Gerry Robinson is making a programme about the proposed reforms. Panorama have said that they want to include as many GPs as possible giving their views. I have given mine (as Scottish GP looking on with alarm and horror.) Please join me. http://tinyurl.com/66ty56p
The following personal case history illustrates one of the aspects of the way in which patient choice (in England) is distorting our health economy. The proposed changes in the current bill will make this even worse. What the bill needs to concentrate on is removing those parts of current legislation which allows the nonsense illustrated in this case history to be perpetuated; i.e. abolish the purchaser/provider split, as they have done in Scotland.
Targets and consumerism handicaps clinically focussed healthcare in England.
Since devolution Scotland have delivered healthcare without the English distraction which allows providers of healthcare to massage their own income. I will illustrate this with a personal history and then refer you to the source of some ground-breaking, as yet unpublished, data which should make any MP think twice about voting in support of the current healthcare bill.
Recently I developed pain in my right ear and some associated but mild deafness. I dutifully attended my GP surgery where I received a cursory examination and was prescribed some “cure-all” eardrops. After a few days my symptoms were worse and I had become quite deaf in the affected ear.
Being a retired doctor I saw little point in resubmitting myself to more of the same at my GP’s surgery, and instead went straight to the clinic of one of my erstwhile colleagues. She saw me at the end of her long arduous clinic. I did not mind waiting for three hours for that privilege.
It turned out that the diagnosis was fairly straight forward and should have been made by any competent GP. The treatment was equally simple and I was able to leave the clinic completely symptom-free.
Now, you might think I am blaming my GP for her short-comings. Well, I’m not. The problem lies with the way in which GPs are paid. They receive a fixed capitation fee whether or not I see my GP, and then extra cash for meeting a wide range of “health improvement” targets such as requesting me to come along to have my BP measured. It doesn’t take a rocket scientist to realise that for every minute spent seeing patients with real medical problems (which earns them nothing), there is less time to spend massaging the surgery’s cash register.
If I were Mr Average then the only “second opinion” available to me, short of going private, would be to attend the nearest A&E Department. There I might well be seen by a Junior Doctor with less experience than my GP, but whereas in the past that Junior Doctor could have referred me straight to the ENT clinic, all he can do now is request the GP to do that. In that situation two episodes of hospital activity would have been generated. A more thorough initial examination at the GP’s surgery would have obviated both.
The unpublished Scotland v England data shows that since devolution and especially since PbR was introduced in 2006, hospital activity has mushroomed in England but not in Scotland. Gerry Robinson needs to speak to the author of this study if he wants his TV presentation to be founded on today’s realities. Ask me for details.
You can read more about other adverse aspects of NHS activity on the NHSCA website (NHSCA.org.uk) or contact me personally.