Patients Need Independent Informed Choice
The Competition Commission say that the lack of comparable information makes informed choice difficult and raises the cost of medical care. They go on to say that due to private hospitals dominating local areas there is a lack of competition from which the hospital can make excess profit at the cost of the patient.
The Commission suggest that twenty hospitals need to be sold off in order to allow entry for greater competition, to improve choice and thereby bring down costs. Further information on this will be made available on Friday, but the report lists BMI Healthcare, Spire Healthcare and HCA International as hospital groups that benefit from dominance in certain localities.
What appears to be lacking from the report is how, in an attempt to reduce the cost of claims most insurers are actively restricting choice by only allowing members access to a restricted number of (cheaper) consultants. The GP is encouraged to write an 'open referral' letter, and the insurer uses this to tell the patient which consultant they should see. This raises the serious question as to who is the actual medical gatekeeper - insurer or doctor? However, further information on this point may also come out on Friday.
Medical Consultants Independent of Private Hospitals
Medical consultants in the UK are normally independent contractors who are not paid by the local hospital. Many consultants maintain their total independence of any particular hospital group and will operate from clinics in a number of different hospitals. The hospital marketing teams compete to attract the local consultants into their facilities, however the level of choice for the consultant is also often governed by the number of local hospitals.
The Role of the GP for Private Referrals
80% of all private medical referrals in the UK are insured and the insurer normally insists on a referral letter from the GP. The GP is therefore normally the gatekeeper for deciding which consultant the patient should be referred to, although the patient should also have a say in this decision. Up until recently neither GPs or their patients have had access to comparable, independent information on the choice of hospitals and consultants according to the patient's need. However, this situation is now changing as a result of the launch of new independent sources of medical choice information such as gprefer.co.uk, totalhealth.co.uk (this website) and consultant-search.co.uk
The website gprefer.co.uk is only available to GPs, but is designed for them to share the key elements of 'informed choice' with their patients.
gprefer allows your GP to:
- Search specialists by locality, hospitals and clinics
- Search specialists by specific insurer approved or self-pay
- Search consultant(s) by diagnosis and co-morbidity
- Search specialists by real-time availability
- Directly compare consultants to discuss options with patients
- Select a consultant and make an online referral
- Attach a referral letter
- Receive confirmation of the referral and receive update notes
- Link to patient-facing articles and websites prepared by the consultants
- Integrate electronic records into the practice management system
Although the information on the 10,000 leading UK medical consultants is currently only available to GPs, the information is also being made increasingly available for patients via the consultant-search.co.uk and totalhealth.co.uk websites.
Diagnostic Search - defining the patient need
The real beauty of both gprefer.co.uk and consultantsearch.co.uk is that they are entirely independent of any hospital groups and the patient can search for an appropriate specialist according to either their diagnosis, or need for a confirmed diagnosis, This is the central search philosophy.
Open Referral Letter
The way in which most insurers will restrict patient choice and hence the cost of the claim is via the so-called 'Open Referral'. To a large extent this system enables the insurer to dictate which consultant the member will see and to direct the patient only to those consultants who have agreed to the insurers payment terms. The fact that the major insurers are placing this pressure on consultants is understandable, but it cannot be at the cost of informed choice and patients need to be aware of this.
For further information Medical Logic Ltd are responsible for developing the new private patient consultant-led comparable information website and can be contacted on 01296 613116
