Private doctors are beginning a campaign against private medical insurance (PMI) providers over the growing control they argue insurers have in the market.
They are seeking “immediate overall systemic change” in the way insurers work with them, claiming they and their patients are “increasingly affected by the influence” of insurers.
It is the latest move in an increasingly public clash between the two sides.
Five key issues have been raised in this dispute, including fees, ability of patients to choose treatments and consultants, derecognition of doctors by insurers, and understanding by patients of their coverage.
This campaign is being led by representative body the Independent Doctors Federation which released a statement detailing its concerns.
“The Independent Doctors Federation is committed to support its members and their colleagues and patients, who are increasingly affected by the influence the private medical insurers have over the healthcare sector,” it said.
The federation said it will strive to ensure that:
- Clinicians have the freedom of choice when treating their patients and that private medical insurers should not have the ability to restrict any treatment choices,
- That patients should understand what they are paying for and the value they get,
- Patients should be able to access the specialist of their choice,
- Clinicians are able to set fees that enable them to focus on delivering an excellent and safe service,
- There is a fair and objective appeals process for private medical insurers’ derecognition.
“As such over the next six months we will be developing a campaign that will call for immediate and overall systemic change to address these issues now and in the future,” the body continued.
It added it would represent and advocate for any UK independent practitioner “to ensure that private healthcare in the UK is a first class bespoke healthcare service that protects the fundamental rights of a patient to access the care of their choice”.
Soaring tensions
Tensions have been rising between medical practitioners and insurers for more than a year with increasingly public arguments.
In October 2022 Independent Doctors Federation consultant orthopaedic surgeon Susan Alexander argued that for some procedures insurers were paying less than they had in 1999.
She contended that it was increasingly difficult to maintain service quality and that there was no reward for experience and expertise, with consultants becoming increasingly angry.
However, when questioned by practitioners at the time, Bupa Insurance CEO Alex Perry said the insurer was not seeing “widespread challenges” with securing consultants and anaesthetists to conduct procedures due to the fees it was paying. However, Aviva admitted there were significant pressures.
Then in March, Federation of Independent Practitioner Organisations (FIPO) chairman Dr Richard Packard told the Health & Protection Health Summit that PMI would become less attractive to doctors “if relations between private medical insurers and consultants do not improve”, particularly where fees were concerned.
He also cited the growth of open referral policies and argued “an awful lot of the time” patients were not being sent to the right surgeon.
Most recently reports emerged last month of an uprising by anaesthetists against Bupa giving 30 days’ notice to resign from their contracts with the insurer, prompting an increased fee offer.
Health & Protection contacted several insurers for their response to the statement.
An AXA Health spokesperson said: “We will continue to work closely with doctors and their representatives, and all other partner organisations, to ensure our members have access to the right specialists and care to meet their needs.”
Aviva and Bupa did not comment.