Knowledge Bank

Worrying pitfalls being ignored in UK PM's new health plan

A new initiative reported in the Financial Times to incentivise doctors’ pay appears to skate blithely over worrying pitfalls. It will lead to a top-down, one-size-fits-all system of prescribing medicines which is wide open to corruption, and in which patients will be used as guinea pigs to test new medicines.

Prime minister David Cameron has announced a new plan for the National Health Service for doctors’ pay to be incentivised, and the more patients they make better, the more their salaries will increase. This new scheme will assess doctors according to which drugs and treatments they recommend, and whether they’re prescribing ‘innovative’ and new pharmaceuticals for their patients.

However, you don’t need to be a brain surgeon to recognise the capacity for corruption that this new system would be vulnerable to. For instance, who would appoint the members to the the boards and committees which assess whether the doctors are prescribing the ‘right drugs’ or not? And how can we guard against them being in the pay of, or at least incentivised by, certain pharmaceutical and biotech companies?

This new policy came out of a speech David Cameron gave to the FT Pharmaceutical and Biotechnology Conference this week, in which the prime minister said be believed that the “current slow adoption of many cost-saving innovation technologies is a massive missed opportunity which is out-of-kilter with the whole spirit of the NHS”, and pledged to “take the best of the NHS to remedy the worst.”

Mr Cameron insists that his new, top-down approach will encourage “early access” programmes to accelerate the experimental testing in British patients of life saving medicines. In other words, and with all the euphemisms removed, NHS patients in the UK will become guinea pigs for new drugs that haven’t yet been sufficiently tested.

He added that the move towards clinically-led commissioning under the current NHS reforms should encourage more rapid uptake of cost effective medicines. For ‘cost effective’ read ‘cheap’.

There is another way ...

However, Mr Cameron and his advisers might like to consider another method of incentivising doctors ~ one which worked very well for thousands of years in the Far East.

A local practitioner of ayurveda or traditional Chinese medicine would always be paid a small amount, every week or month, by each adult in their community. But if a person became ill, they became exempt from having to pay the doctor again until he made them well.

One wonders how our doctors’ pay would fare under that system? It would certainly incentivise them to use whatever means it takes to get a person well again, and not necessarily by prescribing drugs that they feel forced to use under a top-down approach which is wide open to corruption and shady practises.

The doctor would also be much more open to treating the patient as an individual rather than as a set of symptoms which he has to match with his 'incentivised' MIMS tables.

Just a thought!

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