Relative Values Review and the Office of Fair Trading - Update from FIPO

August 2002

The Relative Value Review (RVR) was instigated by several major private medical insurance companies, with the help of members of the profession, some time ago. The purpose of this exercise, which was undertaken by Newchurch Ltd - a healthcare consultancy and information service (www.newchurch.co.uk), was to restructure the reimbursements to patients for consultant fees for various operative procedures and other treatments.

The concept was developed because it was recognised that some reimbursements were inappropriately funded and the changing practices and technology also required a rethink of the whole fee reimbursement system.

The RVRs published by Newchurch left many in the profession confused because there were still a number of inconsistencies. However, before the RVRs could be implemented in any guise, PPP (who were not part of the RVR process) reported the whole matter to the OFT. PPP's claim was, we understand, that such a new fee structure would amount to some form of cartel as it was to be implemented by several insurers.

At the moment no official response has been made by the OFT although unofficial rumours suggest that they have rejected PPP's claim. BUPA Insurance are currently negotiating a limited number of increased fee reimbursements to certain specialty groups. Anaesthetists have agreed a number of procedures with increased fee reimbursements.

The LCA's view

It remains to be seen what the overall impact of these increases of fee reimbursements will mean to different specialties but it continues to be the LCA's position that such reimbursements are made to the patient for consultant fees and any shortfalls remain the responsibility of the patient. The LCA reiterates that it does not condone excessive or unreasonable charges.

Members of the LCA wishing to utilise a Fee Explanation note to distribute to their patients, which covers some of these issues, can request a copy online...