BMJ 2015;350:h2098 doi: 10.1136/bmj.h2098 (Published 20 April 2015)
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News
NEWS Doctors must not accept inducements for referrals, GMC says Clare Dyer The BMJ
The General Medical Council has written to all UK licensed doctors to warn them that they must not accept incentives to treat patients at any particular private healthcare facility or refer them there for tests, after an investigation by the Competition and Markets Authority found that such schemes were widespread in the private health sector.1 The letters follow an order from the competition authority placing new legal requirements on doctors from 6 April, including a ban on “requesting, agreeing to receive or accepting any direct incentive or any obligation” from a private hospital to give preference to its facilities when doctors treat patients or refer them for treatment or tests.2 The GMC’s initiative also came after an investigation by The BMJ that found that private hospital chains had been “buying” referrals to their facilities by offering consultants inducements, ranging from free office space and administrative support to commission based cash payments and share schemes. The BMJ accused the GMC of taking no action after a leading healthcare insurer handed it a dossier of evidence in 2012 showing that such practices were commonplace.3
The GMC’s letter to doctors, which will be sent by email over several days from 17 April, also alerts practitioners to the order’s requirement on doctors to give patients written estimates of costs, reasons in writing for further tests or treatments, and details of financial interests that they have in the medical facilities and equipment used.4 The order also bans referring doctors from holding shares in a private facility or equipment unless they pay the full market value of the shares and the financial interest is no more than 5%. A doctor who holds shares must not be under any obligation, express or implied, to refer patients to the facility, and the hospital must publish on its website the names of any referring doctors who own a financial interest.
For personal use only: See rights and reprints http://www.bmj.com/permissions
Niall Dickson, the GMC’s chief executive, said that it took the issue of conflicts of interest very seriously. He added, “We would be concerned about any scheme that gives doctors a financial incentive to influence their clinical judgment. Our guidance, Good Medical Practice, is clear that decisions about clinical care must always put the patient’s interests first. “Patients must also be able to rely on doctors to give them clear and timely information about their fees and financial interests. This is unequivocally set out in our Financial and Commercial Arrangements and Conflicts of Interest guidance.” A recent study of patient safety in private hospitals highlighted the “lack of accurate and robust performance data” for private hospitals, when compared with NHS facilities.5 The order provides for the setting up of an information centre to which private hospitals will be required, from September 2016, to provide information, including readmission rates, revision surgery rates, mortality rates, frequency of adverse events, and unplanned patient transfers to NHS facilities. thebmj.com Feature: The truth about cash for referrals (BMJ 2015;350:h396, doi:10.1136/bmj.h396) 1 2 3 4 5
Competition and Markets Authority. Private healthcare market investigation: final report. 2014. https://assets.digital.cabinet-office.gov.uk/media/533af065e5274a5660000023/ Private_healthcare_main_report.pdf. Competition and Markets Authority. Private healthcare market investigation order. 2014. https://assets.digital.cabinet-office.gov.uk/media/542c1543e5274a1314000c56/NonDivestment_Order_amended.pdf. Gornall J. The truth about cash for referrals. BMJ 2015;350:h396. GMC. Conflicts of interest: new legal requirements [letter to doctors]. Apr 2015. www. gmc-uk.org/CMA_ORDER_April_2015_GMC_Email_to_doctors.pdf_60553372.pdf. Leys C, Toth B. Patient safety in private hospitals: the known and the unknown risks. Centre for Health and the Public Interest. Aug 2014. http://chpi.org.uk/wp-content/uploads/ 2014/08/CHPI-PatientSafety-Aug2014.pdf.
Cite this as: BMJ 2015;350:h2098 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
News
NEWS Doctors must not accept inducements for referrals, GMC says Clare Dyer The BMJ
The General Medical Council has written to all UK licensed doctors to warn them that they must not accept incentives to treat patients at any particular private healthcare facility or refer them there for tests, after an investigation by the Competition and Markets Authority found that such schemes were widespread in the private health sector.1 The letters follow an order from the competition authority placing new legal requirements on doctors from 6 April, including a ban on “requesting, agreeing to receive or accepting any direct incentive or any obligation” from a private hospital to give preference to its facilities when doctors treat patients or refer them for treatment or tests.2 The GMC’s initiative also came after an investigation by The BMJ that found that private hospital chains had been “buying” referrals to their facilities by offering consultants inducements, ranging from free office space and administrative support to commission based cash payments and share schemes. The BMJ accused the GMC of taking no action after a leading healthcare insurer handed it a dossier of evidence in 2012 showing that such practices were commonplace.3
The GMC’s letter to doctors, which will be sent by email over several days from 17 April, also alerts practitioners to the order’s requirement on doctors to give patients written estimates of costs, reasons in writing for further tests or treatments, and details of financial interests that they have in the medical facilities and equipment used.4 The order also bans referring doctors from holding shares in a private facility or equipment unless they pay the full market value of the shares and the financial interest is no more than 5%. A doctor who holds shares must not be under any obligation, express or implied, to refer patients to the facility, and the hospital must publish on its website the names of any referring doctors who own a financial interest.
For personal use only: See rights and reprints http://www.bmj.com/permissions
Niall Dickson, the GMC’s chief executive, said that it took the issue of conflicts of interest very seriously. He added, “We would be concerned about any scheme that gives doctors a financial incentive to influence their clinical judgment. Our guidance, Good Medical Practice, is clear that decisions about clinical care must always put the patient’s interests first. “Patients must also be able to rely on doctors to give them clear and timely information about their fees and financial interests. This is unequivocally set out in our Financial and Commercial Arrangements and Conflicts of Interest guidance.” A recent study of patient safety in private hospitals highlighted the “lack of accurate and robust performance data” for private hospitals, when compared with NHS facilities.5 The order provides for the setting up of an information centre to which private hospitals will be required, from September 2016, to provide information, including readmission rates, revision surgery rates, mortality rates, frequency of adverse events, and unplanned patient transfers to NHS facilities. thebmj.com Feature: The truth about cash for referrals (BMJ 2015;350:h396, doi:10.1136/bmj.h396) 1 2 3 4 5
Competition and Markets Authority. Private healthcare market investigation: final report. 2014. https://assets.digital.cabinet-office.gov.uk/media/533af065e5274a5660000023/ Private_healthcare_main_report.pdf. Competition and Markets Authority. Private healthcare market investigation order. 2014. https://assets.digital.cabinet-office.gov.uk/media/542c1543e5274a1314000c56/NonDivestment_Order_amended.pdf. Gornall J. The truth about cash for referrals. BMJ 2015;350:h396. GMC. Conflicts of interest: new legal requirements [letter to doctors]. Apr 2015. www. gmc-uk.org/CMA_ORDER_April_2015_GMC_Email_to_doctors.pdf_60553372.pdf. Leys C, Toth B. Patient safety in private hospitals: the known and the unknown risks. Centre for Health and the Public Interest. Aug 2014. http://chpi.org.uk/wp-content/uploads/ 2014/08/CHPI-PatientSafety-Aug2014.pdf.
Cite this as: BMJ 2015;350:h2098 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
