In the House of Lords, Lord Walton, former chairman of the
General Medical Council, has tabled two parliamentary questions.
The first asks whether the Government has assessed
restrictions placed by BUPA and other private medical insurers on the choice of
consultant or hospital to which insured patients can be referred, irrespective
of the advice of their general practitioner, and the impact on healthcare.
This follows BUPA’s introduction of its open referral
process on private medical insurance policies.
Instead of referring patients directly to a consultant, GPs complete an
open referral form provided by the insurer simply outlining the nature of the condition
or procedure, but without naming a consultant.
Patients then contact Bupa to gain pre-authorisation and, provided this
is covered by their policy, will be given a short list of Bupa approved
consultants whom they may see.
Lord Walton’s point is that Bupa claims are in direct
contradiction to the findings of the Office of Fair Trading in its market study
into private healthcare:” In their submission to the OFT market study PMI
providers indicated that they did not possess sufficiently detailed information
on the quality of care offered by consultants recognised by them and were in
most instances unable to advise patients beyond information relating to the
consultant speciality and location.”
Geoffrey Glazer of the Federation of Independent
Practitioner Organisations (FIPO) says: “Bupa has made several claims about the
variation in clinical practice between specialists, but has never been able to
produce hard data to support the contention that this leads to better outcomes.
The implication that the approved consultant is of a higher quality is entirely
unsubstantiated. In fact, only those consultants who have agreed to the
insurers scale of fees will be on the list of approved consultants, thereby
actually restricting patient choice.”
The second question asked what assessment the government has
made of the degree to which Bupa and other private medical insurers exclude
pre-existing conditions from their cover, and its impact on healthcare.
Private medical insurance news: 9 March 2012