Doctors reject BUPA 'approval'

Doctors are being urged not to sign up to BUPA's 'approved network'

Doctors are resisting plans by private health insurer BUPA to draw up a list of 'approved' eye specialists.

The BMA and the Royal College of Ophthalmologists said regulation of doctors was the job of the General Medical Council not BUPA.

BUPA said the aim of the scheme was to assure the quality of services but the British Medical Association suspected the goal was to force down prices.

They have urged ophthalmologists and hospitals not to sign up to the scheme.

BUPA has given doctors until 19 June to complete the forms which ask for qualifications and standard of service.

"The quality of eye surgery is extremely high so it's not really about quality of hospitals or surgeons and we don't believe they are in a position to determine quality" Derek Machin, British Medical Association

Specialists who don't comply will not be included in the approved ophthalmology network, which doctors say will limit patient choice.

A letter has been sent to all consultant ophthalmologists and anaesthetists from representatives from eight organisations including the Association of Ophthalmologists, the BMA and the Association of Anaesthetists of Great Britain and Ireland, listing their concerns about the scheme and asking doctors not to take part.

The letter states that accreditation of consultants is they role of the Royal Colleges and the GMC and regulation should be done by the Healthcare Commission.

An eye specialist network would be "detrimental to patient choice" and could "interfere with doctor-patient relationships" it states.

Under the scheme, hospitals are also expected to submit details on fees which the BMA warns is being done to cut consultants costs - as has happened in other clinical areas.

In a separate letter sent to its members, the Royal College of Ophthalmologists said BUPA's plans were "flawed" as all specialists were subject to robust annual appraisal.

Brenda Billington, president of the College said: "We don't really think it's their role. We feel the proposals are misleading patients into thinking the ophthalmologists who are approved is in some way better than the ones that aren't."

High quality

Derek Machin, a consultant surgeon and the chairman of the BMA private practice committee said the scheme was about cost not quality.

"The quality of eye surgery is extremely high so it's not really about quality of hospitals or surgeons and we don't believe they are in a position to determine quality.

"It's a complete nonsense. It is really about price."

Mr Machin said the same thing had happened with MRI scans and high quality hospitals with "state of the art" scanners had not been included.

"The network they have set up with MRI scans has excluded many experienced units and prevented clinicians sending patients to their usual hospital.

"And consultant fees dropped 20 to 30%."

"We are ending up with incorrect reports and that is negative quality. It is completely unfriendly to patients."

Mr Machin said BUPA had indicated they would also be looking to create approved networks in orthopaedics, cardiology and other surgical specialties.

He added: "The situation is very simple, without the doctors the insurance companies don't have a business.

"At the moment it looks as if they will have no surgeons in central London which is not a good advert for BUPA."

Paula Franklin deputy medical director BUPA Health Insurance said the scheme was not about regulation.

"Patients are asking us more questions about their condition, their treatment and doctor who treats them and we want the information with which to respond to them.

"We want to complement existing regulations by gathering information and promoting existing quality standards in the independent sector.

She added: "While we understand the BMA's concern about consultants' fees, we have an obligation to our customers to keep premiums affordable.

"We see significant variation in practice and cost which is currently inexplicable and which this initiative will help us to understand."