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May 2014

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www.independent-practitioner-today.co.uk

May 2014 Issue 61

INDEPENDENT PRACTITIONER To day THE BUSINESS MAGAZINE FOR DOCTORS WITH A PRIVATE PRACTICE

In this issue Partnerships

What you should do when your line-up changes P25

Bupa is to push private hospitals to cut their prices by at least 15% in the wake of the competition inquiry. Announcing the move to consult­ ants and GPs at the BMA’s priv­ate practice conference, the insurer vowed it would use the money saved to give insured patients better value and to grow the market ‘for the benefit of all participants’. Bupa Health Funding managing director Dr Damien Marmion said it would chase significant reduc­ tions from hospitals found by the Competition and Markets Auth­ ority (CMA) to be charging ‘exces­ sive’ rates and profits. He said: ‘It is an absolute priority of ours to address this – and to secure the agreement of current and future private hospital owners for significantly lower fees.’ The amount would vary by hos­ pital group, but in some cases the insurer wanted a 15% cut or more. Asked how Bupa arrived at the In association with

Four feature articles in this edition examine the fall-out of the competition inquiry into the private healthcare market  Starting on page 8

Your guide to finance

So what next for private doctors’ finances? We review the state of play after a year of change P42

Bupa pushes hospitals for 15% fee cut By Robin Stride

AFTER THE BOMBSHELL

15% figure, a spokesman told Independent Practitioner Today: ‘This has been carefully calculated based on the relative pricing of some of our hospital providers, compared to others – for example, where some hospital operators charge sig­ nificantly more than others, with no evidence of better quality or patient outcomes.’ In a lengthy speech, Dr Marmion defended policies that have angered many specialists, claiming these were needed to reverse the decline in the market. But he argued that the results showed greater retention of customers and were attracting new corporate clients. He admitted relationships bet­ ween doctors and insurers were ‘badly strained and in serious need of repair’, but he and other key speakers called for all parties to now work together to resolve issues. Responding later to the ‘15% plan’, BMA private practice commit­ tee chairman Mr Derek Machin questioned if hospitals would try

SUPER-DOC: Dr Kate Hersov is a private doctor with a comic business. Read all about it on p22

and recoup losses by charging other insurers more. He said hospitals might cut back on their staff as a result of having to find 15% efficien­ cies and that would be a safety issue. At the main event, The Fed­era­ tion of Independent Pract­itioner Organisations (FIPO) criticised the CMA for not taking account of pri­ vate medical insurers’ (PMIs) ‘over­ whelming powers’ nor the paradox of fixed fees imposed by insurers on clinicians in what it said should be a competitive market. Chairman Mr Geoffrey Glazer warned that, with insurers’ power unchallenged, the UK private health care sector would go the way of the US. He said: ‘Instead of having a pri­ vate healthcare system that pro­ vides care management, we are going to have one where care is managed by the PMI providers restricting cover, benefits and choice. And that is a disaster we are about to sleep-walk in to.’ FIPO supported the CMA’s call for doctors’ fee estimates, quality

outcomes data and banning uneth­ ical incentives to clinicians. But he believed consultants’ transparency should be matched by insurers, who he claimed failed to clearly explain policies and what they covered. Mr Glazer argued that fees were fixed by insurers, making a non­ sense of the inquiry’s requirement for consultants to publish consul­ tation and standard procedure fees to patients. He called the proposed system of monitoring ‘very bureaucratic’ and said the CMA had ignored the fact there was unlikely to be any finan­ cial or clinical benefits for patients through the proposed hospital selloffs. Mr Glazer also claimed there was no evidence that any resulting small savings would make private medical insurance cheaper. Some doctors in the audience expressed further criticism of Bupa, but Mr Machin observed: ‘We either work together or we hang together.’ ➱ continued on page 3


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