Doctors face price-fixing investigation

DOCTORS are to be investigated by the Monopolies and Mergers Commission over possible 'price- fixing' in the fees charged for private treatment.

Sir Bryan Carsberg, director- general of the Office of Fair Trading, was prompted to make the reference to the commission yesterday by concern over guidelines published by the British Medical Association.

These set recommended fee rates for medical and surgical procedures. The BMA suggests a payment of pounds 310 to the surgeon and pounds 135 for the anaesthetist for the private removal of a wisdom tooth. A tonsillectomy might cost pounds 355 and pounds 140 respectively, the guidelines suggest.

Unusually, the OFT action has arisen not out of a complaint, but out of its correspondence with the BMA earlier this year, when the existence of the guidelines came to light.

'If these are adhered to by a significant proportion of consultant doctors, they may affect the nature of competition and the level of fees in the market for the supply of private medical services,' an OFT spokesman said.

'This raises the question of how effective fees competition between consultant doctors is at present.'

The commission will investigate whether a monopoly situation exists and, if so, whether any aspect of the supply of the services operates against the public interest.

It will report the findings of its first investigation into the private medical sector to Michael Heseltine, President of the Board of Trade, within 12 months.

The BMA insisted yesterday that its guidelines promoted patients' interests as they helped to prevent overcharging.

'Obviously we will co-operate with this inquiry, but we do point out that the fees referred to are merely guides, not recommendations,' a spokesman said.

However, the foreword to the new edition of the guidelines, published last week, states that it is intended for use by specialists, health insurers and general practitioners, 'who may wish to use it to advise their patients of the likely costs of treatment in the private medical sector'.

The guidelines deal with nearly 1,500 different procedures. They suggest that fee levels should be about 16 per cent higher than those contained in the last edition, published in 1990.

The BMA says the uprating is in line with the independent Doctors' and Dentists' Pay Review Body report earlier this year.

Submissions to the Monopolies and Mergers Commission must be made by 30 October.

Allegations of restrictive practices in the systems governing medical qualifications and the promotion of doctors to consultant posts are already the subject of a separate Department of Health inquiry, chaired by Kenneth Calman, the Chief Medical Officer.

Earlier this year, the Office of Fair Trading expressed its concern over the specialist medical accreditation system operated by the medical training authorities.