Turmoil over ‘sell-offs’

By Robin Stride

Hospital group HCA enters 2015 unsure whether to crack the champagne or dig in for another costly battle to stop the Com­petition and Markets Auth­ority (CMA) forcing it to sell two flagship London hospitals.

With the judgment of legal hearings awaited as Independent Practitioner Today went to press, it was anxious to give no official response to reports that The Wellington, The Platinum Medical Centre (right), London Bridge and Prin­cess Grace hospitals were safe.

Hundreds of consultants were, however, assured at a Christmas party that the CMA had backed down and HCA, which has spent £3m-£4m defending itself, would not have to sell any hospitals.

It is understood the CMA privately agreed it failed to follow statutory processes and made mathematical formula errors, which flawed the basis of its decision to try and force HCA to sell.

But a CMA spokesman said reports implying it was giving up on the HCA issue, part of its long-running private healthcare investigation, were inaccurate. It was requesting the Competition Appeals Tribunal (CAT) – which meets to consider two other appeals on 19 January – to reconsider.

In a cagily worded statement, the CMA, which has already dropped earlier plans to force sell-offs by BMI and Spire, said: ‘It would not be appropriate for us to comment on or disclose the detail of confidential matters that are before the CAT.

‘We can, however, confirm that, in light of certain matters identified during the litigation and in order to ensure fairness to the parties, we have invited the CAT to remit these matters to the CMA so that the parties can have the opportunity to make further representations upon them to the CMA and for the CMA to consider those representations before final decisions are taken. None of this pre-judges the ultimate outcome.’

The Federation of Independent Practitioner Organisations (FIPO), which is appealing to CAT over the CMA’s requirement on publication of consultant fees, declined to comment on the HCA issue, but said that a report suggesting the watchdog wrote to it on the subject was inaccurate.

Another appeal is scheduled at the same time from AXA PPP (Independent Practitioner Today, June 2014).

If the fees requirement is upheld, then the CMA would expect it to be included in the existing time­table. It said that consultants were meanwhile ‘free to make such information available voluntarily’.

Roger Witcomb, CMA private healthcare investigation group chairman, said the information revolution would be ‘the most wide-ranging and significant change to result from our investigation into this market’.

He claimed publicly-accessible information would make it easier to compare providers and consultants and so increase competition on costs and performance to the benefit of paying patients.

But the CMA ruling that consultants can’t have an interest of more than 5% in a business to which they refer (Independent Pract­itioner Today, May and October 2014) is proving anticompetitive, according to evidence from a leading medical accountant.

Ray Stanbridge, giving a personal view, said he knew of 20 consultant-owned businesses being sold to private hospitals – effectively the only real buyers around.

As many as 1,000 potential private doctors outside London were also now avoiding independent hospitals due to factors including the CMA’s drive to make them pay for rooms.

Mr Stanbridge added: ‘An attempt to promote competition and economic efficiency in the healthcare market looks like having the completely opposite effect.’