Those who joined us for the September LCA Lunch with Richard Packard, senior consultant and Chairman of the Federation of Independent Practitioner Organisations (FIPO), were given a particularly timely insight into issues that could have a profound bearing on the future of private medical practice.

Richard, who has been involved in private practice since the 1990s, began with what might have sounded like a history lesson – but it quickly became something much more relevant to every consultant in the room. His account of how private practice has evolved since the last general increase in fees in 1993 provided a striking backdrop to the changes now taking place.

At the heart of his presentation was a question that goes well beyond remuneration.

Who ultimately controls the patient’s clinical pathway – the doctor or the insurer?

Richard described the succession of changes that, over the years, has given private medical insurers an increasingly influential role in decisions affecting consultants and their patients. He explored the wider implications for reimbursement, clinical decision-making and professional independence, and why developments now unfolding could prove particularly significant in the months ahead.

For those in the room, this was not simply a discussion about the economics of private practice. It was an opportunity to step back from the day-to-day pressures of consulting and consider where the direction of travel may be taking the profession – and what that could mean for individual consultants and their patients.

One observation in particular provided food for thought. Insurers may refer to those using their services as clients, but, as Richard reminded us over lunch, they are our patients. That distinction goes to the heart of the professional relationship and the responsibility that consultants have towards those in their care.

The discussion was made all the more valuable by the opportunity for members to question and exchange views with Richard directly in the informal setting of an LCA Lunch. It was one of those occasions where the conversation continued well beyond the formal presentation, with new perspectives emerging and considerable interest in what may happen next.

For anyone involved in private practice, the issues Richard raised are not remote or theoretical. They touch on the way consultants are remunerated, the choices available to patients, the relationship between doctors and insurers and, ultimately, the degree of professional autonomy doctors can exercise in the future.

If you were not able to join us, you missed a genuinely thought-provoking discussion at a particularly important moment for private practice. And, judging by the conversation that followed, there was a strong feeling around the table that this is an issue that will merit watching very closely.

Fortunately, there will be another opportunity to join an LCA Lunch very soon.

Top: FIPO and LCA Chairmen, Mr Richard Packard and Dr Shabbir Moochhala