NHS family doctors are being paid thousands of pounds not to send their patients to hospital for specialist treatment

Doctors paid thousands not to send patients to hospital for treatment
Report in the Sunday Telegraph

Extract:

"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."

Dozens of practices across London, Essex, Oxfordshire, Devon and Wiltshire have signed up for schemes which pay GPs up to £4.50 for every patient on their list if they hit targets, including a target to reduce the proportion of patients they send to hospital.

The average family doctor, with a patient list of about 2,000 patients, stands to make between £6,000 and £9,000 if they achieve all the targets, on top of a performance-related pay system which already gives the average GP an income of £110,000."

New GP contracts have delivered "eye watering" pay rises for doctors, while some services to patients have declined, a damning report by MPs says.

GPs given 'eye watering' pay rises for less work, say MPs
Article in the Telegraph

Extract:

"Family doctors' hours have been cut and their productivity has fallen at the same time as some received up to 58 per cent salary increases, according to the Commons Public Accounts Committee.

The Department of Health's failure to properly estimate how much the deal would cost has also led to an overspend of £1.8 billion, the report says.

MPs on the committee also criticise the newly introduced system to link GP pay to performance, which its says allowed family doctors to earn salaries much greater than expected.

Controversy has surrounded the new contracts since they were introduced in 2004.

They were widely criticised for handing GPs large pay rises at the same time as allowing them to opt out of out-of-hours cover.

The report also attacks the contracts for failing to significantly improve access to GP services or increase the number of family doctors in deprived areas.

Edward Leigh, the committee's chairman, said that the new deal "has so far failed to live up to expectations".

"Partners in GP practices are now putting in less time and their productivity has decreased. Only their pay is burgeoning, having increased on average by an eye-watering 58 per cent since 2003," he added."

The incompetence of the Department of Health never fails to amaze. They are certainly no match for the medical profession's skilled negotiators...)o:

Report reveals big rise in GPs' pay and shorter working hours

Report reveals big rise in GPs' pay and shorter working hours - Guardian

Extract:

"The NHS work of the average GP in England has been cut by about seven hours a week since the government introduced a new contract in 2004, official figures revealed yesterday.

The contract, which removed GPs responsibility for treating patients outside normal office hours, increased their earnings by 25% in the first year, raising the average for a dispensing partner in a GP practice to £117,000. Many doctors boosted earnings by selling out-of-hours services to their primary care trust that they used to provide for free.

A report from the government's information centre for health and social care showed the average GP worked 36.3 hours a week for the NHS in 2006-07, compared with 43.5 hours in 1992-93. The reduction was due to more part-time working and fewer out-of-hours responsibilities.

The latest figures showed only 62% of GP partners and 22% of salaried GPs work full-time."


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Patients experience very little benefit despite huge increases in cash for the NHS.

Patients miss out as NHS cash floods in

Extract:

"Billions of pounds of taxpayers' money pumped into the National Health Service has gone on improving the salaries of GPs and consultants and paying for increased pensions rather than on improvements in patient care and frontline services.

A damning report by the highly respected health think-tank, the King's Fund, reveals that productivity in the health service has actually declined, despite the huge injection of cash.

The report reveals that only 30 pence in every pound of the Government's record NHS budget has been aimed at directly improving patient care. As well as salaries, the rest has gone on a growing bill for clinical negligence payouts and rising drug costs."

Patients seem to come last in importance for the NHS. Doctors' pay and drug company profits seem to be the priorities.

British GPs 'to get bonuses for working evenings'

GPs 'to get bonuses for working evenings'

They are already the highest paid doctors in Europe!

Another nice little earner for Britain's overpaid GPs! - GPs' piecework pay boosts chronic caseload

Extracts from an article entitled "GPs' piecework pay boosts chronic caseload" which appeared in the Telegraph on 14 Jan, 2007:

"New GP contracts could be open to exploitation by doctors, it is feared, after nearly 850,000 extra cases of chronic disease were diagnosed in England last year.

The rise follows the introduction of a contract which pays doctors when they identify diseases and provide treatment. It has seen their annual earnings rise 63% in three years to an estimated average of £118,000.

The greatest increase has been the number of patients with high blood pressure. An additional 371,000 cases were identified between the beginning of the contract in 2004/5 and 2005/6. As a result, the proportion of people officially suffering high blood pressure has risen from one in nine to one in eight, in a year.

At some GP practices, alarmingly high levels of disease have been identified. At one in West Yorkshire, one in 14 patients has been diagnosed with emphysema or chronic bronchitis, when on average only one in 71 patients in England is a sufferer. Bradford and Airedale Primary Care Teaching Trust admitted that the GP had "had difficulty in recording accurate data". At a practice in east London, one in 32 patients has been diagnosed with cancer when on average, only one in 143 patients in England has been diagnosed with the condition. The GP declined to comment.

Michael Summers, a spokesman for the Patients' Association said the findings were a cause for concern. "There appears to be a sudden onset of diseases that were not present one year ago. One could be forgiven for suspecting that in some cases, the sudden diagnoses were driven by the desire for a greater income. Some patients could be receiving treatment – and medication – unnecessarily.""

See also aboutsalt.blogspot 2006/09/01 archive

many doctors are failing their patients

sleaze in the medical profession

prescribed steroids - potential for grave harm