Our NHS is in serious danger – we should be scandalised – GPs are being paid not to refer cancer patients to hospital and free hearing aids are being axed. All the politicians are cowards.. This is a healthcare system under strain, but where is the debate?

They all know it must change, and yet all the politicians are cowards. So it’s failure gets worse, and the solutions get harder and harder. (Nigel Hawkes in the BMJ – NHS truths that dare not speak their name) and on NHSreality

Waiting list prisoner

Owen Jones in The Guardian opines 3rd September 2015: Our NHS is in serious danger – we should be scandalised  – GPs are being paid not to refer cancer patients to hospital and free hearing aids are being axed. This is a healthcare system under strain, but where is the debate?

Wanted: somebody who can explain why this story is not being reported as a national scandal. There are English GP practices being paid money not to refer patients to hospital, including cancer referrals, in order to cut costs. One clinical commissioning group reportedly offered more than £11,000 to slash everything from follow-ups and emergency admissions; another more than £6,000 to GP surgeries to bring their referrals down to practices at the bottom of the league for referral rates.

This is playing with people’s lives. Britain is already languishing up to two decades behind the survival rates of other European countries. The NHS should be encouraging more referrals, not incentivising fewer. The inevitable risk, of course, is that early symptoms of cancer will be missed, leading to even more unnecessary deaths.

If you want to look for other evidence of a healthcare system increasingly under strain, it won’t take you long. Hearing aids break the solitude of those who are hard of hearing, giving them independence and the ability to carry on life as normal. But North Staffordshire’s clinical commissioning group is to stop giving free hearing aids to its predominantly older patients. Again, here is an attempt to save costs in a way that undermines the NHS’s central mission of defending the wellbeing and health of the British people.

Difficult though some will find it to listen to advice from the Liberal Democrats, the ex-health minister Norman Lamb should be listened to when he warns the NHS could face a crash without an emergency injection of billions of pounds. It is worth considering what the NHS is going through. It has experienced the most protracted squeeze in funding since its foundation in 1948. Cuts to local care services are piling on extra pressure. It suffers from the combined legacy of private finance initiative (PFI) and the chaos of the Tories’ current marketisation drive, effectively stripping the “National” out of National Health Service.

Despite the Tories’ gimmicky and vague election promises of extra money, our healthcare system is in great danger. But where is the debate or the scrutiny? It will be health and lives imperilled without an NHS that is properly integrated and resourced. It would be naive to believe that incentives not to refer cancer patients and the scrapping of free hearing aids is the end of it. The direction of travel is clear, and it should scandalise us.


This entry was posted in A Personal View, Consultants, General Practitioners, NHS managers, Perverse Incentives, Post Code Lottery, Rationing, Stories in the Media, Trust Board Directors on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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