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Gut Reaction #23 CMA Article 22 – Consultant Fee Disclosure

This month’s blog will take an alternative approach to the usual format, focusing not on the patient but instead the practitioner.

In 2012, the Competition and Markets Authority (CMA) opened its investigation into the private healthcare market. The key finding of the subsequent report (please find here), published in 2014, found that there was a lack of publicly available fee information on consultants. The CMA concluded that this was anti-competitive because it prevented patients from exercising effective choice while reducing price competition between consultants.

The solution, article 22 of the 2014 Order, stated that consultants were required to disclose fee (and related) information to patients and established a new patient-orientated information organization – the Private Healthcare Information Network (PHIN). This came into effect between January-March 2018 ensuring that patients were made aware of consultant fees prior to their outpatient appointment and follow-up treatment as well as confirming their understanding of their insurance cover.

What does the CMA Order cover?

  • Consultant fees for initial and follow-up outpatient appointments
  • Consultant fees for follow-up treatment or tests
  • Consultant financial interests in medical facility/equipment
  • List of insurers that recognize the consultant

It is worth noting that this Article does not cover hospital fees.

Consultants are therefore required to:

  • Send letters to patients containing the necessary information prior to their outpatient appointments as well as before any follow-up tests or treatment
  • Give patients the necessary information verbally if the appointment is at short notice/urgent

This CMA Order was implemented for both the patient and practitioner, enforcing transparency and trust in the private healthcare system.

West Kent Gastroenterology Ltd is compliant with all the recommendations of Article 22.

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