Getty ImagesNew Benenden Health members from Northern Ireland will have to be a member for two years before they can claim for surgical treatment.
Benenden Health is not-for-profit mutual friendly society that provides discretionary healthcare to its members.
In the rest of the UK, the Benenden Health eligibility period is six months.
It will remain six months for people in Northern Ireland who joined Benenden before February 2024.
The company said members from Northern Ireland were more than three times more likely to claim straight after qualifying than those elsewhere in the UK, due to the “significant pressures on the healthcare system”.
This puts Benenden at risk of effectively replacing the system in the region, the company told The Nolan Show.
“That isn’t the role of Benenden Health, who aim to complement public healthcare, not replace it, nor do we have the financial resources to do so.”
Dr Tom Black, a GP and former chair of the BMA in Northern Ireland told the show that the situation was “another symptom of the difficulties in the health service”.
‘A very difficult position’
Dr Black said the health service in Northern Ireland does not have “the funding, the workforce, and our waiting lists are getting longer”.
“None of us see any improvement in this in the next five to 10 years,” he said, adding that more funding from Westminster is needed.
“The public know we’re in difficulties. They’re doing the best they can to get themselves seen privately, very often through insurance but also very often bunching up in families and paying for granny’s hip replacement in cash.
“That’s a very difficult position for patients and the health service.”
Dr Black added that it was difficult to provide a service when the Sláintecare programme in the Republic of Ireland was “paying double the wages and taking a lot of the workforce away”.
“I’m sitting here in Derry and I can’t get a GP to work for me because they go to Buncrana for twice the money and half the work,” he told the show.
Balancing act
Benenden said the 24-month eligibility period will “protect the collective interests” of members.
It aims to “balance treatment costs” while ensuring “high quality, affordable, healthcare services” are offered.
Insurance expert Malcolm Tarling said there was a “difficult balance” for insurers to find between providing affordable cover to as many as possible while also protecting existing customers.
“If they don’t [find that balance] premiums will go through the roof to such a level that it will become virtually impossible for many people to get [insurance].”
Different companies have different approaches, he said, and “the stance of one company is not necessarily going to be replicated by others”.
“All insurers will look at regional differences and changes in provision of state healthcare in areas and set their premiums and conditions to reflect that,” he added.
