Summary of the FIPO July 2010 Survey
Following an announcement that BUPA would be seeking the views of its consultants through a questionnaire, FIPO felt it important to conduct a survey of consultants generally to establish their views on the consultant-insurer relationship and identify those issues of importance that impact the consultant-patient relationship. This survey was an online confidential survey carried out in June 2010.
To date, 330 consultants have participated in the survey representing the fields of ophthalmology, anaesthetics, general surgery, ENT, orthopaedic surgery, orthopaedics and trauma surgery, gastroenterology, rheumatology, cardiology, dermatology and others.
The results were statistically representative and revealed that:
- 90.9 percent of respondents believe insurers, as financial services companies, do not have the capability to act as regulators by reviewing their personal audits, multisource feedback other clinical information such as complaints or incidents
- 93 percent of consultants believe that the independent hospital governance systems and MAC should define the scope of practice
- 98.5 percent were against insurers defining scope of practice
- 89.4 percent felt that providing data to an insurer who requests detailed audits and outcomes would lead to limited preferred consultant provider networks being created
- 96.7 percent believe consultants who have been derecognised by an insurer should have the right to an independent appeals process
Of those that have completed this short survey, 88.8 percent think that a CCT and substantive NHS consultant appointment is the sole professional requirement for recognition by private medical insurers. Regarding regulation, there is a strong consensus that this should not be the responsibility of insurers but rather an independent organisation. 96 percent believe that insurers should not have the right to act as a regulator by reviewing a consultant’s detailed personal audits, multisource feedback and other clinical information with 90.9 percent believing private medical insurers do not have the capabilities to be a regulator.
The survey also touched on revalidation and terms and conditions for newly appointed consultants. Concerning newly appointed consultants, there was a strong sense, 95.7 percent of respondents, that insurers should not be responsible for monitoring initial progress, appraisal and results. This should rather be part of the independent hospital governance process and it’s MAC.
There is clear evidence of distrust by consultants of insurers and 84.5 percent of respondents feel requests for details audits and outcomes might be used to negotiate volume discounts on fees with almost 90 percent feeling this will lead to insurers creating preferred provider networks.
On de-recognition of a consultant by an insurer, almost 97 percent felt strongly that if an insurer de-recognises a consultant, that individual should have the right to an independent appeals process, something that is not currently in place.
166 respondents made additional comments after completing the survey. Overall these comments postulated that there should not be a consultant-insurer contractual relationship; rather the relationships should be between the patient and insurer, and the patient and consultant. Most importantly, it strongly and repeatedly argued that the clinical interests of the patient should outweigh commercial considerations, and that the relationship between the consultant and patient is of the utmost importance.