Blogs For Victory

Want national health care? Well, be careful what you wish for:

Dozens of incentive schemes have been uncovered which allow GPs to profit by slashing the number of patients they refer for hospital care.

Under one scheme, GPs stand to gain £59 for every patient not referred to hospital, if they cut an average referral rate by between two and eight per cent.

Torbay care trust in Devon will pay up to £15,000 to the average-sized GP practice if it hits a swathe of targets, including reducing hospital referrals.

NHS managers say referral rates, which rose 16 per cent nationwide during the first quarter of this year, have to be cut to save money. They claim many patients can receive equally good care from community NHS staff, such as physiotherapists and nurses.

But critics fear that patients could suffer if GPs’ decisions are swayed by the prospect of a cash bonus.

A leading surgeon said that patients’ cancers had already gone undiagnosed after they were denied specialist care under two such “referral management” schemes.

Orthopaedic surgeon Stephen Cannon, former president of the British Orthopaedic Association and a consultant surgeon at the Royal National Orthopaedic Hospital, described the cases as an “absolutely terrible” warning that decisions by non-specialist doctors could have devastating consequences.

He said: “I recently encountered two cases in which patients referred to physiotherapists later turned out to have a malignant tumour. If they had been sent to a consultant the outcome may have been very different.

“In one case a young man was referred to a physiotherapist because of sudden knee pain. Had he come to a specialist the symptoms should have been recognised and he should have been urgently referred to an oncologist. In this case, after the delays, the outcome was amputation. It was devastating for the patient and his family.”

If we could find a way to staff a national health service entirely with Saints, we’d be ok – but as we’re going to staff any health service with human beings, we’re going to have to deal with the fact that human beings will act, well, like humans.

Think of it like this: the bureaucrat in charge of budget matters wants to find a way to cut costs because the government is pleased when costs are kept low and money is freed up for new initiatives which make it look like things are constantly advancing – now, the bureaucrat can cut costs by cutting bureaucracy, or by cutting services to patients. Which way do you think the bureaucrat will go? Cutting the bureaucracy means you’ll have a bunch of people you work with shouting at you and threatening to go out on strike, which will make your elected bosses look bad, and they won’t like you as a result…cutting patient care means that people you don’t know won’t receive treatments you don’t know about with results you’ll never be made aware of. Its a no-brainer – unless the bureaucrat is a Saint along the lines of Francis of Assisi…and just as soon as the socialized medicine people find thousands of Saint Francises to staff our health care system then I’ll find it in my heart to support such a scheme.