These are difficult times for private consultants

Mr Ellis Downes

As the new year gets underway, private consultants face some of the most challenging times that Mr Ellis Downes, the new chair of the London Consultants’ Association (LCA), has seen in two decades of independent practice. Here he spells out why.

The independent medical sector, working in partnership with the NHS, has established itself over many decades as a vital pillar of healthcare. 

Why do most doctors go into private healthcare? The opportunity to increase income is an obvious factor, but this is only a small part of it. 

I believe that the ability to give high-class individualised high-quality healthcare where the doctor-patient relationship is paramount is the over-riding reason. 

A consultant-led service, the ability to introduce innovation –within governance guidelines – and a degree of control over working practice are also key drivers.

But the wind of change, is as we all recognise, blowing hard in the independent sector. 

Traditional ‘practice privilege’ models, where doctors treat their patients in private hospitals, are transitioning to new models of delivery of medical care.

Salaried consultants, chambers models and fixed contracts are now becoming more common in private practice. 

It remains to be seen whether these new models of working will replace the traditional working practices.

The future of private healthcare is unclear. There is clear evidence that recently appointed consultants are less attracted to private medicine. 

This may be because of start-up costs, lower remuneration rates from insurance companies compared to more established colleagues, increasing administrative overheads and the ability to boost incomes without significant expenses by doing additional paid NHS work.

Significant shortages 

With colleagues retiring, this will, in the near future, lead to a significant shortage of doctors in the independent sector with severe consequences for patient care and indeed the healthcare system in this country as a whole.  

It is vital that these disincentives to independent practice are acknowledged and challenged to maintain the long-term health of the sector.

I hope in the next few months that the LCA will have a significant membership drive. I know from feedback from colleagues that challenging insurance companies individually can be difficult. 

A collective approach to ensure fair remuneration is undoubtedly going to lead to greater success than the current prevailing environment.

We practise medicine in challenging times. I hope the LCA, working with insurance companies, private hospitals groups and political stakeholders, will robustly ensure that the interests of our members – doctors undertaking private healthcare – are strongly represented for the benefit of future patients.

I am proud and honoured to be the new chairman of the assoc­iation and look forward to working with the board as we try to give our patients the very best care in some of the most challenging times I’ve experienced in over 20 years of consultant practice. 

I want to pay tribute to my predecessor, Dr Mark Vanderpump, for his hard work and devotion and am delighted he is continuing to serve the LCA as vice-chair.

Mr Ellis Downes is a consultant obstetrician and gynaecologist in Harley Street