Q&A about private healthcare and insurance in the UK with Aviva’s Medical Director, Dr Doug Wright - ANSWERS BACK

[LucilleMumsnet]

Are you interested in learning about private healthcare or insurance but can't find the time to do it amongst all your other pressures? This week we’re running a Q&A with Dr Doug who’s on hand to help you decide whether it's right for you. No question is too big or small for him to answer, your questions can be as simple as ‘what is it?’

Dr Doug is the Medical Director at Aviva. He joined Norwich Union Healthcare (now known as Aviva) 15 years ago from full time practice as a GP and has combined clinical background with strong commercial expertise. He has held various roles at Aviva and his role now is to ensure that Aviva makes business decisions based on a sound understanding of what is needed clinically.

Aviva says “Every day we’re faced with different pressures – whether it’s juggling our work-life balance, getting used to life with a new baby or simply finding time to deal with that pressing piece of admin. Even the most resilient amongst us needs a little support every now and again. That’s why we include a 24-hour stress counselling helpline as part of our private health insurance policy. Customers can call a specialist counsellor at any time of the day or night to talk chat through their concerns. And, if they need extra help, there’s additional specialist support available.”

Even if you’re not an Aviva customer, you can get invaluable stress management tips by following the progress of our Mumsnet bloggers as they embark on their ‘stress less’ challenge – a personal action plan developed by Aviva’s experts. You can also share your own tips on dealing with stress here.

Post your questions to Dr Doug before the end of today (Tuesday 6 May) and we’ll send over a selection and post up his answers on Monday 26 May.

This Q&A is sponsored by Aviva.

As other posters have said, adverse selection is an issue. You can't have a proper market if people can't get insured, or if people are not allowed to switch providers without much in the way of penalty. Does he see Government intervention happening here to ensure a level insurance playing field, as was the case for high flood risk areas and household insurance?

Hi all,

Thanks for raising your concerns on this one.

This is a sponsored Q&A from Aviva who we have been working with for a while. Aviva are looking for feedback on what people want from their services and how they can better help. We thought this was a nice fit for Mumsnetters who have health insurance and an opportunity to get a question answered from the horse's mouth.

Any and all feedback is welcome, as ever. Mumsnet is a business and we do make our money from advertising but if you feel that there is a lack of synergy between ourselves and a specific industry/brand then we will have a look at this.

I think if Dr Doug is prepared to be eaten alive by the vipers, he should be more than welcome to try his chances.

NHS paid for his training, right? Pre student fees? Now he works for Aviva. He has laid himself wide open there, for a start.

Any health insurance company that has an ethical approach to adverse selection will be worth listening to. We don't need poxy counselling helplines, tbh, they are done to death. we need someone to fix us if we have a bad birth or car crash or have a nervous breakdown. Can they do that? We need insurers who pay up fast, and reliably. We need friendly British people on the phone when we ring up with claims. We need insurers to kick ass with private hospital chains owned by venture capitalists, so someone is fighting out corner. This is what we really want.

Over to you, Doug.

No, they can't do that. If someone gets sick in a private hospital post OP or whatever ( they are mainly for simple surgical procedures there aren't any acutely unwell medical admissions into private hospitals) the patient is transferred into NHS hospital by 999 ambulance pronto for us to sort out.

So no one should forget that the NHS is the only place you can be sorted out when you are proper life threatening sick.

Interestingly having had a bad birth and requiring subsequent surgery, my private medical insurance refused to contribute. Though I do expect it to stump up when I eventually need more repair work, which will probably happen.

We've now got the answers back from Dr Doug Wright and will be posting them up shortly.

@SueDNim

I'm curious as to how much use your helpline gets. I have access to a similar helpline and I think also one through my profession and it has never occurred to me to use them.

You are absolutely right, most people do forget that they have access to these type of helplines so the use of them is low. However, once people have used them my experience is that they find them very useful and use them again much more readily. The main challenge for us is to keep it at the front of people’s minds which is one of the reasons that we are working with Mumsnet to raise awareness.

@angryangryyoungwoman

My question... Do you think it is acceptable to help create two tier leveled health care in a country that has one the best health care systems in the world, which is, crucially, available to everyone, regardless of social status? Justify why some people deserve a different level of care because they have money please.

Privately funded care has happily coexisted with the NHS since 1948. Indeed much of the care funded by the NHS is provided by organisations that are independent providers to the NHS. The majority of General Practices, Pharmacies and Dental Surgeries are paid from NHS funds but are actually independent contractors to the NHS. More recently private hospitals have helped the NHS meet the waiting list targets by providing extra capacity for surgery. Equally many NHS hospitals provide privately funded care which gives them an additional income stream.

The big advantage the UK has over many other countries is that everyone has access to care that is funded from taxation, free at the point of delivery and considers all healthcare needs. Private healthcare complements this and allows people make additional choices over their healthcare needs.

@FumiYamamoto

Doug I have medical insurance and when I need to use it I find it much cheaper when I go to the specialist and pay myself and then claim back from the insurance company however I'm not encouraged to do this at all.

This makes me very uneasy as I don't like paying over the top for something and I find it morally wrong that insurance companies appear to be encouraging this.

The specialists I have attended all seem to be in one the game as well as they always ask about whether I have insurance or not. If I say I have then the cost goes up. If I say I haven't I get a much better price, pay myself and then claim on my insurance.

Would welcome your comments.

In my experience we do see the occasional example of this, however most doctors do not consider it ethical to set their fees at different levels depending on where the funding comes from. I am sure there are occasions where this does happen but they are few and far between. Unfortunately there can be a sense that insurance is a faceless source of funds and people easily forget that we all fund it through our premiums. What was your consultant’s rationale for this when you raised it?

@sickofsocalledexperts

When will the private health insurers start helping our children with autism? It is definitely a core health need, affecting pretty much every single aspect of my son's life (from talking through to eating , washing, sleeping, safety etc etc) and yet from a private health perspective it is 'sayonara' straight after diagnosis.

In the US they now fund behavioural therapies like ABA or physical stuff like occupational therapy.

Will we follow ? Thanks for reading.

Private health insurance in the UK is primarily set up to provide funding for the treatment of short term medical conditions. The treatments you describe simply aren’t part of what private health insurance is designed to cover. So at the moment treatment for autism isn’t treated as part of our cover. As an insurance provider, we can certainly set up policies which would cover it, however we need to ensure there is sufficient demand from customers who are prepared to pay the premiums and enough customer in total, prepared to buy the insurance in advance of the need arising to manage what is called the risk pool. This means that we need enough customers who buy the product to spread the risk of those customers that need to make a claim.

@SnowyMouse

Can you get insurance with pre-existing health conditions?

Private health insurance doesn’t provide cover for all conditions and treatments. As I mentioned before it’s set up primarily to provide funding for the treatment of short term conditions. However depending on the underwriting type, pre existing conditions or past medical history may not be excluded. For example if you had diabetes we wouldn’t cover you but if you had knee problems which were operated on and you haven’t had any problems with your knee since, you could get cover for new problems with your knee. In simple terms insurance doesn’t provide for events that will happen it covers you for events that might happen, that is there is a quantifiable risk.

@WooWooOwl

Is it possible to get decent insurance when a member of your family has a pre existing condition like type 2 diabetes? Does it make a difference if it's well controlled, or if there have been previous complications?

As I mentioned to SnowyMouse private health insurance covers short term conditions. Diabetes is a long term chronic condition which private health insurance doesn’t provide cover for. Nor any condition directly related to the diabetes. However if it’s a condition that unrelated then we would cover you for example a hip replacement. We are also looking at the possibility of including cover for chronic conditions such as diabetes. If we were able to do this it would make a difference whether the condition was well controlled or not and it might make sense to include in the product cover for the management of the condition itself. At the moment our thinking is at an early stage but it would be interesting to hear your views.

@weebarra

Do you cover things like prophylactic mastectomy in the case of individuals being BRCA positive? Lots of companies don't.

We do pay for it to prevent further cancer if you’ve already been treated for cancer. As you say not all insurers do, we took a long hard look at our cover for cancer and substantially increased what we do pay for. It is true though that any insurance does need to define what is and is not covered so at some point a decision has to be made on what benefits are included for the premiums charged. Where someone hasn’t had cancer and simply knows that they are at high risk we don’t cover the costs of the mastectomy. This links back to the core purpose of PMI, that is it provides benefit for the treatment of short term conditions, in practical terms this means that purely preventative treatment, whilst the right clinical option, is not funded.

@BoffinMum

As other posters have said, adverse selection is an issue. You can't have a proper market if people can't get insured, or if people are not allowed to switch providers without much in the way of penalty. Does he see Government intervention happening here to ensure a level insurance playing field, as was the case for high flood risk areas and household insurance?

No I don’t think this will happen because the government’s safety net is the NHS with the private healthcare market providing supplementary services to them. This is different to household insurance where the government does not provide a safety net so the arrangements to ensure that flood cover is available have been put in place. We are fortunate to live in a country that has universally available health cover, free at the point of delivery and funded centrally by government. This means that the market for private healthcare provides a supplementary cover to that which is already funded, it has defined benefits and defined underwriting so that people choosing to purchase it can be very clear on what is available and can make a choice as to whether they wish to or not.