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GPs must make patients, not profit, their priority
• STEVE Hill does not seem to know how GPs are paid, and what the difference is between a GP’s “business” and that of a multinational company with shareholders who they have to satisfy; let alone the huge salaries and bonus payments awarded to themselves (Paying GPs, Letters February 19).
GPs are paid by the NHS according to the number of patients registered with them. So if they have more sick and elderly patients they have to work harder to earn their money; if they have more young and healthy patients they can take on a greater number and thus earn more. As far as I can ascertain this principle holds good for the companies that take over our surgeries. Only that, increasingly, they also set up clinics for patients with short-term uncomplicated conditions where they can claim for each medical intervention which is not likely to need follow-up, thus filtering off patients from established surgeries who would have balanced out the list for the doctors who will see all patients irrespective of their medical or financial condition. In short we, the taxpayers, pay for both services.
On good authority I am told that GPs earn an average of £60 per patient per year; whether they earn too much is, of course, a matter for debate. Yes, they have a business in the short term; since 2004 they can be awarded five-year contracts, but increasingly they are awarded to multinational companies who undercut the doctors’ bids as loss leaders which they can well afford. UnitedHealth, which has taken over the practice where I am a patient, have to insure a fast turn-over of patients, therefore the interviewing time for each patient has been restricted to 10 minutes, and patients are not allowed to bring more than one problem to a consultation. The policy is to use nurses (no complaints about nurses, but they have a different training and expertise) because they are cheaper.
I have been a patient with the group practice in Camden Road for 20 years which used to give an excellent service to its patients until UnitedHealth was given the contract to run the practice.
After it took over two of the best doctors were dismissed (it appears the PCT left them out of its contract, presumably to make it appear a cheaper practice to run), a third left owing to stress, and now the senior partner is ill; moreover, the doctors have not been replaced.
One day last week a locum GP had to be called in from another surgery.
It is more difficult to get appointments.
As for “efficiency” I would wish to be treated by a GP whose first concern is his patients’ health, not how much profit has to be made for the company who employs him or her.
Ruth Ingram
Camden Mews, NW1
Your views on surgery
• I FELT I should write to advise patients at the Camden Road surgery that a leaflet has been put up in the waiting room saying there has been a meeting arranged on Wednesday March 4 at 2pm for patients to discuss the problems at present affecting them due to the absence of resident doctors and problems with appointments.
UnitedHealth and Camden NHS are inviting our views on how the running of the surgery can be improved.
Please advise the receptionists whether you wish to attend.
June Swan
St Pauls Crescent, NWI
Sell-off plans
• AS the healthcare in the privatised GP practice in Camden Road goes from bad to worse the PCT in Camden stealthily continues to plan for further sell-offs and has even changed its title to NHS Camden.
Once GPs become employed by private businesses they lose control of decision-making, as well as their pay and conditions of service. Medical criteria take second place to shareholders’ profits. Foreign companies, such as the American UnitedHealth, which now controls three GP practices in Camden, has little sympathy with, or knowledge of, the NHS history or values. This company has just lost another court case in the US, where it was overcharging private insurance firms for patients’ treatment.
However, the fact that the NHS is funded centrally, paid in National Insurance contributions, makes it easy prey to global corporations, when central government is sympathetic or weak. Because the secrecy about the NHS (PCT’s) reorganisation plans, most people do not seem to realise how serious the threat is to our integrated health services. We could soon see fragmented services competing with each other for “business” with patients coming far behind the list of priorities.Why is the government continuing to trust businesses to run a very complex service like the NHS when so many have failed or proved to be corrupt recently?
On Saturday March 28 a Put People First demonstration will set off from Victoria Embankment to protest against the step-by-step privatisation of our public services and loss of democratic control.
Join in.
SHEILA PATTON
Spencer Rise, NW5
Private firms
• SURELY GPs practices are themselves also private firms.
Like solicitors or accountants, they are professional partnerships offering their services to the public, in their case under contract to the NHS.
The present GPs contract, paying them more to see patients within 48 hours, has already cost the NHS £2billion more than planned over the past four years, so keenly have the practices welcomed this boost to their earnings. Ironically, it is actually making it more difficult for many patients to be able to see a doctor at all.
Frustrated patients at my own practice have forced it to abandon the hopeless attempt to pack all appointments into a single day – the cumulative effect of the 48-hour policy.
Instead it allows them to be made for up to two weeks. This must surely be the only way forward if practices are to face and survive the sharp competition ahead
James Collins
Belsize Grove, NW3 |
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