GP dementia charging: the profit motive has no place in healthcare

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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