Insurers are claiming some progress in stemming private medical costs, following moves to increase transparency of specialist fees.
Regulations for the new National Care Standards Commission, which begins inspections of private hospitals in April 2002, deal with a long-standing gripe over fees charged by “support” doctors.
Specialists such as anaesthetists and pathologists have never been required to state in advance their fees to prospective private patients, whether self-paying individuals or insured policyholders.
The result has been that while surgeons disclose their fees, patients recovering from surgery can find unwelcome extras tagged to their bills.
A further complaint is that this gives the insurer or self-payer no say in who administers anaesthetic or examines biopsies. The issue is taking on added impetus because anaesthetists, traditionally paid half the surgeon’s fee, are pressing for pay parity.
This would add significantly to costs for insurers and self-funding patients.
The Office of Fair Trading (OFT) has renewed pressure on consultants to disclose charges. It recently raided anaesthetists’ premises following allegations that they are operating cartels to force up prices.
Documents seized in Oxford, Reading and Wales will help determine whether “anti-competitive” practices have been used, an OFT spokesman said.
In 1999 the OFT called for transparency in all doctors’ fees to little effect. Five years earlier the Monopolies & Mergers Commission urged consultants “to charge fairly and reasonably and give advance notice of fees”.
At last the competition authorities, backed by insurers, can claim success. Regulations governing the Care Standards Commission say prospective patients must be told “the amount and method of payment of charges for all aspects of their treatment”.
PPP healthcare spokesman John Dubois said: “We have been lobbying for ages for greater transparency. In the old days it was nice if the doctor told you what he was charging. Now he must.”
Turn to the feature on page 46 for further information on the legal issues.