The introduction of mechanisms that mimic the market add unnecessary levels of bureaucracy.
The introduction of mechanisms that mimic the market add unnecessary levels of bureaucracy
The plan to pay GPs £55 for each patient they diagnose with dementia has rightly been condemned as ‘odious’: it’s a threat to the trust between patient and doctor. Patients will wonder whether the diagnosis they receive is coloured by the lure of extra cash, rather than clinical need.
But it also illustrates, very clearly, what’s wrong with our approach to the NHS, and many other public services today.
We’re taking a service that relies on professional skills, compassion, caring, and treating it as though it concerned the manufacture of widgets.
Performance-related pay, of which this is just a particularly gross example, might make some kind of sense in a factory, or at least one where each worker has the same tools and makes each item personally, but in the many other environments in which free market ideology has placed it, the effects are distorting, damaging, even disastrous. As of course it has been in our financial and commercial sectors, with their runaway bonus cultures.
We’re surely going to see more of this damage in the teaching profession this year, as performance-related pay continues to be introduced. Putting even more pressure on teachers to teach to the test and pitting them against each other will do little to give pupils a good, rounded education in a healthy environment. We know that only a team of teachers, assistants and support staff, working with the pupils themselves and parents and carers, can together give pupils the skills and knowledge they need.
We’ve already seen the impact of performance-related pay in the NHS, where the focus on financial targets at Staffordshire Hospital caused immense pain and suffering.
But there’s an even deeper problem which the £55 diagnosis fiasco exposes. That’s the market mechanism, competition instead of cooperation, being used as a way to manage and run the NHS.
That’s what Professor Allyson Pollock’s NHS Reinstatement Bill aims to tackle: to end the division between purchasing and private bodies, and to severely restrict the role of private companies in provision of NHS services. The Green Party is entirely committed to its central principles.
The Green Party says the profit motive has no place in healthcare, and the introduction of mechanisms that mimic the market have added unnecessary levels of bureaucracy, and acres of paperwork, to the costs of the NHS.
I was privileged to be able to join the People’s March for the NHS last month for a day. I heard from the healthcare workers who made up the majority of the marchers. They told me of the impact of NHS privatisation, the massive costs of Private Finance Initiative schemes that have done such damage to healthcare in so many areas, and the destructive effects of this government’s wholesale reorganisation of the NHS.
Not only are we handing over our facilities and services to multinational companies that come out of the disastrously poor and expensive American healthcare system, not only are we slashing funding for essential NHS services and imposing massive “efficiency savings” that began with Labour and have continued with this government, but we are imposing a costly, damaging market approach where it doesn’t belong.
Let’s hope this furore will help shine a light on the problem, and build support for the removal of market mechanisms from the management of the NHS.
Natalie Bennett is leader of the Green Party
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28 Responses to “GP dementia charging: the profit motive has no place in healthcare”
Peem Birrell
>>the profit motive has no place in healthcare
Tell that to the pharmaceutical industry
gwilym
Flawed. With an artifical bar such as this it is going to make sense to err on the side of caution and over-diagnose to the detriment of other illnesses…in another context Wilde commented on the unspeakable in pursuit of the uneatable – tories and cash…
Leon Wolfeson
But there also has to be a healthy discussion of science in medicine, and what works for patients.
And that, given the Green party’s opposition to GMO-based medicine (or are you hypocrites?) and other science cannot provide.
(Moreover, Labour massively increased funding and then looked for efficiencies, which is the right want to do it – NHS performance was just getting to where it should have been for the funding when the Coalition’s disorganisation hit, slashing care budgets for burocracy and demanding “efficiencies” at a time of falling resources!)
Mapesbury Green
Alzheimers disease international reported that over 75% of people are undiagnosed.
Whilst Alzheimers Society have also reported that access to timely diagnosis of dementia remains variable depending on where you live.
“In some areas, less than 40 per cent of people with dementia have a diagnosis while, in others, more than 75 per cent of people with dementia are diagnosed (Alzheimer’s Society, 2014).” Provision of post-diagnosis support is patchy at best.
As much as a Green I am against privatisation and commercialisation of the NHS etc, you still have to work within the system that you’ve got until it is changed.
The reality is, for whatever reason people are not being diagnosed. These targets can be a pain for GPs as they have to think about something different each day, but they have been shown to be effective at sharpening peoples minds.
Alzheimers Society called for these existing policy measures of financial incentives to be used to achieve the governments ambition of 66 per cent diagnosis by 2015. Once rates of diagnosis are up the idea is that a stronger argument can be made to commissioners for post diagnosis support.
If Alzheimers Society have called for this, it is because they have the interests of people with Alzheimers or other forms of dementia close to their hearts.
GPs have a multitude of other priorities and the diagnosis of alzheimers and post support has been low down their list and deserves to be brought up their list.
Until the system is chanced (Everyone vote Green) these are the tools that organisations and charities have to instigate change within services.
Leon Wolfeson
Not really, charities are interested in promoting their own interests a lot of the time, and in this case the massively negative consequences for the NHS are more important.
It can be seen what the pursuit of profit has done to UK dentistry.