Covid didn’t stop our fight for docs

Dr Mark Vanderpump

Dr Mark Vanderpump, London Consultants’ Association chair 2019-2022, gives Independent Practitioner Today a reflection on his three years in office.

The mission of the London Consultants Association (LCA) is to promote good practice as per the Patient Charter, carry out good governance, support both professional medical organisations and individual consultants working in the private sector and, most importantly, to promote patient choice and good quality care. 

My time in office as chair of the LCA from late 2019 was dominated by the pandemic, which required an adjustment of its operations and re-evaluation of how we could continue to support our consultants and patients.  

Early in the pandemic, private hospital providers entered into a contract with the NHS to ensure that there was sufficient provision of beds, ventilators and facilities to meet the anticipated escalation in demand. 

Practice disrupted

The medical professionals who provide the expert care on which this market is founded were not involved in the contracting agreements and overnight the private healthcare market ground to a halt. 

Many consultant colleagues offered their services to support the national effort, but, as a result, their private practice was disrupted and has only recently restored to pre-Covid-19 activity. 

In March 2020, consultant practitioners working partly or wholly in the independent sector lost all of their income as practices collapsed.

The results of the LCA survey were reported in our July issue

A LCA consultant survey describing their concerns was published by Independent Pract­itioner Today in July 2022. The nature of the emergency meant that there had been little time to consider the implications of what was, in effect, a short-term nationalisation of the private sector. 

The pandemic-induced closure of private hospitals and clinics had increased the general mood that the consultant body feels their expertise is under-valued. 

The LCA, with the support of Richard Packard of the Federation of Independent Practitioner Organisations and David Hare, chief executive of the Independent Health­care Providers Network (IHPN), and Keith Hague of Goddard and Hague Recruitment, helped kick start the process to allow the market to recover.

Better supported

The LCA had to rework how we ran meetings and events. We continued voicing concerns and inciting conversation and action from organisations such as the IHPN and the private medical insurers in Independent Practitioner Today and Financial Times. 

Together with our sister organisation FIPO, we appealed with the Government, the Competition and Markets Authority (CMA) and liaised with IHPN to ensure that consultants and their patients were better supported during the pandemic. 

In 2021, the LCA reported via Independent Practitioner Today the significant concerns of its members at the three stages of a consultant career:

 In the first five years when newly appointed;

 During the next 15 to 20 years during peak activity;

 Finally towards the end of their career. 

At all stages, there were frustrations with the significant increased costs, financial and administrative, of private practice with fees having remained static for many years.

Insurers’ attitudes

An important issue common to all remains the attitude of private medical insurers to consultants. Much of the profit from private practice flows from consultant choice by patients, not by choice of the institution. 

The LCA feels that the consultant body has not appreciated the power of their position, including where to admit patients and the choice of where to perform investigations. 

External pressures and changes in the market resulted in a situation discouraging to both existing consultants and those who might have been considering entry. The activities of the insurers threaten the ability of patients to choose the consultant with the expertise most relevant to their needs.

The LCA supports consultants in all phases of their private practice, most importantly those younger consultants attempting to navigate through the difficult early phase of setting up a private practice. 

We offer newly-appointed consultants a support network, including an appraisal service access to senior members providing mentorship. Medico-legal training was greatly enhanced by regular meetings generously supported by Guatam Chawla of Hempsons solicitors.

The LCA has introduced corporate membership and I am very grateful for the support of Pharma­cierge, Incision Medical Indem­nity, Civica Medical Billing and Collection, and Medserv. 

I also wish to thank all members of the committee for their support and I am especially grateful to Rosemary Hittinger for all her efforts, including continuing to monitor the activity of the Private Healthcare Information Network  with which all consultants must now engage. 

I am delighted that Ellis Downes has agreed to be the new chair – see ‘These are difficult times for private consultants.