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
28 Responses to “GP dementia charging: the profit motive has no place in healthcare”
Peem Birrell
privatised?
But if you mean nationalised … which country should nationalise them and thereby ensure they have no pharmaceutical industry?
Leon Wolfeson
Erm…no, generally the UK does not invest directly in private pharmaceutical firms drug studies, unlike America.
A good deal happens via Universities, but more state control there is the last thing which is needed.
Leon Wolfeson
Except, of course, “dementia” is a wide variety of conditions, and is diagnosed on symptoms – many of which can be related to other medical issues.
It’s nothing like as simple as the diagnosis rates for the removal of i.e. appendixes because of appendicitis, where if a doctor removes no healthy ones then he is very very probably missing ones which will then burst and cause peritonitis.
(Which is truly nasty indeed, hence the principle…)
Mapesbury Green
Unfortunately, the healthcare system responds to these bribes. The main focus for managers is money and they will place pressures on people to achieve whatever targets to meet these bribes. These bribes are then predominantly met, or if not met achieved a darn-sight better than they were previously. The system has known for year, longer than this parliament and the last that dementia has gone under-diagnosed. They’ve run out of other options really… unless we vote for a party for change.
Mapesbury Green
Yes indeed!