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

28 Responses to “GP dementia charging: the profit motive has no place in healthcare”

  1. sue

    I really don’t have a problem with GP’s being paid for every
    dementia case they diagnose…. the huge problem (The Elephant in the Room) is
    where do they then refer these cases onto…. We have a totally inadequate
    system or actually almost NO system in place for these many many cases …. or
    as I prefer to call them.. People.. !! Yet another case of lets bash the GP’s
    … keep the masses occupied squabbling amongst themselves and they’ll not
    notice what’s really going on…. The GP’s are on OUR side…. remember who the
    real enemy is here !!!

  2. Leon Wolfeson

    Again, the problem being your bribes will come out of the system which follows, so…

  3. treborc1

    I asked my GP for a copy of the page of my medical record which has my conditions listed and a page with my medicines and I also had a page with my out look, three pages cost to photo copy lets be nice and say £20 each.

    I paid £350 to have them photo copied and placed into an envelope it must have taken twenty minutes .

    And by all accounts most GP’s in my area are making a killing because of WCA and now PIP’s money makes the world go around.

  4. Jill Hopkins

    Surely money cannot be allowed to be the only incentive, it is bound to distort doctor patient relationships. See Richard Titmus’s The gift Relationship refers to blood donation in UK compared to USA purchase system and reduced quality of blood products etc …I can think of better ways to spend health service cash, mainly preventative stuff. Jill Hopkins

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