I HAVE JUST COME BACK FROM ANOTHER SITE MEETING with Openreach and feel the need to share…
After nearly a year of planning it became evident on the phone recently that our BT co-ordinator had not realised we were building a new practice, but had thought we were replacing phones in the current one.
As part of the build we have had to move a telephone pole (paid for nearly a year in advance and that took many hours of negotiating on the phone to get it moved). Our project co-ordinator told me she was worried that it would break the phone connection to our practice too early on. “But that pole is a quarter of a mile away from where we work now, serving a few houses down a track,” I told her. “Why would it affect our current practice? It’s to do with the new one.”
“What new practice?” she asked.
Anyway, somehow progress has been made and someone turned up today who assured me when I asked that he had never heard of our project co-ordinator and had no idea who she was or what she did. “That’s BT,” he said, implying it was nothing to do with him.
BT and Openreach are always at pains to point out they cannot speak to each other on the phone on your behalf and they aren’t really anything to do with each other. It makes me smile then when you see “Openreach, a BT group of companies” emblazoned on their vans and on the sweater of the guy stood there telling you he is nothing to do with BT.
So we are some way forward now in getting a copper phone cable installed. Our project manager is expecting fibre optic, but there is no capacity. To be honest I would be happy to have a tin cup and a piece of waxed string on opening day as long as there is something.
One mistake we made was not registering our project as a new site with BT, something that often gets forgotten between project manager and architects. Our man today informed us that the local Starbucks could not open because of this oversight. Why no one at BT or Openreach reminds you of this is another of their mysterious ways. He also told us there was a development going up locally of 120 houses with only 20 phone lines available.
We have spent huge amounts of money and effort on the new practice and many other vets do the same. Many friends and colleagues are studying for exams and furthering their qualifications. It then is extremely disappointing when huge swathes of clients can be directed away from certain practices due to the decision of an insurance underwriter.
This slightly stretched link brings me of course to the subject of RSA and its “Network”. A group of referral vets has formed a group – “Vets for Choice” (http://vetsforchoice.co.uk/) – and I put some questions to them for the benefit of readers.
Who are Vets for Choice? Who started it?
A group of referral practices who came together because of mutual concern about the impact of RSA’s preferred referral network on the clinical choice of first opinion vets and, therefore, their patients.
What are its aims?
To ensure first opinion vets retain the freedom to refer where they deem the patient/client is best served, and to defend pet owners who should be able to take their pets to the vet of their choice without the risk of being financially penalised.
What would you suggest as an alternative way for insurers to control fee inflation and fee variability?
A complex issue which we accept is a struggle for both insurers and the profession. A good place to start would be to ensure clarity on why there is fee variability between practices and not assume it is simply a difference in profit taken.
The insurer insists the network is necessary to increase levels of pet insurance take-up. But this has always been historically low.
But we fully accept the need for cost control and believe this could be better achieved by greater transparency and fixed fees for certain procedures. It would also be a positive step if there were more data available on what procedures are more effective than others and which ones are less successful and therefore more expensive in the long run. Insurance companies are in an ideal position to drive such initiatives.
What legal or regulatory avenues (i.e. any) can you go down to enforce a change/abandonment of the RSA policies?
None that we are aware of.
Do you believe the RSA policies are actually illegal/unethical/contravene the VSA 1966, or just an inconvenience? Has the RCVS given an opinion on this?
We believe they are anti-choice and penalise customers while at the same time removing control from primary care vets. Regarding the RCVS, that is really a question for them but they have given their response via the RCVS website: http://www.rcvs.org.uk/news-and-events/news/rcvs-response-to-rsa-groups-pet-insurance-proposals/
Pet owners need a better understanding of what it is they are actually covered for with various insurance policies. RSA has shown that not all policies are equal.
Many geographical gaps in referral services are filled by certificate holders. Is Vets for Choice also pushing an agenda of Specialist-only referrals?
Absolutely not; we are pushing for choice, awareness and fairness. One example we can give for this is that the RSA policy has been adopted by John Lewis, Argos and Tesco. Yet John Lewis is not charging the £200 “fine” for customers who seek to go outside the network.
The question to be asked is what makes John Lewis customers different to those with Tesco policies? The RSA insists the £200 has hardly been charged – then why have it in place in the first place? There are so many unanswered questions.
In my last article I ended by dropping in the demoralising effect of vets pursuing further study only to have an underwriter not let you see referral patients. Has the next generation of referral vets been canvassed for opinion?
Many first opinion vets have sympathy for RSA in wanting some control on what fees are charged as there is huge variation between referral centres. What would you say to those vets?
The first opinion veterinary surgeon should remain in control of the referral process, since they know their patients and clients best. Many factors should be considered, with the owners, on deciding which referral option is best. Cost is clearly a factor in this, but should be assessed in the context of the care on offer and the clinical needs of the patient, as well as the owner’s means.
Are you aware of other underwriters going down this route? As well as the philosophical arguments against the RSA policy, if other underwriters create different networks it will become a logistical nightmare for referring first opinion vets.
We are not.
I notice you had a petition online. What’s next? What can you actually do?
We can continue to highlight the issue and encourage those making decisions to consider carefully whether this solution is in the best interests of the patients and their customers.
Have you any feedback/support from the RCVS?
No and we would not expect them, as regulators, to provide such.
Have you any support from other insurers? I have spoken to the MD of one and he seemed surprised at the cost this must be incurring for RSA and had no plans to follow suit, but was watching with interest.
No. It is also worth pointing out that Association of British Insurers figures for the pet insurance industry from 2015 show that income for pet insurance (gross written premiums less gross claims incurred) has steadily increased over the last few years from £114 million in 2007 to £318 million in 2015, suggesting that the industry is fundamentally healthy.
Are you aware of other underwriters planning to piggy-back on the network once it’s up and running? Do you think that is in RSA’s game plan? Personally I think it must be to make it worth doing.