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Independents' Day

Jump in private referrals after GPs are told to ask patients about insurance

Exclusive CCGs in one area of England are giving GPs a 'gentle reminder' to ask patients to consider using private health insurance if they have it, in a bid to save money on NHS treatments.

NHS Mid Essex CCG told Pulse that it has seen a 6% increase in referrals to private healthcare since it wrote to practices asking them to discuss with patients how they can use private insurance.

Meanwhile, NHS Basildon and Brentwood CCG last week sent posters to practices to display under its ‘Private Healthcare; another patient choice’ scheme, and encouraged GPs to ask about patients’ private healthcare options.

Both CCGs say that the schemes have been introduced in a bid to cut costs.

GP leaders criticised the schemes, warning it may lead to patients feeling guilty for using NHS services, and would increase health inequalities.

NHS Mid Essex CCG is part of one of the 11 most financially challenged health economies in the country. As such, a spokesperson said, it was ‘having to consider options for gaining maximum benefit from limited NHS resources’.

Its scheme began in November 2015, when it wrote to practices to ‘seek their support in specifically discussing with patients who have private healthcare cover, how use of the cover would affect their care pathway’.

The spokesperson added: ‘We have seen an increase of referrals to private healthcare of 5.75% in the first six months of 2016 compared to the same period in 2015.’

The letter from NHS Basildon and Brentwood CCG, sent last week and seen by Pulse, asks GPs to display a patient leaflet, which is headlined: ‘Do you have private healthcare cover?’ and explains that ‘as part of a local NHS project your GP may ask you if you have private medical insurance’.

It also asks GPs to pose the question about private health cover ‘simply to highlight the option for the patient to make a considered choice but by no way impeding on their ability to choose’.

A spokesperson for NHS Basildon and Brentwood CCG told Pulse: ‘In order to meet our statutory obligations to balance our books we have had to consider all available ways to reduce costs'.

They added the policy was a ‘gentle reminder to patients to inform their GP of their private health insurance carries potential benefits for both the patient and the local health economy during this time of financial constraint'.

The CCG was ‘not expressing a view on whether people should have private health cover or not’, they added.

NHS Basildon and Brentwood CCG is also in the process of consulting on rationing a number of services, including a complete ban on bariatric surgery and stopping all vasectomies and female sterilisations on the NHS, in a bid to tackle a £14m deficit.

Dr Andrew Green, chair of the GPC’s clinical and prescribing committee, said he would not encourage patients to use health insurance ‘as all patients have a right to NHS care and should not be made to feel guilty about using it’.

Dr Green added that ‘a further unintended consequence will be that patients already lucky enough to live in an area where large numbers of people can afford private health insurance will gain compared to those in more deprived areas who already suffer worse health, so this is hardly a step towards reducing inequality’.

Dr David Wrigley, deputy chair of BMA Council and GP campaigner against privatisation of the NHS, said: ‘It is a sad state of affairs when GPs are asked by their CCGs to encourage patients to use private healthcare for their illnesses. Surely, with their own GP suggesting this, it will make patients think the NHS is not coping and lead to them seriously consider purchasing costly private health insurance.’


Readers' comments (16)

  • They don't say whether NHS referrals have gone down, or whether more people are being referred overall. I know that when I have a patient with a hernia, or varicose vein I'm not going to refer them on the NHS but as soon as they say they have insurance I'm no longer the gate-keeper

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  • It is surprising how often patients with private insurance don't think to use it. Always worth asking the question, otherwise why are they paying their premiums.

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  • May I say that I think it if offensive for the NHS to ask patients to use their private insurance to bail out the NHS, however wealthy or however insured they might be. The NHS is supposed to be free to ALL, at the point of need, irrespective of their ability to pay, paid for out of general taxation (as we all do). I for one am incensed that the NHS might ever try to weasel out of its commitments just because it is financially convenient to do so. What's next? 'If you've got private insurance then you are automatically barred from using NHS facilities?' I can quite see this coming.

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  • What is the point of being free if you have to wait 2-3 years for something eg elective surgery. I don't know of anywhere in the world, even USA where if you have a life-threatening emergency you have to pay for your emergency treatment.

    The dogma of "free at point of use" is a fairly useless utopian slogan like "All animals are equal"

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  • In "wealthy areas" where people traditionally had private insurance the NHS budgets were correspondingly low. When the 2008 crash came budgets for these areas were based on historical figures despite the fact that as much as 10% of those who, in the past went privately, relinquished their private insurance and came back to the NHS - all the while expecting the same kind of private service. I have always asked if patients have private insurance as quite frankly the speed at which they are seen and investigated is much better, and if they have it they may as well use it. However, it still does not help in areas of traditionally high private usage whose budgets were historically low to reflect this have now been shafted as private insurance affordability has dropped. These patients have a right to proper NHS care as well

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  • Over several years I have referred many patients to private providers due to patient preferences.

    Several patients have policies linked with company contracts and are happy to utilise these services due to convenience of time, including weekend and evening services, not to mention rapid turn around of results and procedures.

    By using these services, funds may become available to help sustain services for NHS patients.

    I would however want to know more about the impact on premiums if we continue to expand the use of private resources.

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  • Won't the insurance companies get wise to this? Either premiums will go up, 'No Claims' bonuses imposed or conditions requiring NHS treatment if available.

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  • even worse-the insuranc e industry might charge higher premiums if you live in Mid -Essex or Basildon and Brentwood!

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  • Makes perect sense. It's been happening in other countries in the world, who realise that the 'free at the point of contact' idea is a sham.

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  • This is wrong in so many ways not least in being further stealth privatisation. If they go privately after being directly asked are they going to get tax relief on the private cost having declined a benefit they are entitled to?
    No - I thought not. Resist this nasty underhand bit of what morons without any sense of ethics consider to be pragmatism.

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