Specialist Ophthalmology Tendering by BUPA and PPP
– Implications for all Consultants

was held on
17th January 2007
at The King's Fund

A meeting was held at the Kings Fund on 17th January 2007 to analyse the current status of the BUPA and PPP strategy for ophthalmology and to review the implications.

This meeting was well attended by some 70 consultants and approximately 40 ophthalmologists. The Chairman, Mr. Glazer, introduced the various speakers.

Mr. Ian Winspur, Consultant hand Surgeon, discussed the ways in which managed care worked in America. He explained that having trained in the UK he moved to work in orthopaedic and hand surgery in California but returned to the UK in 1990 because of the pressures of the managed care system. His group practice of several surgeons required that each had a personal nurse, a personal secretary and one person devoted entirely to dealing with insurance issues. Preauthorisation for care was extremely difficult and there was an expense before taxation for each surgeon which ran at approximately 60% of income.

These intolerable conditions drove him back to the UK but he was pleased to note that some major US insurers were now dropping the whole of their preauthorisation mechanisms because they were far too expensive and did little to advance the health care of their patients.

Mr Michael Bonehill, Solicitor, spoke about the Competition Law and described in detail the legal definitions of chambers, partnerships, limited liability partnerships and limited companies. He then went on to discuss in detail Chapter II of the Competition Act which dealt with cartels, price fixing and dominant market forces. These were all then debated in the context of the current changes facing the independent sector.

Mr. Simon Levy, Consultant Ophthalmologist, gave a detailed analysis of audits and the complications arising from cataract surgery. He alluded to BUPA Insurance’s statements that posterior capsular opacification and retinal detachment were important and infrequently measured outcomes. Mr Levy denied that these were true measures of cataract complications, a point which was picked up and agreed with by the specialist audience.

There were then several contributions from ophthalmologists and an oral surgeon from different parts of the UK explaining their local situations in regard to the BUPA and PPP tendering process. There was a general anxiety about the tendering process because of its impact on patient choice and clinical standards. The oral surgery network introduced by PPP for three basic conditions was also discussed and it was noted that this was affecting continuity of consultant care and patient choice.

Details of some of the slides and Mr. Bonehill’s presentation are available in our password controlled area for members.

original programme

back to previous page