The general practitioner community is busy shooting itself in the foot these days on a regular basis. If they are not taking £250,000-plus salaries, they are installing revenue-generating phone systems that earn the doctor a cut from every patient’s call. As the UK creeps towards the American model of a 24/7 society, most GPs have chosen to work Monday to Friday from 9am to 5pm and leave busy accident and emergency departments to treat patients who have the temerity to be ill outside office hours.
The public perception of NHS GPs is in PR meltdown. I was amused recently to see a report on breakfast TV that referred to that august body, the British Medical Association, as “the GPs’ trade union”. This is, indeed, as confirmed by their website, part of the BMA role. However, it was clear from the presenter’s mocking tone that they were seen primarily as an organisation dedicated to defending medical fat cats. Oh, how the high and mighty have fallen.
Now that general practitioners have swollen the ranks of the professions which the British public loves to hate, perhaps it is time for the financial services’ industry, a profession not exactly high in the public’s esteem, to make common cause with the medical profession and see if we can find more efficient ways to serve people.
At the last FTRC Adviser Forum a couple of weeks ago we had a presentation, organised by Friends Provident, from two members of the medical profession on the scope for automating the process by which medical information is supplied to insurers. Many of the recent tabloid headlines about GPs’ footballer-level salaries have been driven by the substantial additional payments that GPs earn by collating key medical statistics about their patients, known as clinical indicators.
To be fair to both the medical profession and the Government, which introduced this mechanism, it was recognised as a proactive approach to identifying future illness and taking preventative action.
Significantly for the industry, such information can also be extremely useful in the underwriting process. Not only does it enable a more accurate assessment of a client’s health but because the doctors are remunerated for delivering information regularly, a long-range picture can be built.
One of the major developments in the NHS over the past few years has been the introduction of an electronic patient records transfer. The process enables the movement of a patient’s records from one practice to another as an electronic message rather than, as previously, via the physical transfer of paper files.
As doctors now have a rich vein of patient data stored electronically, there is a compelling case to see if information can be transferred in more efficient ways between doctors and insurers.
We have, of course, made attempts at electronic general practitioner reports before. But the previous service was launched when relatively few medical practices were fully computerised. The Government has now given GPs major financial incentives to computerise records and IT is at the heart of the current NHS contract.
The spectre of non-repudiation is also lurking in the background of the protection market. From my perspective, if the industry cannot find a way of recouping the hideous percentage of claims that are declined, we probably deserve to have a solution forced upon us by the Law Commissioners.
The established process of sending paper medical report forms to doctors to be filled in and returned by post is unnecessarily wasteful when the data is sitting on electronic systems. It is an opportunity to improve the quality of service and cut costs for all concerned. At a time when the postal unions are constantly threatening to strike, electronic systems become even more attractive.
The doctors who gave presentations to us at Adviser Forum made it clear that their staff dislike completing GP reports as much as advisers and life offices dislike chasing them. They did, however, accept that the supply of such reports is a lucrative sideline. With the cost of GP reports due to rise from last year’s £74.70 per report to £94.30 by 2010, the industry could be looking at a very large large bill indeed for reports.
Even if only 15 per cent of cases required PMA reports, assuming around £1.8 million policies a year would see costs soar to £25m.
Electronic medical reports give insurers the chance to demand far more specific information and to do so more often. They can also ask for the information that was relevant to the case being underwritten, rather than the much wider array of information obtained under the present process. This should be a catalyst to cutting costs.
There is one point I would urge, however, on anyone involved in reviewing such processes. The current operation of the Access to Medical Reports Act is highly inefficient. The legislation dates back to a time when the original Financial Services Act had only just been put in place and the levels of fitness and probity in our industry were nowhere near what they are now.
The medical profession needs to review the whole process, not just the way the information is supplied by the doctor to the life office.
GPS are keen to extract further revenue from the additional data the government has paid them to collect. If they can do this in ways that enable insurers to deliver faster and more efficient underwriting decisions, while at the same time removing many paper processes, they may have a strong case.