BUPA and PPP Tendering for Cataract Surgery
5th December 2007
The BUPA ophthalmology network has not been implemented, which is good news for many patients who would otherwise have faced loss of choice and on going care from their previous consultant. However, the dispute between BUPA Insurance (the largest UK private medical insurer) and the BMI Healthcare (the UK’s largest private hospital group) continues with no sign of immediate resolution. This is causing problems for a number of BUPA subscribers who are being forced to transfer their care to alternative venues not of their choosing and under consultants who may be perfectly satisfactory but with whom they have had no previous contact or relationship. This remains a concern and the profession hopes this matter can be resolved quickly.
In October 2007 AXA PPP has started to roll out its restrictive network for cataract surgery. It would appear that the terms and conditions for its subscribers will be modified as their contract comes up for renewal. We understand that this means patients will be directed to PPP network hospitals according to whether they live within particular catchment area, defined by travel time.
Hospitals that have joined the network so far include the Nuffield Hospital Group and some other small independent units. The Nuffield Hospital management has written out to their local consultants suggesting that new arrangements will have to be made between the hospital and the profession if these ophthalmologists wish to continue to treat this group of PPP subscribers in Nuffield Hospitals for cataract procedures.
Undoubtedly this will mean package pricing and will pass the choice of consultant to the hospital manager who will then select from a smaller group of consultants.
It is unclear whether the PPP network will be established in London although attempts are being made to introduce this concept to certain hospitals. In effect this is similar to the BUPA plan and, if implemented, will again restrict patient choice, destroy continuity of care and break the GP to consultant referral pathway.
The medical profession has previously expressed extreme disquiet over these types of insurance schemes and it remains to be seen whether consultants will engage with PPP “recognised” hospitals.