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Response to Competition Commission Provisional Findings

Today the Competition Commission (CC) published the provisional findings of its investigation into the UK private healthcare market.

Bupa have been engaging with the CC on behalf of their customers throughout the 18 months of investigation, and have called for bold action to secure the long-term sustainability of the private healthcare market in the UK. Our goal has been better value for money healthcare for our customers high quality care at affordable prices, allowing more people to access private healthcare.

Some of the CCs key findings are:

  • Hospital market power - Hospital groups gain strength from owning hospitals that have local market power, hospitals that patients and insurers have little option but to use. The CC found over 100 hospitals in the UK that face too little competition, and it raises specific concerns about the weak competitive constraints in London.
  • Consultants - the CC found a widespread practice of hospitals giving consultants incentive schemes (both payments in cash and in kind) to encourage additional patient referrals, and is concerned that this may lead to referrals that are not in the patients interests.
  • Information transparency - the CC found that there was insufficient published information on hospital and consultant quality, lagging behind the NHS in many cases. It also found that consultants needed to publish their fees more clearly. This absence of information weakens competition and means that patients, GPs, and insurers cannot make informed choices.
  • Insurers the CC found that Bupa and AXA have some bargaining power against hospitals and get better prices than smaller insurers, but not enough to offset the power of hospital groups. Insurers have bargaining power with consultants, but the CC found no evidence that actions taken by insurers in relation to consultants caused harm to competition. The CC noted that Bupa needs to communicate more clearly what customers are eligible for under their policies and the consultants that they are offered.

Among the key remedies the CC is proposing are:

  • Hospital market power - large hospital groups sell off hospitals in certain areas where they control a cluster of hospitals, and it has identified 20 such hospitals.
  • Consultants - banning hospitals from using consultant incentive schemes that bias consultant referrals.
  • Information transparency hospitals and doctors to publish outcomes and quality data. Consultants should also be required to get written agreement on fees with patients before treatment begins.
  • Insurers there were no specific remedies targeted at insurers. However we will, of course, continue to communicate clearly with our customers and, with the improved information being required of hospitals and consultants, we foresee a step change in what we can say to patients about quality and value for money.

Bupa welcome the CCs provisional findings. It has found significant concerns about ineffective competition between hospitals and insufficient transparency from consultants. It has proposed remedies that would improve competition between hospitals and between consultants. It has also acknowledged the important role insurers play in getting better value for money for customers.

The findings are aligned with Bupas calls for reform of the private healthcare market and our initiatives such as Open Referral, which enable patient choice around the cost and quality of the treatment they receive.

The CC will now consult on these provisional findings and remedies and, over the next six months, we will be working with the CC to design remedies that are effective in getting the best possible deal for our customers.

Please find a Q&A attached to help answer any questions you may have


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