The Patient Liaison Group is deeply concerned by Bupa's introduction of an open referral system.  There are numerous layers of concern: 

It seems to us that the rationale given by Bupa is flawed on several levels because of the apparent lack of patency and the references to unpublished and unsubstantiated data. 

In our view, there is no justification for the schism being driven between the patient and their GP; further, the implication that a GP may not know the local specialists, or what is best for the patient, is disingenuous. 

At a time when the DoH is giving patients wider options, we are concerned that Bupa’s open referral system may be counter-productive in that it may limit patients’ rights over where, when and by whom they are treated. 

Bupa states that this system will reduce the number of patients who have to 'top up' the fees charged by a private hospital & clinician. However, we do wonder if the obverse will not often be the case, as patients may well have to select a 'non-Bupa-tariff' doctor because any Bupa options are too inconvenient for the patient or their family. 

We note that there may be some patients who prefer the Insurer to nominate a specialist, but question the rationale behind extending such an arrangement to all patients in order to satisfy (what must be) a minority amongst them. In our view, Bupa should instead make it clear that every client has the option of either going to an ‘approved’ clinician, or paying extra to go to one whose charges are outside the Bupa tariff. 

In summary, we believe that with the open referral system introduced by Bupa, there is a risk of undue interference in the patient-GP relationship and that ultimately, the system may serve to limit patient choice.