Independence declaration
By Robin Stride
Consultants have unveiled their blueprint for a private health market disruptor aimed at giving them greater control over fees and give patients a bigger say over who treats them.
The ambitious move has already received backing from hundreds of specialists and was cheered by doctors at the BMA’s annual private practice conference where the concept was announced.
It is proposed a new union-owned company called ‘BMA Health’ would function as ‘a national super-chambers’ for doctors, providing much of the business back-up they need to practise and it would also administer services for patients.
The plan aims for the first time to unite private doctors into a single corporate entity, legally entitled to collectively negotiate on behalf of its shareholders.
It would have an initial focus on self-payers and new consultants, and provide practice management services such as appointments, diary, letters and billing.
Comprehensive insurance
Later it would offer a ‘no exclusions’ comprehensive private medical insurance product, bring in senior consultants and use scale economies to negotiate ‘fairer’ hospital rates for self-payers.
Dr Leon Creaney
Sports and exercise medicine consultant Dr Leon Creaney, a BMA private practice committee member and lead for private medical insurer negotiations, stressed it would not fix prices.
The plan had potential ‘to do a lot of good’ in the private sector with doctors setting their own rates as they thought fit and allowing market forces to decide, he said.
BMA Health would negotiate with insurers on behalf of doctors and patients, who would be offered GP and consultant finder services.
It is hoped consultants will now express widespread interest. Dr Creaney received the day’s biggest applause at the London event, declaring: ‘If we get the feedback from large numbers that this is something the private doctors’ community wants, it’s going to happen – and we are going to fix things not just for doctors but for patients as well.’
BMA Health would also negotiate the unbundling of fees for radiologists and pathologists, who would return to setting their own fees with hospitals.
Wholly owned subsidiary
Income would come from doctors paying practice management fees and from patients’ ‘moderate’ subscriptions. It would be a wholly owned subsidiary of the BMA, eventually being 49% owned by doctor-users.
Dr Creaney argued private healthcare is ‘unwell,’ with doctors outsmarted by global corporations employing divide and conquer tactics. ‘Doctors need to show solidarity with each other. It’s up to us to reclaim our territory and mend a broken sector,’ he said.
He listed a variety of consultants’ frustrations including many saying they were not doing private medical insurance-paid work because it was not worth it, restrictions on what experienced consultants could earn, and consumer inability to shop around.
Patients were experiencing ever increasing premiums for ever decreasing coverage, the reason people went private was being eroded, and now there were private consultant waiting lists.
According to a new BMA survey, most private doctors are in the late 40s and 50s age group and there are not the numbers of younger people to replace them, said Dr Creaney. ‘In the next ten years I worry the number of private doctors is going to fall off a cliff.’
Insurance rates are 30-40% less than on the open market and it is becoming more favourable to work in the NHS than privately, he added.
BMA private practice committee chair Dr Jennifer Yell said insurers should allow consultants to charge top-up fees. Doctors wanted fairness all round and she urged delegates to know their worth and not to be afraid of lobbying.
Bupa fees increase
The BMA Health announcement followed a Bupa letter to consultants announcing fee increases.
This drew a lukewarm response from the Independent Doctors Federation (IDF) to which the insurer commented to Independent Practitioner Today: ‘We are committed to ensuring the fees we pay balance affordability for customers as well as fairly reimbursing consultants for the services they provide.’
Its letter promised more fee transparency to ‘make it easier for you to work with us,’ more input from clinicians, 10-28% rises for anaesthetic procedures and 5-23% for surgical procedures depending on the complexity rating, all from 1 November 2024.
Bupa wrote it would review fees regularly using an improved model, ‘continue our helpful dialogue with consultant representative bodies,’ and was committed to maintaining an ongoing, transparent dialogue with individual consultants.
The IDF called the fee rise a ‘positive step’ towards addressing longstanding issues with consultant remuneration but warned these fell short of adequately reflecting consultants rising costs.
It said most fees were currently 20-30% from where they should be and, while it appreciated the setting up of a consultant panel, it called for this to represent all consultants working in private practice bound by fee constraints.