Posts Tagged ‘Services’

Kinds of mental health services to search for

May 13th, 2011

Mental health illness is one of the most challenging situations to deal with. It becomes even more tough when the mental stability of an individual is lost and is regarded as to be incredibly serious in scenario. It is extremely essential to get the appropriate mental health services in order to provide the particular person with the best treatment feasible to check out and provide him back to normal. The mental illness can be caused because of a lot of possible reasons like the shock throughout an incident or an event, emotional disturbance, hormonal changes and many far more elements. There are several mental health services that can supply the best of the treatment to the individuals struggling from mental illness or emotional disturbances.

It is extremely generally seen that the family members of the individual who is suffering from mental sickness try to conceal the circumstance by not discussing the identical with the medical practitioner or a psychiatrist. It is very essential to understand the stage and the problem that the particular person is heading via to get the finest possible mental health services.

There are several mental health organizations that supply services which assist the individuals suffering from various mental problems like the autistic spectrum issue, tough behavioral issues disabilities etc. The teaching programs and mental health clinics conducted by these organizations assist the individuals in comprehension the various aspects of irritability, mental hygiene and mental well being. They also educate normal individuals for acquiring the very best mental health and to offer with pressure, irritability and numerous far more things. The following are the different types of mental health services that an individual struggling from mental sickness can be put forward to:

? They provide mental health training packages which consist of the effective tools to deal with stress, irritability and common nicely being of mental health.
? Workshops for mental health are executed which teach practical methods to preserve general mental health and lie the life happily.
? The mental health services supply full psychiatric reports, assessments and prognosis with efficient suggestions of the want fro suitable treatment. It helps the doctors style an appropriate program for the treatment of the mentally sick affected individual.
? Assess the risks for violent and aggressive behavior and the reasons for the exact same and also recommends a treatment plan.
? It aids recognize the various anxiety levels with the teaching applications and workshops to manage the scenarios far better and helps in comprehension the challenging behavior which can result in to self harm.
? They also provide for on-line training by providing access to issue solving services, burnout syndrome, alcohol use disorders remedy etc.

The mental health services have several advantages for the patient. They offer professional and educated service which can give the very best remedy results. The mental health services would provide the best health facilities that would boost the health of the particular person reliving him of most of the mental problems in due course.

How A Private Health Services Plan Can Save You Money

April 14th, 2011

You might have heard of a PHSP or Private Heath Services Plan (also called a Cost Plus plan or a Health and Welfare Trust), but how does it actually work? Can it really save you money? It sounds like a gimmick when you first hear the concept: pay for your medical expenses yourself and then pay an extra 10% premium to have the expense run through your company. Are you just paying and extra 10% over the cost of your medical expense for nothing? How does this tax savings actually put more money in your pocket?

 

This article will try and unpack the concept of a Private Health Services Plan (PHSP) from a tax savings perspective. There are two main things to consider here: a taxable expense and a tax deductible expense. Since controlling taxation in Alberta and Canada is a corner stone of income and wealth management, you have to understand how this can be implemented to add up to significant ongoing savings.

 

You must be incorporated!

In order for this to work you must own an incorporated company (it can be provincially or federally incorporated – it doesn’t matter). All employees of the corporation can then benefit from the PHSP. In essence, the PHSP allows the employee to incur an eligible medical expense and then get reimbursed by the corporation as a tax free benefit. The expense is then transferred to the corporation and can be claimed as a tax deduction from corporate profits.

 

This can result in significant savings, since your personal tax rate could be much higher than the corporate tax rate. Let’s look at an example of an incorporated consultant who has only two employees in the company (the consultant and his/her spouse). The marginal tax rate of the consultant is at the maximum of 39% (in Alberta). He incurs a dental expense of ,000. Here is how the PHSP would save him money on this one expense:

 

The consultant pays the dentist ,000
He/she then submits the ,000 expense to his/her PHSP administrator
The PHSP plan carves the corporation ,100 for the expense and the admin fee of 10%
The PHSP plan sends the consultant a cheque for ,000 as a tax free benefit
The corporation can deduct the full ,100 from it’s corporate profits

 

At this point no taxes have been paid on the medical/dental expense incurred. This is far better than the consultant paying for e expense with his/her after tax income. Here is how much he/she just saved in taxes:

 

Gross income required to net ,000 = ,639 (at a 39% marginal tax rate)
Immediate tax savings = ,639 – ,000 = 9
Administration fee paid = 0
Net savings of using the PHSP is 9 (9 – 0)

 

As you can see the 10% administration fee is very minor compared to the tax savings by setting up such a plan. Also the company can tax deduct the entire expense, the eligible medical expense and the administration fee.

 

You can also expense your health and dental plan premiums through your PHSP. If you are spending 0 per month for a family health and dental plan, this premium can be reimbursed to you as an eligible health care expense and all claims that are paid to from the insurance company providing the health and dental plan would be tax free income to you also. This creates a real win-win scenario.

 

As you can see, there is a lot of benefit to owning a Private Health Services Plan (PHSP). It can turn medical expenses from your own after tax income into a tax deductible expense for you and your family. It can even be used if you are an empires with a PHSP plan for the employee group. You can save thousands per year in taxation if you had a lot of medical and dental expenses. And there is almost no carrying cost to the plan. It only cost 0 per year to keep the plan active. Otherwise it is a pay as you go plan, only costing you a 10% admin fee for your health and dental expenses.

 

If you would like more information on how a PHSP could benefit you or your employees, please check out our page on PHSP plans with our strategic partner, Beneco.

Health Services Career Training Opportunities

April 12th, 2011

Gaining a degree in health services can be done by enrolling in an accredited educational training program. There are a number of schools and colleges that provide students with the opportunity to earn the degree they desire in the field of health care. Students can enroll in a program to earn an undergraduate degree which includes an associates and bachelors, or a graduate degree which includes a master’s and doctorates level degree.

*Undergraduate Degrees

With an undergraduate degree program students who choose to pursue an associates level degree will be able to obtain their degree in as little as two years. An accredited associate degree program will allow students to study a variety of courses. Coursework may consist of studying:

Communication
Psychology
Sociology
Medical Terminology
Health Care Systems
Biology

 

With an accredited education at this level students can enter into careers as medical coders, billing specialist, transcriptionists, and much more. Students who wish to enter into a degree program at a bachelor’s level can do so and obtain their degree in four years. Students who earn a bachelors degree in health sciences can obtain careers in hospitals, nursing care facilities, physician’s offices, home healthcare, dental offices, and much more. With an accredited undergraduate degree students can find the employment they desire.

*Graduate Degrees

An accredited graduate degree is obtainable in the field of health services, and students can choose from masters or doctorates in the field. A master’s degree will allow students to enter into the career they desire with just two additional years of study. Coursework may include:

Planning
Health Systems
Finance
Public Health Policy
Human Resource Management
Economics of Health Care

 

Students who decide to pursue a degree at this level will be prepared for careers working in hospitals, physicians offices, nursing care facilities, ambulatory healthcare services, and much more. Students can enroll in a doctorates degree program once a master’s degree is obtained. With an accredited doctorates or PhD students will complete education with an additional four years of study. An accredited doctorates degree will prepare students for careers in research, teaching, nursing, mental health services, and many other related careers. By earning a graduate degree students will have the opportunity to enter into the workforce in the career of their dreams.

Although the levels of education vary some may cover the same coursework. Students can also expect to learn a variety of skills in several areas no matter what level degree they choose. Students can study sociology, anatomy, economics, public health, accounting, and health policy. Areas of study may also allow students to learn healthcare administration, epidemiology, health regulations, health law, neuroscience, and abnormal psychology. Start by enrolling in a program to learn more about topics that will be covered in training.

When looking to enter into an educational program, ensure the program carries full accreditation. Agencies like the Accrediting Council for Independent Colleges and Schools (ACICS) can provide proof that the best education will be received. Students can learn more by requesting information about the school or college that best fits their educational need and goals. By enrolling in a health services degree program students can start the path to a new career today.

 

DISCLAIMER: Above is a GENERIC OUTLINE and may or may not depict precise methods, courses and/or focuses related to ANY ONE specific school(s) that may or may not be advertised at PETAP.org.

Copyright 2010 – All rights reserved by PETAP.org.  

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Top Reasons to Have a Private Health Services Plan

March 26th, 2011

A Private Health Services Plan, which is an excellent idea for employees of businesses or those that are self-employed, is a great way to decrease the amount that you will have to spend out of pocket on a variety of different types of medical, dental and therapeutic treatments. A PHSP is very flexible and ensures that you have additional coverage in the event that many of the medical, dental, vision or therapeutic services you require are not covered by your provincial insurance. In addition these plans can be a great tax saving for both the employee and the business.

Although most of the major medical expenses are covered in Canada and the risk for individuals to find themselves in financial ruin because of medical bills is not a factor as it is in the United States, most families still spend between ,000 and ,000 per year on medical expenses. This may be more if you have several children in the family or family members that have significant dental problems, vision problems or that are requiring orthodontic treatment. In addition those that regularly visit a chiropractor, massage therapist or use an alternative type of treatment such as acupuncture may find that their current insurance caps the claims allowed or has a set limit each year.

The benefit of a Private Health Services Plan to these individuals, which may include employees and their families depending on the employer’s design of the plan, is that these additional expenses can be covered. While the employee files the claim, a small amount, usually about 10% of the approved claim, is charged without the need for regular monthly premiums. It is literally a pay as you claim system for most small companies with the amount that they end up covering fully tax deductable as a business expense. There are some guidelines established by the Canada Revenue Agency that outlines the eligibility of each type of claim, but typically services provided by a licensed professional will be covered.

For very small companies that want to offer employee benefits the Private Health Services Plan option is an ideal choice. The coverage is more comprehensive than that found with traditional types of additional insurance coverage plus you can be flexible as to how you want to operate the program. Some companies opt for a pre-pay option that allows them to roll credits or unclaimed values from the previous year into the next year. The company’s contribution within the year is deductable for the company while the employee is not taxed on the money they use to cover their medical expenses.

This plan covers a variety of services, not specifically just medical expenses. Some of the best plans will cover things such as dental cleanings, preventative oral health treatments, vision care, laser eye surgery, prescription glasses, prescription medications, therapeutic services and a variety of other expenses related to preventative or treatment types of health care services.

For businesses the cost of enrolling in a Private Health Services Plan for their employees is much less costly than traditional insurance options. There is usually a one-time fee that handles all the administrative paperwork to set up the account, plus a small fee for each employee. After that the fees are entirely based on the claim amount. The added benefit to you is that this initial set-up fee, like the funds provided to employees; is completely tax deductible in the year that it was made.

Home health care services ? the need of elderly beings

March 23rd, 2011

 

Home health care can provide you with services in the comfort of your own home; these services are generally coordinated by a home health care agency. Some of these services include skilled nursing care, physical and occupational therapy, speech-language pathology services, and medical social services as advised and ordered by your physician. Additional home health care services may include personal care, some housekeeping, meal preparation, and general health management. Home health care can help facilitate staying in the home for senior citizens and disabled individuals.

Home health care agency staff can teach you and your caregivers to continue care such as wound care, therapy, and disease management. If you are leaving a hospital or skilled nursing facility, the discharge planner can help you to set up in-home care.

In order to be eligible for Medical coverage, the health services used must be both reasonable and necessary in the treatment of an illness or injury. A certified Home Health Care Agency may provide the following services:

Part-time or intermittent skilled nursing care by a registered or a licensed practical nurse
Personal and occupational therapy
Speech-language pathology services
If you are receiving skilled care or other therapy from the home health care agency, you may also receive part-time or intermittent home health aide services
Certain medical supplies that are part of your care, including wound dressings
Durable medical equipment such as a walker

 

Choosing a right home care agency always turns out to be a headache as there are so many referrals and recommendations that it becomes really difficult to choose the right one for your elders. There is no dearth of information pertaining to Home Health Care Agencies. One can refer to search engines on the internet or look up phone directories or contact information providers or get references from the family doctor. But the best way to choose the right agency is to ask people who have utilized home health care agencies as they have first-hand experience. Moreover, if they are recommended they are probably more reliable and good. In the event of not knowing anyone who has availed of home health care services it is best to interview caregivers from a few agencies and shortlist the best.

 

Besides taking into consideration word-of-mouth reputation and the services required, one should also consult the insurance company that is going to cover the expenses of the treatment and care. It is more convenient and advisable to contract with a Home Health Care Agency which is listed with your insurance company, provided the agency in question offers you what you are looking for. This avoids cumbersome paperwork and complications.

 

Where are we heading in “Modern” Health Services?

March 19th, 2011

 Where are we heading in “Modern” Health Services?

Although I am aware that there are significant differences between health services in different countries -and in fact within the same country-; as health worker, we all share an underlying commonality to a certain degree. I am writing this article under the assumption that, in this current era of “globalisation” and “standardisation”, there is a universal demand for the “modernisation” of health services. The health system has been forced to incorporate, within its constitution, terms such as health delivery management, strategic planning, strategic improvement, governance and quality, amongst many other fashionable words brandished around these days (the likes of which, yours truly finds confusing sometimes). However, we must accept that all of the above are part of the continuous evolution of the health service.

Before I proceed further, I would like to clarify to the readers the use of the word “modernising” in the context of this article. Here, I am referring to the involvement of numerous and diverse areas of expertise (e.g. business, aviation) within the field of health. This new approach has placed additional expectations on the clinicians, requiring them to possess reasonable knowledge in various fields. These skills include management, budgeting, cost, strategic development and other tasks which were previously left to the administration ‘to deal with’, whereas we clinicians were expected to focus on improving our clinical skills and, even more importantly, satisfying /managing our patients. I imagine that many of you will agree with me that this is a very nostalgic view, which is rarely found in this modern day and age.

I am not going to bore you with details about the health service where I work, as I do not believe it to be of significant importance; it would in fact defeat the purpose of provoking a debate relating to the key question of this article (i.e. the title). It would suffice to say that there is a pressure, as a health provider, to embrace a great deal of management, business and budgeting concepts. I am like most clinicians; work in a rapidly “modernising” health system.  Hopefully, once the reader continues scanning through the article, they will understand why I elected to use this generalization.

My guess is when we look at “modernizing” health services in different countries there appear to be a significant difference between them at first glance but once we “dig deep” and examine in depth the fundamental structure of most of the health services (wither it is private, governmental, insured, free or hybrid) I assume that the reader will find common points, at least partially.

 I, as a health provider find myself in a strange position of being instructed to be knowledgeable about “quality ” , “management”, “strategic planning” ,”updating my evidence based knowledge” , “understanding the fundamentals of accounting and budgeting”  amongst many other words, which my memory could barely remember ,let alone grasp.

The main problem is all of the above are dictated to me by different parties whose priorities (rightly or wrongly) lie within their own “primary target”.  

One could argue that all of the above could be part of one thing and by doing one; this will lead to the achievement of the others (i.e. domino effect). This is a point which I hope my article would encourage debating.

From my humble point of view, I still cannot cope with all “the priorities” I am bombarded with and I do find contradiction in many of them; especially when it comes to (if we break it down in to a simple, old fashioned targets) patients’ care versus cost which- rightly or wrongly- in my opinion, what the main issue boils up to (this is again a controversial statement and subjected to debate).

I am here not to find a solution or to offer an “ideal” way to balance a juggling act, as I am still picking up the pieces and trying again and again to be able to pull up the act efficiently in front of many anticipating audiences, each looking at me from a different angle with different expectation.

I wish that I could say that I managed but the reality is that I could not. My department and my hospital could not and more importantly my health service leaders cannot which is the most worrying concern because it is these “experts” who are suppose to guide us,  yet sometimes you feel that the blind leading the blind.

So what happened in a decade or so to lead us; and I apologies for the generalization; to be entangled in this “modernizing” health service?

I myself are nostalgic for the day when we say patient comes first and we DO mean patient comes first. Yet, I find myself focusing less on patients and looking more at statistics, strategies, missions, visions, audits, surveys etc and although (please do not get me wrong) I am all for the above, but it is becoming harder and harder to balance my already flawed juggling act.

Allow me to give an example to demonstrate what I mean. As a consultant psychiatrist, I obviously posses skills that my colleagues may lack or are not be “privileged/ technically speaking” to carry. An example for a surgeon is a type of surgical procedure, for a radiologist a special radiological technique. In my case a therapy for certain disorders that required years of supervision and learning. Again, one may argue that I should take responsibility and that this is my own fault as I should transferred my knowledge to my colleges, but here where the dilemma lie, as time, ethics are against me. Clinically I am expected to priorities my time but this raises another dilemma as my time is not entirely in my hand and the vicious cycle goes on.   

Let me give a real life example which I hope will demonstrate the above argument. When I joined my current department I started (naively) to accept undertaking therapy for patients with personality disorder (i.e. a condition which requires specific skills learned through years of supervision and practice) as the waiting list was long, and I was the only person with the expertise to manage this population. I went to my secretary and with an authoritative instruction, told her to arrange booking one hour a day every Tuesday at 11am for at least 20 weeks minimum, with the possibility of increasing the number of session. The poor secretary looked at me and did the necessary.  After two sessions of relatively positive rapport building with my client, the time for the third session approached.  As the time for the session came my secretary called and informed me that there is a “mandatory” emergency meeting for all heads of department with the human resources to discuss an extremely important issue. Dilemma again, what should I do?  I thought that our motto of “do no harm” and ethically as my patient has a real risk of feeling abandoned (which could have a catastrophic effect on therapy) and more important could lead to risk of serious self harm, I made the decision not to attend the meeting and see the patient instead.

Next day, a warning letter was delivered to me through my work email and due to my absence (even though I have sent the reason, and asked one of my colleges to attend the meeting) our department has lost in term of some administrative decision making.

That was my baptism of fire and my welcome to the modern health care. As a head of department I find myself more and more involved in writing the ideal setting to serve our clients but the time consumed in this preventing me from doing exactly what I am writing!.

I wish that the issue is related to me only, but even down the “chain of command” each member of my staff is finding it more and more difficult to focus on patient, and more of their work involving replaying to emails, cutting cost, achieving targets, filling endless forms, auditing, teaching, gathering educational hours, coming with initiatives, fulfilling their objectives in the appraisal and much much more.

I hope that my experience and my words echoes with similar experiences with the readers and as I have mentioned in the beginning, I am not looking for solution but I am hoping to provoke a serious debate about where are we heading in this era of so called “modernisation” and is the involvement of many parties and philosophies in the process beneficial to the end result (patients)?.

I am looking forward for a thought provoking debate and would be grateful for any of the readers from different evolving health services to share their thoughts and opinions.

 

What Health Care Consulting Services Can Do For Your Healthcare Facility

March 19th, 2011

Creating your medical center the most effective in your space- Banahan Communications will give you with the tools needed. One amongst our purchasers, in central LA, has gone beyond these days’s standard Diversity Coaching and Political Correctness categories, and have reached out to the surrounding communities, letting them grasp HPMC will be trusted. Changing into #1 within the LA area was achieved by building a trusting relationship with the community through excellent communication for health care consulting services. The ability to communicate and trust HPMC was the most necessary step toward their success as a health care consulting services.

Jim Banahan, founding father of Banahan Medical Marketing Firm said, “We have a tendency to are serving to build a relationship with the community based on the simple principle of trust”. The health care consulting firm visited work within the LA space, analyzing demographic knowledge, and personally surveying (via phonephone) the numerous various surrounding communities. When asked, the communities in the LA area if they wished to understand a lot of concerning our consumer the health care consulting agency, the solution was a powerful YES.

Health care consulting is additional than an advertising health care consulting team. Our consultants are additional match makers for the community and glorious health care, consultants realize out what the community wants and is trying for and shows them the way to become the right choice. Any strengthening their relationship is done through employs physicians, nurses, and technicians from the same diverse backgrounds as their patients. When people of the same cultures, languages, and backgrounds offer health care, communication becomes additional comfortable, relieving the stress of the patients and also the physicians treating them, thereby providing higher health care and happier, healthier patients.

As advised by our health care consulting team, we have a tendency to brought our consumer’s message to the community, where the population congregates and commutes. One amongst the successful promoting tools used to focus on each ethnic background in their own communities, was the utilization of every house, from bus stops, to subway signs, to teach the general public about our client’s commitment to quality care and safety. The photographs showed actual physicians, nurses, and patients, and highlighted the hospital’s dedication to improving the health and welfare of all the residents of Los Angeles. For example, Korean translations on the advertisements within the Korean neighborhood, Spanish in the Mexican part of town, etc. allowed HPMC to take their message to each community, creating all ethnicities feel comfortable and welcome.

To express dedication and quality, trust and family, we have a tendency to have the employees and the physicians facilitate unfold the message to expedite results for turning into well known and trusted for providing better health care to the community. In addition to improving our consumer’s relationship with the community, the community is changing into healthier due to the accessibility of health care consulting services they trust and therefore use on additional regular basis. The people in these communities are keeping latest on preventative drugs and alternative measures to remain healthy as a result of they have healthcare facilities they’ll trust and understand.

Pay service tax for Health services!!!

March 13th, 2011

Pay service tax for Health services!!!

Prepared By:

CA Pradeep Jain,

CA Preeti Parihar and

CA Rajani Thanvi

 

In the chain of imposition of duty on new services the levy on hospitals has also been added in the budget 2010-11. Although the rate of service tax is kept constant at 10% but in order to increase indirect tax revenues the Hon’ble Finance Minister has proposed a new levy for hospitals. In his budget speech he expressed that the hospitals having 25 or more beds with centralized air-conditioner system is proposed to be taxed under service tax system.

Earlier levy: – Before this proposal the services provided by hospitals, nursing home or multi-specialty clinic are taxable if the same is provided to-

 

A. an employee of any business entity, in relation to health check-up or preventive care, where the payment for such check-up or preventive care is made by such business entity directly to such hospital, nursing home or multi-specialty clinic; or

 

B.  to a person covered by health insurance scheme, for any health check-up or treatment, where the payment for such health check-up or treatment is made by the insurance company directly to such hospital, nursing home or multi-specialty clinic;

 

As there was levy only on the services for which value of service is received either from the insurance company or from the employer in case of treatment for an employee. In that situation a person, who is going to hospital to get benefits for his health, has not to pay a single penny for his health treatments for service tax.

New proposal :-But this is now proposed to be amended in this budget. For this purpose the clause no. zzzzo of sub section 105 of section 65 of Finance Act, 1994 is proposed to be replaced as follows:-

for sub-clause (zzzzo) the following sub-clause shall be substituted namely:-

“(zzzzo) to any person,-

(i) by a clinical establishment; or

(ii) by a doctor, not being an employee of a clinical establishment, who provides services from such premises for diagnosis, treatment or care for illness, disease, injury, deformity, abnormality or pregnancy in any system of medicine.”;

 

To explain the meaning of clinical establishment used in above sub clause sub section 25a of section 65 is also intended to be amended in following manner:-

(25a) “clinical establishment” mean

(i) a hospital, maternity home, nursing home, dispensary, clinic, sanatorium or an institution, by whatever name called, owned, established, administered or managed by any person or body of persons, whether incorporated or not, having in its establishment the facility of central air-conditioning either in whole or in part of its premises and having more than twenty-five beds for in-patient treatment at any time during the financial year, offering services for diagnosis, treatment or care for illness, disease, injury, deformity, abnormality or pregnancy in any system of medicine; or

(ii) an entity owned, established, administered or managed by any person or body of persons, whether incorporated or not, either as an independent entity or as a part of any clinical establishment referred to in sub-clause (v), which carries out diagnosis of diseases through pathological, bacteriological, genetic, radiological, chemical, biological investigations or other diagnostic or investigative services with the aid of laboratory or other medical equipment,

but does not include an establishment, owned or controlled by-

(a) the Government; or

 

(b) a local authority;

 

From the above definition all the hospitals will be covered under the tax regime. Although the government hospitals or the hospitals owned or controlled by a local authority has been kept away from this levy. But for all other hospitals it will be required to charge service tax on the bills of services provided by them.

Service Tax rate will be 5%

 

In the budget speech the hon’ble finance minister also expressed for the abatement of 50% in service tax rate. Hence the service tax will be chargeable on services provided by hospitals at the rate of 5%. In the TRU Letter viz. D.O.F. No. 334/3/2011-TRU dt. 28.02.2011 following para is included:-

6.4 Finance Minister has announced 50% exemption from the value of this service. The exemption notification will be issued when the new levy is enacted.

The Issues: -

1. The service tax is levied if there are more than 25 beds or centralized air conditioning provided during any part of the whole year. If a hospital expands his business in the month of March then he has to pay the service tax for the whole year. This will not be intention of the Government and it should be amended.
2. The doctors will also be registered and pay the service tax. They will charge from hospital. The hospital will take the cenvat credit. He will also charge service tax from the client. But he will pay the differential amount. In nutshell, the Government will get the same service tax. The doctor should be exempted. The hospital will be paying the same tax to Government. Hence, there is no need to do such exercise and covering so many people.
3. Further, tax paid by diagnostic centers is charged form clients and not from hospitals. Hence the credit of the same is not available to Hospitals.
4. There is lot of opposition on this levy and even the Revenue secretary has promised to review the same. It is likely that this levy will be rolled back.
5. The Government has exempted Government hospitals from this levy but they will be clubbed in future in the name of fair competition as is being done in commercial coaching and training centre. The universities giving degrees has also to pay tax if they are running coaching centers. They were exempted earlier. This is also done for unauthorized service station in name of fair competition in this budget.

 

From this letter it seems that the government initially intended to include the hospitals under tax net by levying lesser rate of service tax but in future it may be raised. So now one has to pay tax even for services taken for his/her health also.

 

************

 

Health Services and Facilities Around the Work Place

February 18th, 2011

There are many factors that are taken into account while considering necessity of a health service facility around the work place. It depends upon the type of work the organization is promoting and the health hazard associated with the work. For example, if the workplace is developing highly toxic chemicals and fertilizers, the organization would prefer a health services near or even within the organization in order to avoid any unfortunate incident when an employee develops some health issue and need immediate health consultancy and medical treatment. While there are few businesses that do not require extensive health facilities such as regular office jobs etc., most big budget businesses maintain a small health service department, which is equipped with basic medicines for common illnesses such as the common colds, coughs, headaches, etc. The reason why business offices maintain such health services and facilities around the work place is because they do not want the creativity and the productivity of the company to be altered by employees that are suffering from common illness. A quick trip to the medical consultant and taking medication from the health services and facilities around the workplace can help in solving this problem. In businesses that require hard labor and much manual work there is a great need of a medical facility near by. In hard labor work it has been estimated that nearly 650,000 workers suffer from work injuries and if they are not given immediate medical consultancy then this could lead to serious health problems. There have even been cases where workers death have occurred due to the unavailability of a proper medical and health service facility near the work place. Keeping these factors in mind the business association and factories tries to maintain health facility within the organization or to setup the industry at a site which has a hospital or health service near by. There are many advantages of having health services and facilities around the work place which includes the following: * Medical facilities would help the business to avoid economic losses due to employer health issues. * It would enable the employer to get health consultancy when require. * The employer health interest would be safeguarded. * The medical compensation can be added as a benefit the company is offering. There are many other reasons and advantages of health service and facilities around the work place. But more prominently establishing your business near a health facility and providing medical assistance to your employees is consider as a healthy and friendly gesture which would help you in bringing in more employees to the business.

Roundtable Debate: UK Public Sector Shared Services – Where Now and Where Next?

February 14th, 2011

Sharing services has risen up the agendas of the UK’s national and local governments in recent years, propelled by political and financial trends as well as by more concrete factors such as Sir Peter Gershon’s 2004-5 Efficiency Review and Sir David Varney’s report on transformational government. In an attempt to throw some light on recent developments and to examine where shared services may be headed in future, SSON convened a roundtable debate involving a group of practitioners and advisors at local and national level, chaired by SSON’s online editor Jamie Liddell. The results were, indeed, illuminating…

Attending were:

Tony Isaacs Programme Manager Warwickshire Direct Partnership The Warwickshire Direct Partnership is an alliance comprising all six local authorities in the county of Warwickshire: North Warwickshire Borough Council; Nuneaton & Bedworth Borough Council; Rugby Borough Council; Stratford District Council; Warwick District Council; Warwickshire County Council; and three private-sector partners in Steria, MacFarlane Telesystems and Northgate Information Systems. The partnership includes a shared services programme relating to its CRM [citizen-relationship management] system. For more information see www.thewdp.org.uk

Dominic Swift Head of Shared Services Browne Jacobson Browne Jacobson is one of the largest law firms in the Midlands with offices in Nottingham, Birmingham and London. The firm acts for over 100 local authorities, either directly or through their insurers. It recently published its Shared Services Survey ’08, one of the most comprehensive surveys ever carried out into shared services in the UK. For more information see www.brownejacobson.com

Peter Telford Chief Executive Officer Research Councils UK Shared Services Centre Research Councils UK (RCUK) is a strategic partnership between the seven UK Research Councils. RCUK was established in 2002 to enable the Councils to work together more effectively to enhance the overall impact and effectiveness of their research, training and innovation activities, contributing to the delivery of the Government’s objectives for science and innovation. For more information on the RCUK Shared Services Centre see http://www.rcuk.ac.uk/aboutrcuk/efficiency/sharedservices

Ray Tomkinson Local Government Improvement Specialist and Shared Services Author Ray Tomkinson is the author of Shared Services in Local Government: Improving Service Delivery (Gower, 2007). Ray managed the Welland Partnership shared services project and currently operates as a consultant.

 

SSON: Peter, you’re at the head of one of the more prominent national shared services centres [SSCs]. Can you explain a little about the drivers behind the move in your organisation?

Peter Telford: Behind the Research Council’s business case are benefits focusing on what are seen as financial gains which will be passed back to research and the research community, but probably more importantly in the early stages is the feeling that we can secure better effectiveness in business support to that research community by aggregating the seven Research Councils’ services onto one common platform, and transforming them. The business case started with an outline about two years ago. There was a lot of work done on certain parts of the shared service model even before that, but the activity’s really come together in the last two years. The full business case was accepted by the Research Councils in line with CSR07 [Comprehensive Spending Review 2007] in August last year, and the intention at the moment is that we will go live on the platform at the beginning of next year. We already have some services live in the IT and strategic sourcing areas.

SSON: Tony, your project’s been going for rather longer than that. Would you say that the drivers behind the Warwickshire Direct Partnership are similar?

Tony Isaacs: I think ours were slightly different in that when we started off in 2002/3 the driver behind that was, basically, to capitalise on the money that was available from central government at the time. We made a bid as the Warwickshire Online Partnership, and set up that particular group specifically to bid for that money: a total of £2m. We identified a number of different projects that we would attempt to procure and implement with that money, not least of which was the joint procurement by all six authorities in Warwickshire of a CRM [citizen-relationship management] system and associated telephony systems. We got the full £2m and since then we have actually implemented it; we jointly went to procurement and we’ve ended up with the Northgate front office CRM system.

Now I don’t think the goalposts have changed, but the drivers have. I think the drivers have changed in that there is no money available now; it’s exactly the opposite insofar as before there was money splashing about, if you will, from central government, and now it’s the opposite insofar as with CSR07, with all the efficiencies and demands that there are on local authorities to save, there is an overriding need to make things more effective and more efficient, and shared services is seen as being one key method of doing that – with the consequence that we are in a position now where our chief executives, our leaders, are very keen in looking at what can be done. And based upon that – or around all this – is the whole area of the two-tier structure within Warwickshire, and the drive that the government may want to push – and seems to be pushing – with regards to unitaries. But Warwickshire is very clear that it wants to retain its two-tier organisational structure and will do so by sharing services.

Dominic Swift: Tony, I just want to follow something through on that, because it’s a theme that emerged when we did our research on shared services [Browne Jacobson’s Shared Services Survey ‘08] that certainly efficiency savings and improvements in the way services are delivered are key drivers, but what you’ve identified as a lack of money was one of the real inhibitors, because in order to deliver shared services there is a considerable cost: You’ve already mentioned telephony which was obviously put in as part of the grant, and one of the problems that people seemed to face was the immediate increase in costs to deliver a shared services stream before any efficiency savings could actually be delivered.

Tony Isaacs: You’re absolutely right insofar as there’s a need to spend in order to deliver efficiencies, and what we’re seeking to do is to build up good, strong, powerful business cases that maybe looking over a five-year spread, so that while there is a recognition that to begin with you may need to spend money, over the period following that it’s anticipated that there will be savings. And Warwickshire may be different, but we don’t necessarily regard it just as pounds saved: it could be efficiencies. So it’s non-financial benefits as well as financial ones.

SSON: Ray, do you see many differences between the drivers for local and national shared services?

Ray Tomkinson: Yes I think there’s one big difference, which is the issue of government compulsion, as it were. There’s no doubt about it: central government departments recognise that they really don’t have much alternative at the moment to creating some element of shared services – because the Treasury makes sure that they do, because the Treasury controls the purse strings. It’s less clear that in local government every council is going to have to go down the shared services road.

As was being made abundantly clear a minute or two ago, local authorities have different ways of approaching their financial restrictions or their political considerations, one of which is the unitary agenda – or the two-tier agenda in other councils. So some councils are going to have to go down the shared services route because it’s the only way organisationally that they’re going to function. Other councils don’t have that imperative at the moment and I’m working with one group of four councils which are looking at sharing services but not because of financial pressures. They’re looking at it because they want to make service improvements, to improve resilience of services, and also give opportunities to create new services. So it’s a very different agenda between the two.

SSON: Peter, from a national perspective are you seeing an increased pressure from government to implement?

Peter Telford: Yes. Historically I’ve been in shared services in the private sector, local authority and now central government so I suppose I can absolutely empathise with the previous comments. I think the compulsion from central government is largely fiscal although there is a feeling that the transformational agenda that sits behind it is also very prominent. I think the other difference in central government is it is easier to identify and reach a critical mass where you can actually effect a transformation and deliver efficiency and effectiveness. At the local government level, it is more difficult to create critical mass – which then makes the funding routes and the benefits probably more difficult to determine in the early stages.

SSON: OK. There’s been a lot of talk about what advantages other than cost savings can be delivered through shared services. And this brings us on to the issue of benchmarking. When it comes to savings you can obviously benchmark against what you’re saving and how much you’ve saved against previous budgets, for example. But when it comes to service-delivery, how can one establish exactly what you’re benchmarking, and against what and against whom? Is there a common thread here in terms of where you go for benchmarking?

Dominic Swift: I think benchmarking’s so different, for different projects, is the long and the short of it. What we’ve seen through our research is that there’s a very wide range of different projects – we’ve already talked about the drivers, and it really depends on what you want out of your project. One of the frustrations that we heard at the national launches that we did of our review, was that there wasn’t enough benchmarking of the actual outcomes. And a lot of people said to me “how do we judge whether this has been a success?”

One of the problems is that if you produce a much more efficient service, which is more attractive to the general public (if it is a front-facing service, which more and more are) is that it will actually be used more. And as a result you’re getting better value, in terms of hits, but the cost of the service may actually go up. So it is quite a complicated job to benchmark and I think it requires some very clear outputs to be identified at the outset, and to look for comparable projects.

SSON: Tony, you’ve got a wide variety of services you need to benchmark…

Tony Isaacs: Yes, that’s right. I can concentrate really around the CRM system, because all the information we’ve got is via customer services, and improvements we’ve made to that around the CRM system. What we’ve done is take benchmarking as a very serious exercise in its own right, and what we’ve sought to do is to get customer insight by using different databases, information from the CRM, information from MacFarlane – the telephony system – and pool all that information among all the partners. And what we’ve done then is to say “ok, concentrate on the areas that we want to concentrate on” and to make sure that we do improve the services that we are seeking to improve. We have got what we call an Improvement Forum, which is a relatively recent creation and which is proving to be very successful as well. And that’s looking at the way in which the CRM in particular can add value to the whole process of improving customer services.

We are concentrating as well on a variety of different access channels, so we’ve got the CRM system, we’ve got telephone contact obviously, face-to-face via our one-stop-shops – we’ve got eight of them at the moment, with another eight planned for next year. We’ve got kiosks as well. But also I think most significantly, in the next few months or so what we’re looking to do is drive ourselves forward with web self-serve, and look to try to move people more towards that means of accessing services. And I think that will be a double win because the customer will benefit greatly from that in terms of speed of service, but also we will, because we’ll drive down the unit costs, and that quite clearly is a key method of making savings.

SSON: In the private sector a great deal of benchmarking goes on between individual companies and organisations, and as a result you have the idea of world-class et cetera. Is it a pipedream to suggest you might be able to get similar systems set up in the public sector, in which every region and every locality has its own pressures?

Peter Telford: I don’t think it is and I think the benefit of the public sector is, by and large we’re not competing with each other, and therefore people are much more willing to share information and the assumptions that sit under that information to try to help each other along. And I’m quite heartened by that kind of culture. I think the difficulty with the private sector is that it’s usually wrapped in commercial connotations and costings as well, which makes it very difficult to unpick to ensure you are comparing like with like. Albeit that said, the difference is that there is much more evidence when you can find it and it’s much more prescriptive in terms of service levels than I would suggest you would find in the public sector.

Dominic Swift: I’m very interested to see whether there can be some sort of worldwide benching or benchmarking which really does define the success of projects. I’d be very interested in understanding more of what Tony’s doing and how the measurement takes place, capture of information and then the dissemination of that, to actually judge how that service is being delivered and where the successes are – and where perhaps the challenges are. And also what sort of services you’re comparing that with. Because as I see it, shared services range across such a vast array of the different public sector areas – we were talking earlier on about this being local authorities but clearly it goes to health and other public sector bodies as well – and from that point of view the real problem you’ll have it seems to me is comparing apples with apples.

Tony Isaacs: I can give you a fairly high-level description of what we’re doing, and that is that we’re using some software you may be familiar with – Mosaic Data – and we’ve populated a lot of databases according to the information that we’ve gleaned from there, and that’s proving to be very much the benchmarking process that we’re going to go through. And there are certain authorities out of the partnership that are leading on this.

For each of the projects that we have, we have lead authorities who volunteer to lead on particular projects. We’ve got Nuneaton for example to lead on one, as well as the county, and the county has information that it uses from its observatory, and there’s a pooling of information, and there’s an agreement via the Improvement Forum for example whereby they do concentrate on specific areas with the data they’ve accumulated – whether it’s county-wide or just individual authority-wide. But basically they work together as best they can to provide these benchmarking criteria. It’s not a quick process by any means. But over time we build up that data and then we can use it from year to year to do comparisons to see how things are improving.

In addition to that I don’t know if you’re familiar with NI14, the latest government key indicator which has just come out, which is to do with avoidable contact with clients – customers – with local authorities. And we’ll be using the CRM to glean quite a lot of information via the CRM system. But it is a corporate-wide key indicator, so you will have other services, other departments, feeding in this information as well. That information is supposed to be started in October of this year and it will be used year-on-year to gauge how we’re doing, in terms of avoiding avoidable contact, and looking to improve that.

Peter Telford: I think it’s fair to say whilst we have not yet built the longevity of data that Tony describes – and I absolutely agree with him that building a profile and a trajectory is invaluable as a benchmark – we haven’t really got to the point yet where we are able to benchmark our service delivery over a period of time; what we are doing is assessing our performance as we transfer services. We’ve got a baseline against some services from the Research Councils and from my own experience and from talking with others in the public sector we will then aggregate what we believe will be appropriate targets for the Research Councils against their baseline. But I’m with Dominic: initially it is very difficult to compare apples with apples and ensure you’ve got a representative benchmark.

Dominic Swift: Peter, it’s very interesting from my point of view. I quite agree with you about the “apples with apples” thing. I think what’s been said about the public sector is very true: it’s much more transparent, there’s much more desire to learn from each other. One of the things I’m doing tomorrow actually is go down to sit in in Kettering where they’ve been running a shared services project for many years – well, well before Gershon and Varney and the rest. And that’s very interesting because people are open about what’s happening in shared services and happy to learn from each other. The difficulty seems to be that they range over such a wide area, the danger is that unless people come to some common terminology about what outputs are going to be defined for particular services it may be possible to benchmark over time as Tony’s doing, but actually benchmarking across different projects will be very difficult.

Ray Tomkinson: I think that’s very valid. One of the issues is that there is no commonality across authorities as to what constitutes a service. So what you tend to find is that people dive for a process – and even when they dive for a process it doesn’t tell you an awful lot about the service that you’re trying to share. And there’s often a real difficulty in stopping trying to find the trees when you’re trying to fight your way through the forest. So from that point of view I think benchmarking has on occasion got a very bad name because people use it as an excuse for not doing anything; and it’s only in the past couple of years where I think people have been much more prepared to be open about the fact they need to consider sharing as an option and sometimes benchmarking isn’t used as a blockage.

SSON: Let’s move on from benchmarking. We were talking a little about the private sector a minute ago – are we of the opinion that the private sector is an absolute necessity within UK public sector shared services, and to what extent is it a foregone conclusion that this is going to result in a degree of privatisation of services?

Dominic Swift: This is a question we asked in our survey: the sort of view that we had was that of course the private sector is an important potential partner in shared services, but there were just as many opportunities for the public sector to work together without the private sector. So, yes, it’s part of the picture but it certainly isn’t necessarily the whole of it. And I don’t think that privatisation is an inevitability from shared services: where we saw the private sector coming in, and the survey really highlighted this, links back to the funding issues we discussed earlier on.

Where you needed some sort of IT facility and commonality across a number of authorities and participants, quite often the private sector partner was someone who could deliver that in order to relieve some of the initial cost difficulties of setting up a shared service which frankly couldn’t be borne by some of the participating authorities.

SSON: Tony, that’s certainly what you were saying about the initial start-up of Warwickshire, isn’t it?

Tony Isaacs: Yes certainly: and it’s ongoing because we’ve just finished the renewal of the CRM contract and the telephony contract, so from the beginning of next year we will actually be embarking on new five-year contracts replacing the existing ones. And that’s the position of the CRM, the telephony, the ICT systems around it – so yes, it’s inevitable that we have to go down that route. We’ve had good – very good – negotiations with the private sector on this and I’d like to think that all of us have come to a very good, fair new contract.

Ray Tomkinson: I think actually the point that was made about investment is a very good one. There is actually no reason why local authorities can’t do sharing on their own without the private sector, and there are lots of examples around now where groups of councils are trying to do public-public partnerships. But I do agree: where there is a real need for investment – particularly around IT – then that’s where the problems start for local authorities, and that’s why they often do resort to the private sector.

But I do think that it’s worthwhile pointing out that as much as there are needs for investment, particularly in IT, there are lots of services which do not need that investment, and I’m thinking of professional services like planning, or building controls are another good example, or environmental health is another good example, where simply you’re dealing with people. One of the problems though that local authorities do find in that area is the scarcity of professional planners, environmental health officers, building control officers. And often they have to partner with the private sector simply for that reason.

Peter Telford: We need to get back to the point that I think Dominic made earlier which is in analysing what you’re trying to achieve with your SSC you then start to look at how you’re going to do it. And how you’re going to do it may or may not include the private sector. If you do seek investment from the private sector, they will seek a return on that investment; you just have to recognise that. They may indeed want a profit which may erode the efficiency savings you seek to make.

I think another thing that the private sector brings is experience and expertise in the sorts of change and benchmarking data which you may need. That said, I think the blend of public and private sector in trying to get to a shared service centre is the right one and the transfer of risk to the private sector through doing this is always pretty key in terms of what you want to get out against your project.

Tony Isaacs: I was just going to pick up on the point that if you can go for joint procurement as opposed to individual authority procurement, you can really reap the benefits, and the bottom line will be that you do make considerable savings – not so much a profit will result, but it will produce efficiencies in savings. We found that with our negotiations latterly with Northgate and MacFarlane, and also more significantly during the course of the contract that we’ve just had, when we as a partnership stuck together and wanted to get individual things out of Northgate, and/or MacFarlane, by standing firm we could really apply the screws to them, and they were forthcoming; so we could really achieve quite significant savings on different aspects of procurement that we did during the course of the four years we’ve had the system.

In terms of profit, I’m not sure whether profit’s the right word as I just mentioned; what we’re looking for are savings and efficiencies and I choose to use those terms rather than profit. In essence we can justify what we’re doing now: adding value, making sure we are getting the market rate or better, and we can quite happily and justifiably tell our chief officers and members based on the business cases that we’ve produced that we are getting best value, we are making savings and efficiencies on the basis of this joint procurement exercise.

SSON: Moving on: the future form and structure of shared services in the UK is, it appears, going to be determined in large part by competition between authorities, in a lot of areas. How do you see local shared services existing in the UK in, say, two or three governments’ time?

Ray Tomkinson: Two or three governments’ time, that’s interesting. So that’ll be two Conservative and one Labour… I suppose my thinking goes like this: I think that in 15 to 20 years’ time you will see a patchwork quilt across – certainly the local government sector; I’m not quite so sure about the central government sector. And what I mean by that is you will have a group of statutory authorities that are all geographically based – whether that’s a county or a district – there will be differences across the country.

Secondly they will have different types of shared services in different areas. There will be some that will be public-public; some that will be public-private; and some that will be public-public in terms of different sectors: health will have joined in; the police will have joined in. Because the pressures of the CAA regime coming from the Audit Commission mean that all public sector organisations in geographical areas have got to think whether it’s better to work together than to work separately. And as a result of that I think you’ll get a really different appreciation across, and in some areas there will be very heavy private involvement and in other areas probably none.

Dominic Swift: Basically I think it’ll depend a little bit on the nature of the shared service, to be honest. Sorry – I keep coming back to that point really. It struck us during the course of the work we did that there are two different forms of shared service: the ones which perhaps have been more prevalent to date, which have been the sort of back-office, IT function – ICT-reliant functions – and then the front-office function. Now they have very different possibilities in terms of partners. If you look at the front office it is a locally-delivered service and therefore your partners are chosen by geography, and geography alone: they can’t be chosen by much else, other than if you go to some sort of call-centre arrangement. But the other services can actually be amalgamated a lot more and with less sensitivity to geography.

So I think there are going to be some quite different groupings and possibly some legal authorities who particularly drive the delivery of a good service who perhaps sell to a very wide range of local authorities: health, via police, all of these are potential customers for them. And then on the local basis it’s going to be a lot more down to politics and the dynamics between the politicians as to how well their shared services are going to be run, and I think some of the political difficulties we have in Nottinghamshire, where I’m based, may make it quite challenging to get some of those local shared services off the ground.

SSON: Tony, I know this is something you’ve been thinking about, and obviously as quite a successful service provider it must be on the agenda. So let’s put you on the spot: do you think you will be at the forefront of a successful selling of services in the next couple of years?

Tony Isaacs: Yes I think I do in the next couple of years, but if you’re talking longer-term than that I think – and I hasten to add that this is my own personal view – the likelihood is that there will be an increase in unitaries. And there could well be in Warwickshire as well. I can put forward a very rosy picture in some ways – but at the same time you’ve got nagging at the back of your mind all the time the difficulty that there is in actually creating successful shared services – and I think that’s from a political point of view as well as the straightforward business-case point of view.

I think there will be more and more unitary authorities, to be honest. And I wouldn’t be surprised if even Warwickshire eventually ended up with two unitary authorities rather than the six authorities we’ve got now. I think it’s almost inevitable, and I think the government will continue to apply the screws, demand more and more savings year upon year, and the consequences will be that it’ll almost be inevitable that there will be more.

Peter Telford: I think this is too early in our development path to consider and I think building a stable service with reference-ability is key before we could go there. The wider central government agenda is pretty clear in terms of convergence of effort and activity onto some of the core shared services in the bigger departments. That’s already starting to come because of the requirements laid down by the Cabinet Office. And you can see the agenda already moving to: how do you ensure that there’s a commonality of solution and agreement on service levels that are given to customers? How do you allocate customer benefit across a broader-based shared service? How do you prioritise how you would offer services to customers? Those are debates which I think are becoming more prevalent and therefore indicative of activities and departments coming together on shared service platforms.