drove away in disgust!! This is outrageous!.
With this in mind I decided to conduct an investigation into what hospitals are actually charging, and
was shocked by the results. Data is hard to come by, so I sent Freedom of Information requests to nearly
400 hospitals across England, and found that around three quarters charge patients to park on site. This
is in stark contrast to Scotland and Wales, where hospital car parking fees have largely been abolished.
In 2010, the Government published a consultation on scrapping hospital car parking, concluding that it
should be a matter for local NHS Trusts to decide whether they charge for parking, but that where they
do, the charges should be proportionate, and concessions should be available.
Unfortunately, my findings show that many hospitals do not appear to have followed the Governments
recommendations.

Considering this, I have looked at the possibility of abolishing car parking fees. Of course, there is
significant cost to abolishing the fees and it is not a decision that should be made lightly, particularly in
such difficult economic times. But I have also looked at ways in which the shortfall could be resolved,
improving lives for patients without having any impact on their care.

What is the problem?
Hospital car parking fees hit the sick, and their families, at a time when they are at their most
vulnerable. Furthermore, it is apparent that parking charges have a significant impact on an individuals
experience of the NHS. According to the NHS Confederations report Fair for all, not free-for-All, 10% of
all patient comments on patientopinion.org mention car parking, and in the last National Patient Choice
Survey for September 2008, car parking was rated as one of the factors in choosing a hospital by 46 per
cent of respondents.
For many, driving to hospital is not a luxury it is essential. An example often cited is someone suffering
from cancer. The charity Macmillan has pointed out Public transport and hospital transport are often
neither adequate nor suitable for cancer patients, often due to impaired immunity.
Similarly, there are many circumstances that would also make travelling by any other form of transport
more difficult, such as those who live in rural areas, or those who have to travel to hospitals often at
short notice or during unconventional hours.
Therefore driving to hospital is essential for many, and the current fees that patients often face are
excessive - in some cases, as much as 4 per hour!
For many, the charges adversely affect their personal finances at a time when their incomes are already
squeezed. A survey by Bliss found that the average family with a sick or premature baby spent an
average of 282 per week, or 2,256 over the course of their babys hospital stay. A large proportion of
this was down to car parking charges Bliss found that parents who were having to pay for parking
spent an average of 32 per week.
This extra strain on peoples finances can have a severe impact on their wellbeing. Macmillan uses a
case study of a man called Chris, saying that He even had to cut down on food to cover the petrol and
road tax for his car, not to mention the hospital parking fees.[1] The idea that someone would have to
cut down on food due to high hospital car parking rates when they are suffering from cancer is
horrifying.

Furthermore, it can affect the emotional well being of families. Bliss have found that almost a third of
parents reported that travel costs affected their ability to visit their baby, causing emotional distress to
many families. Plus, having visitors has been found beneficial to patients recovery times.[2]
It isnt just patients and their families who are affected by the charges. A problem in many areas across
England is that where hospitals charge for parking, many visitors to the hospital park on nearby
residential streets. This is a particular issue in Harlow, where residents often complain that they are
unable to park next to their own house.

My findings:
In order to find out the charges that people faced, I sent Freedom of Information requests to nearly 400
hospitals in England. Of those who responded to me, nearly three-quarters charge patients and visitors
for parking.
Does everyone charge?

No. Only 75% of hospitals in Britain charge for parking and patients are victims of a complete
postcode lottery. While almost half of hospitals in North East England offer free parking, every single
hospital in South West London will charge you.



National Average 79.43% 1.56 2.18 3.55 7.72 39.49
East Midlands 60% 1.13 1.69 2.24 3.53 10.80
East Of England 91% 2.11 2.57 4.10 8.33 24.95
London 85% 1.86 3.46 6.00 20.23 131.62
North Central and North East London 75% 2.15 3.43 5.83 19.50 112.14
North West London 82% 1.55 2.81 4.81 19.38 128.10
South East London 86% 1.79 3.59 6.03 24.54 166.54
South West London 100% 2.10 4.16 7.75 14.50 92.38
North East England 63% 1.00 1.37 2.27 3.53 20.33
South East Coast 96% 1.81 2.29 4.13 9.54 28.93
Yorkshire 67% 1.11 1.62 2.78 4.57 29.16
West Midlands 89% 2.09 2.78 3.78 6.35 22.70
North West 96% 2.00 2.21 3.37 5.49 19.24
South Central 78% 0.93 1.87 3.21 6.74 40.03
South West 71% 1.46 1.88 3.46 6.74 38.41
National Maximum

4.00 6.00 12.00 72.00 504.00
East Midlands

4.00 4.00 5.00 10.00 42.00
East Of England

3.30 4.00 8.00 20.00 140.00
North Central and North East London

3.00 6.00 12.00 72.00 504.00
North West London

2.70 4.60 8.00 48.00 336.00
South East London

3.00 6.00 12.00 60.50 398.50
South West London

3.00 6.00 10.00 30.00 210.00
North East England

3.00 3.00 6.50 8.00 43.20
South East Coast

3.00 3.00 6.00 25.00 162.00
Yorkshire

2.80 4.00 8.00 16.40 114.80
West Midlands

3.00 4.10 5.50 13.60 70.00
North West

3.00 4.00 5.50 15.00 49.00
South Central

2.20 3.50 6.00 16.60 116.20
South West

3.40 4.00 12.00 15.00 195.00








The highest charges in the UK were*:
1 hour: 4.00 (Nottingham City Hospital/Queens Medical Centre)
2 hours: 6.00 (Royal Free Hospital, Guys Hospital, St Thomass Hospital, Chelsea & Westminster
Hospital)
4 hours: 12.00 (Royal Free Hospital, Guys Hospital, St Thomass Hospital, South Bristol Community
Hospital)
1 day: 72.00 (Royal Free Hospital)
1 week: 504.00 (Royal Free Hospital)
Many hospitals do offer concessions, although research shows that they are often very poorly
communicated to patients. Bliss found that 87% of hospitals provided free parking for parents of
premature or sick babies, but many parents were unaware that they could access parking for free, or at
a reduced rate.

*Royal Free Hospital offer free parking to radio/chemotherapy and haemophilia patients. They
also offer a travel costs assistance scheme for those on low incomes
Guys and St Thomass Hospitals offer free parking to disabled patients
Nottingham City Hospital and Queens Medical Centre offer concessions for those who attend
hospital on a regular basis (no further information given)
Chelsea & Westminster Hospital offer concessionary parking to the following groups, subject to
certain criteria:
Parents and family of patients being treated in the Neonatal Intensive Care Unit (NICU), Intensive
Care Unit (ICU) and Burns Unit
Patients undergoing chemotherapy treatment for cancer
Parents/visitors of children who are inpatients
Bereaved relatives
Macmillan cancer patients

According to their website, South Bristol Community Hospital offer no discounts (except to blue
badge holders).

Hall of Shame

Hospital 1 Hour 2 Hours 4 Hours 1 Day 1 Week
Notttingham
City Hospital
4 4 5 6 42

Queens
Medical
Centre

4 4 5 6 42
Chelsea &
Westminster
3 6 10 30 210
University
Hospital
Lewisham
2 4 8 48 336
Hammersmith
Hospital
2 4 8 48 336
Charing Cross
Hospital
2 4 8 48 336
Queen
Charlottes
Hospital
2 4 8 48 336
Guys Hospital 3 6 12 60 396
St Thomass
Hospital
3 6 12 60 396
Evelina
Childrens
Hospital
2.60 5.20 10.40 60.50 398.50
Royal Free
Hopsital
3 6 12 72 504

What should be done?
Given the current problems with excessive charges, and confusing discounts, I believe that hospital car
parking charges should be scrapped across England where contracts allow (this often wouldnt be
possible for hospitals built under a PFI contract).
In the past, two main reasons have been given as to why hospital car parking fees should stay.
First, they deter people from parking in the hospital who do not have a legitimate reason. I completely
accept this is a problem, however would point out that roughly a quarter of hospitals already do not
charge for parking, and are able to cope. But car parks could be run in a way to how some supermarket
car parks are run, for example, people receive a token when they attend an outpatient appointment or
visit someone on a ward in order to get their free parking.
Second, people are concerned about the cost of scrapping the charges and that it could take money
away from patient care. This is a very legitimate concern, and a viewpoint that the Government has
consistently advocated. The Department of Health - NHS car parking: response to consultation
September 2010 put the cost of scrapping car parking fees at 200 million.
Again, it is worth remembering that some hospitals do not charge for parking anyway, and the extra
benefits to patients and families well being should be taken into account. However there are
alternative ways to pay for it.

How is this paid for?

The money needed to provide hospital parking could easily be found by cutting some of the systemic
waste in the NHS. Just one example of this is the ongoing habit of prescribing branded drugs when the
generic drugs would provide identical standards of care for the patient.

We all know that buying expensive branded paracetamol in the shops is just spending money on
packaging and advertising. So why do the NHS not?

There have been efforts in the past to save money by using generic drugs more routinely. Where they
have been successful, they have saved millions of pounds, but many efforts have been blocked. During a
consultation in 2010, a group of patients and healthcare professionals wrote a joint letter to the Times
to protest the change. Unsurprisingly, it transpired that the PR company who co-ordinated the letter
had been commissioned by a drugs company, Norgine.
1


Branded drugs are worth an enormous amount to the drugs industry, who will work hard to make sure
they keep their profit margins. However strict regulations ensure that generic drugs are kept to the
same high standards.
2


Apart from a few exceptions (like epilepsy and anti-rejection drugs), the generics behave in exactly the
same way as the branded drugs, so we are throwing money away for no benefit.

But just how much money? Overall, only 17% of the drugs the NHS prescribes are non-generic, but
because they are so extortionately expensive, this accounted for 73% of the cost of prescription items in
2010/11.
[1]

[2]
This means 6.4bn being spent on branded drugs every year. Whats more, thats actually
an increase in spending on non-generics since 2006/07.
[3]


How much of that could be saved? Sometimes the branded drug is genuinely more cost-efficient than
the alternatives - especially ones which are protected by patents. However there is still much that we
can do.

1
http://www.bmj.com/content/340/bmj.c1514
2
http://www.bmj.com/content/340/bmj.c2548

The Department of Health ran a consultation in 2010 in which it calculated that just by enforcing the
same rules for GPs that they have in hospitals (allowing pharmacists to substitute branded drugs for a
generic equivalent) we could save 45m every year.
[4]


In 2007, the National Audit Office calculated that Primary Care Trusts waste 200m a year by prescribing
branded drugs. In fact in 2008 they went on to save 394m, without any negative effects for patients, by
prescribing generic drugs for just a few common conditions.
[5]
Even after making these savings, a study
by Prescribing Analytics showed that branded statins alone, which can cost 20 times as much as generic
statins, racked up another 200m in 2011/12.

In addition, the generic market is more competitive, and so NHS consumption will drive down prices
even further. On top of that, as patented drugs lose their exclusivity, a readiness to look for generic
alternatives will ensure money is not wasted by sluggishness.

Altogether, some estimates put the potential savings across the drugs budget as high as 1bn - enough
to pay for free hospital car parking 10 times over.
[6]




[1]
http://www.bmj.com/content/340/bmj.c2548#xref-ref-8-1
[2]
See Library Note
[3]
See Library Note
[4]

http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/group
s/dh_digitalassets/documents/digitalasset/dh_110512.pdf
[5]
See Library Note
[6]
http://www.economist.com/news/britain/21567980-how-scrutiny-freely-available-data-might-save-nhs-
money-beggar-thy-neighbour