Doctors demand investigation into PMI fee schedules

clock • 1 min read

The British Medical Association (BMA) has called for the Office of Fair Trading (OFT) to extend its private healthcare market review to include insurers' fee schedules.

Having provisionally decided to refer the market to the Competition Commission (CC) for further scrutiny, the OFT is now considering the responses to its consultation on the subject.

Since the OFT announced its decision, insurance intermediaries and the Federation of Independent Practitioners Organisations (FIPO), which represents doctors and other clinicians involved in private practice, have called for PMI to be included in the CC's work.

They have now been joined by the BMA which represents doctors in all branches of medicine.

The Association said it welcomed the decision to refer the market to the Competition Commission.

However, its Private Practice Committee's (PPC) response to the consulation added that it was disappointed the review will not address insurers' fixed fee schedules for consultants and their restrictive criteria for ‘recognising' practitioners.

It said: "We are disappointed that the report focuses on the relationship between patients and private healthcare providers rather than concentrating on the influence private medical insurers have on the market."

And the PPC called on the Commission to examine its assertion that a published fee schedule contravenes competition policy.

But it said it welcomed the OFT's reference to the need for greater transparency about consultant fee estimates and to prohibiting referral incentives.

The OFT study's findings were seen as particularly damaging to healthcare providers and hospital groups, noting a power bias to hospital networks in certain areas and the hiking of fees if an insurer proposed to add another hospital network to its services.

It also found a lack of easily comparable information available to patients, GPs and health insurance providers on the quality and costs of private healthcare services and that some healthcare providers gave incentives to consultants, such as loyalty payments for treating patients at a particular facility.

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