Medical insurers strengthen fees control

clock • 1 min read

Insurers are increasingly influencing private medical practice and threatening consultants with being taken off their books, doctors have said.

However the British Medical Association (BMA) also believes demand for private medical treatment could increase with the implementation of NHS reforms.

According to the BMA, half of its consultants have been challenged by insurers over their fees and one in ten threatened with being "derecognised".

The subject of private medical insurance (PMI) providers dictating fees to medical practitioners is a highly sensitive one, with doctors suggesting insurers could in effect be restricting patient choice.

And the problem peaked with the Office of Fair Trading's (OFT) decision to include investigation of the restrictions placed on practicing consultants by private medical insurers in its review of the private healthcare market.

Preliminary results from the Private Practice Committee's income survey, to which more than 600 consultants have already responded, revealed that 11% have been threatened with being cut off from working with that insurer, and half challenged on their fees.

Derek Machin, chair of the Private Practice Committee, explained the seriousness of the results and that the survey indicated the percentage of consultants who set their own fees had fallen from 36% in 2009 to 28% this year.

"This is not a trivial number. This is a significant number of our colleagues who are being threatened with derecognition," he said.

It also found that private practice volume had decreased, something that could reverse with NHS changes causing poorer funding and care.

"The reason why private practice has gone down has been because the NHS has improved. I think that both of the major political parties are recognising that the NHS is unaffordable," he added.

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