Monday, 27 October 2008

PCT referral schemes scrapped but fishy smell lingers

It appears that despite the best attempts of several PCTs to introduce sick cash incentives for GPs to refer less patients to hospital, they have been thwarted by the government who have come out against these schemes:

"It is clearly essential that they do not in any way undermine - or be constructed in a way that could be perceived as undermining - the GP's overriding clinical and professional duty to provide the best care for each individual patient."

The DoH has said something sensible for once. It seems that the government had come under pressure as a result of a Telegraph investigation into these PCT schemes, however I did break the details of the Torbay scheme myself in the middle of last week, every little helps I guess.

One thing that should be emphasised though is the reaction to these schemes from GPs. Although a lot of GPs were concerned about the unethical incentives contained in these schemes, a lot of GPs did quickly sign up. In fact the Oxford LMC (Local Medical Committee) signed off on the scheme despite predicting the negative press coverage, while the Hampshire LMC passed it by 14 to 11 votes. I am slightly disappointed that more GPs didn't tell their PCTs to stick their unethical cash where the sun don't shine.

Another strange aspect to all this is the fact that Mark Britnell, the NHS' director of commissioning, made it appear that he and the DoH knew nothing of these schemes until the Telegraph had alerted them:

"We are grateful to The Sunday Telegraph for raising these three incidents and we have asked strategic health authorities to look at their local incentive schemes with PCTs, to make sure patients are getting the most appropriate care, and to make sure the relationship between the GP and patient is not undermined."

It seems strange that PCTs up and down the country were all rolling out these incentivised referral schemes at exactly the same time without the DoH or Mark Britnell's knowledge, it would be a wonderful coincidence if they had all thought up such similar schemes independently wouldn't it? It all smells very fishy to me.

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