Doctors have accused insurers of putting a chokehold on the private healthcare market and paying less than they were in twenty years ago for conducting certain procedures.
The Independent Doctors Federation said the insurers’ position was unsustainable and would drive down quality of treatment by excluding experienced practitioners.
The Competition and Markets Authority (CMA) said it was aware of the “friction and challenge” between consultants and insurers.
Independent Doctors Federation consultant orthopaedic surgeon Susan Alexander drew loud applause from the audience at the LaingBuisson Private Acute Healthcare Conference when criticising current practices by private medical insurance (PMI) providers.
“Patients are not being offered a proper sense of choice because what the insurance companies are doing is putting a chokehold on the market,” she said.
“They are driving policies whereby you can see certain consultants who they label as platinum consultants but the inference there is that the rest of the consultant body are not as good, and that’s just not right.”
‘Consultants getting angry’
Alexander continued by highlighting that while inflation was soaring, for some medical procedures prices paid to doctors had fallen below those from two decades ago and that was inflaming tensions.
“In 1999 in my field a procedure would cost £589. Just with inflation costs that should today be £1,005 but what we’re getting remunerated now is £550 – less than last century,” she said.
“So what is happening is you now have a consultant body who are getting angry and are getting concerned.
“We don’t know if we can actually continue sustaining quality service at those prices, and what’s going to happen is you’re driving the market down so only a few doctors can do it so you’re pricing out the more experienced doctors.
“There is no reward for experience, there is no reward for expertise in a particular sector. It is completely unacceptable, you would not have this in another industry.”
Alexander said this was a threat to patient safety and had partly been driven by the Competition and Markets Authority (CMA) failing to scrutinise insurers as part of its oversight of the private healthcare market.
“The CMA has put up a screen and said we’re not going to look at that side of the market, but it’s not the full picture because the whole point of healthcare is about safety first from the clinician’s point of view, quality and then choice,” she added.
Earlier in the day, Bupa Insurance CEO Alex Perry had denied consultants and anaesthetists were ditching work with the insurer over is low fees but Aviva acknowledged some practitioners were leaving the PMI market for a range of reasons including fees.
‘Friction and challenge’
CMA deputy director for markets and mergers David Stewart said it was aware of the situation in the market and it was not uncommon for sectors undergoing change to have these kind of tensions.
“We can recognise that the ongoing commercial discussion between insurers and consultants is a source of friction and challenge in the sector,” he said.
“Our concern would be if that process was imbalanced in a way which started to impact on either the functioning of the market and ultimately the interests of patients.
“What we would be concerned about is if one side or the other of that equation was so concentrated or in effect was able to dictate terms to the other that there wasn’t a fair bargain being struck ultimately.
“But at the moment, it’s not something that’s sort of directly in our sights, that’s out of scope of the 2014 order, and that’s it’s a separate issue which people draw to our attention periodically, but we’re not currently investigating.”