Guessing fees is a tricky operation

THE Monopolies and Mergers Commission is considering whether there should be no published guidelines for medical fees as part of an investigation into surgeons' and specialists' charges, writes Sue Fieldman. Instead, the public would ring round surgeons to compare the cost of an operation.

If the results of a survey by Western Provident Association, the third-largest medical fees insurer, are anything to go by, the specialists will be laughing all the way to the bank.

The public massively over-estimates the cost of treatment. Need a new hip joint? The British Medical Association has a guideline cost of pounds 775. The respondents in the survey would pay a surgeon on average pounds 2,947.

Perhaps a skin mole needs excising. A simple enough job at a guideline cost of pounds 150. The respondents thought pounds 390 would be about right for this spot of bother. They thought coronary artery bypass surgery should be pounds 4,430, compared with a guideline figure of pounds 2,075. Julian Stainton, managing director of WPA, said: 'People do not have a clue about the real cost. They were all miles out.'

The more complicated the operation, the more people over-estimate the cost. For an upper gastro-intestinal endoscopy the average estimated cost was pounds 1,264. Call it a visual examination of the inside of the stomach and we are prepared to pay only pounds 690. The BMA guideline is pounds 200.

We are prepared to pay a surgeon pounds 514 for the removal of a bunion. If you refer to its proper name, Hallux Valgus, then the surgeon's time is suddenly worth pounds 1,274. The BMA guideline is pounds 585.

Just by calling an operation an 'appendectomy' instead of 'the removal of the appendix' warrants an extra pounds 100 in the patient's eyes.