News Update on the BUPA Ophthalmology Tender
November 5th 2006
In previous updates FIPO reported that consultations with BUPA had reached a state where it was apparent that the original proposals from the insurer could not be implemented because of the opposition of the profession at large. This opposition was based on serious concerns about restriction of patient choice, the loss of professional independence of consultants, the break up of the GP to consultant referral pathways and the loss of continuity of care that many patients enjoy with their chosen consultant. The all-important contract between the patient and the consultant would be broken and the insurer would take over the gatekeeper role of secondary care.
A backdrop to these discussions with BUPA has been their simultaneous introduction of Milliman care plans which added to the fear that BUPA Insurance were intent on a package of total Managed Care. We received some assurance from BUPA that this was not their intention and they appeared to have withdrawn from this strategy.
It was agreed that the profession would work with BUPA to try and achieve cost-effective practice in ophthalmology although it was the contention of the specialists in that field that there was very good practice currently going on.
A review of current audit practice in the UK
However, since then BUPA Insurance has developed another approach by trying to steamroller consultants in to joining on a local piece-meal basis and they are attempting to do this gradually hospital by hospital throughout the UK.
The present BUPA proposals are long and may be seen at:
A great deal of play is made by BUPA Insurance about quality of care but this is not defined. There is, however, considerable work to show the high standards of care in UK ophthalmology and this was presented briefly at the recent FIPO meeting on 17th October 2006.
It is not possible to answer all the questions that arise from this 23 page BUPA document on a website. In short these proposals would severely restrict the ability of patients to choose their consultant and could adversely affect patient care.
The professional bodies have responded again and the advice from the BMA can be seen here:
www.bma.org.uk/ap.nsf/Content/BUPAOphthalmologyletter31106
The advice from FIPO is similar and our statement is supported by the major ophthalmic and anaesthetic associations.
The FIPO statement
view previous discussions and articles on this issue