While private practice offers many benefits, the take-home earnings of some self-employed physios can be less than the national minimum wage. The low rates paid by some insurers and their intermediaries can make earning a decent living challenging for those who rely on them.
Self-employed physios and small business owners have limited options when it comes to the fees insurers, or their intermediaries, are willing to pay. Most physios have to take what is on offer. There is no negotiation as the power in this market is entirely one sided. This is the real market abuse, not the prospect of physios seeking a fair deal from insurers.
Seeking routes to change
Many independent practitioner members want the CSP, as their union, to negotiate with insurers on their behalf, just as we do with employers. For many years we have advised this isn’t possible for legal reasons. In 2022 the CSP, along with two other health unions, sought fresh legal advice. This confirmed that competition law prevents both the CSP, and any combination of our members, from coming together to seek to negotiate, or set standard, insurance fees.
If we or members did try to so this, we could be subject to legal action and heavy fines. Our legal advice confirms that the only way to change this is to seek fundamental change in the law. So the CSP is pursuing three routes to seeking legal changes to rebalance power in the insurance market.
We are raising the way that competition laws prevent fair negotiation with the UK government. Because the competition rules are linked to European Union law there may be opportunities to secure changes if the government presses ahead with replacing EU inspired rules with new ones. Through supportive MPs we will be asking the UK government about its plans.
Highlighting our own proposals
To highlight what could be done, we are looking to put our own proposals forward. One options might be to seek immunity from competition law action for health unions and their members in the specific circumstances we face. We are looking at the potential to put a presentation bill to Parliament. A presentation bill would draw government attention and could provide a blueprint for future legislation.
With a general election within two years, ensuring the opposition are on side is equally important. The CSP, and other health unions with self-employed members, are talking to Labour Party advisers about their employment policy. We are encouraging them to support new rights for self-employed people to be represented by their unions in the future. So far, we are getting a positive hearing, but it is early days.
We know the ban on representing self-employed and small-business-owning members is frustrating for members. As we progress the lobbying for a change in the law, there will be ways you can help. We’ll tell you how as our lobbying develops.
In the meantime, the CSP advice remains don’t undervalue yourself – judge what you need to set as a rate considering the whole range of costs you face and the income you could earn from working as an employee.
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