Former NHS chief attacks private health insurance 'lottery'

In a speech to the House of Lords today, he criticises “vague, confusing and contradictory” insurance policies that mean patients who thought they had bought complete cancer cover find out after being diagnosed with the condition they have partial cover at best.

He says the Financial Services Authority “must step in to regulate this properly” and ensure policies are transparent and companies are “held to account for what they are selling”.

Lord Crisp, an independent crossbench member of the Lords who was NHS chief executive between 2000 and 2006, said: “They [policies] don’t tell people precisely what they have bought or give them the certainty they need at the time they need it most. Patients find themselves in a negotiation where the insurers have all the cards.

“The vagueness of the policies allows the insurers to make decisions entirely on their own terms. It should be transparent.”

He adds: “Consultants tell me that some health insurance companies are better than others. They all need to act together or the reputation of the whole industry will be completely destroyed. At the moment there appears to be a private health care lottery.”

Lord Crisp cited the creation of the National Institute for Health and Clinical Excellence – due to have its original role fundamentally altered under the white paper – as an example of how the NHS had reacted to claims of a postcode lottery over treatment availability, particularly surrounding cancer drugs.

“NICE is accountable to the public. What we don’t need is to import American style private sector rationing where patients find themselves the victims of decisions made in private by individual insurance companies and where nobody is accountable.”

Lord Crisp said he became aware of the problem through the experiences of a friend who had been diagnosed with cancer, before talking to consultants and taking it up with insurers.

He said: “I was shocked when my friend told me that his insurer was setting limits on his treatment options which weren’t referred to in his policy documents. We met the insurers and won some concessions which have prolonged his treatment. It shouldn’t be like this.

“My friend is not alone. I know of one woman who has to make a decision this week about what to do because her insurer is stopping funding. These would be very sad stories but understandable if it had been clear at the outset what their policies covered. It wasn’t.”