HCA International Limited could be forced to sell one of its hospitals due to market dominance, says watchdog

Competition watchdog says its market dominance means insurance firms are being overcharged

HCA’s dominance of private healthcare in London has stifled competition, the watchdog found. File photo (Getty Images)

One of England’s largest private healthcare providers could be forced into selling one of its hospitals because its market dominance means insurance firms are being overcharged, according to the competition watchdog.

American firm HCA International Limited, which operates some of London’s most famous sites including the Harley Street Clinic and London Bridge Hospital, has been locked in a battle with the Competition and Markets and Authority (CMA) after the government body began an investigation into private healthcare.

The watchdog found last year that HCA’s dominance of private healthcare in the capital stifled competition and ordered it to close one of its hospitals. HCA appealed but the watchdog found against the firm again in its provisional report published on 10 November, which said that lack of price competition is harming customers, and therefore patients, who may have to pay a higher premium than expected.

It stated: “The CMA has provisionally found that HCA’s large market share, combined with high barriers to entry and expansion in central London, result in HCA facing weak competitive constraints and this leads to HCA charging higher prices to private medical insurers than would be expected in a well-functioning market.

“This is in addition to the adverse effect on competition for patients who self-pay in central London, which the CMA identified in its original report and which was not quashed by the [appeal tribunal].”

The CMA said it would now consider a number of options, including whether to force HCA to sell one of its hospitals, allowing competitors access to one or more of its hospitals, or block expansion by HCA in central London. It will publish its final report next March.

The CMA has already brought in a number of changes in the private healthcare market as a result of its initial investigation including the appointment of the Private Healthcare Information Network to provide independent information for private patients on healthcare performance and fees.

Roger Witcomb, CMA panel member who is leading the investigation, said: “Following a long and thorough re-examination of the issues remitted back to us by the Competition Appeal Tribunal we have provisionally concluded that there is still a competition problem that needs addressing.

“We will now consult widely and listen carefully to all responses to our provisional findings and potential remedies before we publish our final report.”

HCA, also known as Hospital Corporation of America, is the world’s largest private hospital group employing 225,000 people worldwide with an annual turnover of more than $40bn. One in three of its patients travel to HCA private hospitals in London from outside of the capital for treatment.

A HCA spokesperson said: “We note the new and alternative remedies in the CMA’s provisional findings. Since this process began, over three years ago, London’s private healthcare market has continued to grow and diversify.

“Recent investments by the Cleveland Clinic and VPS in large new facilities, and Spire’s plans for a new central London hospital by 2018, are yet further signs that London offers an open, accessible and competitive market.”