THE GP website Pulse revealed this week that in four areas in England local clinical commissioning groups (CCGs) have set up a ‘profit-sharing’ scheme between GPs and the CCGs with GPs being offered cash payments for not referring patients to hospitals for tests and treatment in a ‘cash for cuts’ referral system. Under this system, the CCGs are giving GP practices up to half the money saved by not sending patients to hospitals.
Hospitals receive payments for the operations, treatments and tests they carry out, so by sending fewer patients or using cheaper services these CCGs can save money. Pulse recently conducted a survey of 181 CCGs across the country and found that one in four NHS authorities were offering some type of ‘financial incentive’ to cut down the number of patients referred to hospitals. Out of these, eleven offered direct payments to GPs and four had introduced profit-sharing.
In Barnsley, GPs are being offered £5 per patient for cutting referrals by 10% across a whole range of specialities including cardiology, gastroenterology, general medicine, general surgery, gynaecology along with a lengthy list of other complaints that GPs are being ‘incentivised’ not to refer to hospitals.
This scheme has been denounced by the local BMA GPs representative, Dr Dean Eggitt, as ‘unsafe and needs to be reviewed urgently’. The chair of the Royal College of GPs, Professor Helen Stokes-Lampard, stated: ‘Cash incentives based on how many referrals GPs make have no place in the NHS, and frankly, it is insulting to suggest otherwise.’
Dr Peter Swinyard, chair of the Family Doctor Association, called this profit-sharing scheme ‘bizarre’ adding: ‘From a patient perspective, it means GPs are paid not to look after them. It’s a serious dereliction of duty, influenced by CCGs trying to balance their books.’ In fact, it is the deliberate policy of this Tory government to deliberately block GP hospital referrals and they have been financing private companies to carry this out. An investigation last year revealed that the NHS is spending millions on private companies operating ‘referral management centres’.
These centres can block or redirect GP referrals for procedures like hip and knee replacements and this week the Royal College of GPs issued a report saying that these centres, used by a quarter of CCGs in England, are ‘ethically questionable’ and ‘prioritise savings over care’. They may be ethically questionable but that hasn’t stopped the private companies that run them making millions out of the NHS.
This latest scandal denying patients the medical treatment they need follows on the heels of the Tory government telling parents to go to pharmacies when their child is sick rather than the local A&E department. It is part and parcel of the Tory drive to destroy the NHS as a public service, free at the point of need and throw it open to the privateers out to make millions out of health.
This makes the response of the Labour shadow health secretary, Jonathan Ashworth, to this cash-for-cuts policy not just inadequate but a complete betrayal of the NHS. He said: ‘Ministers should step in and ban this practice immediately.’ He added, ‘These cash handouts – which some might even describe as “bribes” – to block referrals are totally unacceptable and the latest pernicious effect of Tory underfunding of our NHS.’
His only solution is to ask Tory ministers, presumably Jeremy Hunt, to step in and stop this attack.
While Ashworth and the Labour leadership are sitting back waiting for the Tories to step in and stop their own plans to privatise the entire health service, the NHS is being systematically destroyed by this same weak, minority Tory government that only clings to power because of the refusal of the Labour leaders to bring it down.
The working class will not sit back and wait for the Tories to step in. The only way to defend the NHS is by demanding that the trade unions take action by calling a general strike to throw out the Tories and go forward to a workers government that will finance the NHS by nationalising the banks and big pharmaceutical companies and use their vast profits for the benefit of all.
