A report by the Civitas
thinktank accuses GPs of playing the system to attract
maximum benefits at the expense of treating patients
properly in a number of areas including depression and
The graphic from the Daily
Mail, below, is revealing. Notice that bonuses are
paid out for 'monitoring.' 'tests,' 'measuring,' 'reviewing'
and 'recording'. Part of the agenda of shepherding and
keeping tabs on the public or genuine concern?
Now I understand why I have had my blood pressure taken
so often in recent years, which has been normal since
I stopped drinking alcohol over a decade ago, when previously
it used to be high.
You would hope that compassion was offered as standard;
basic humanity overriding the temptation to shoo away
a difficult patient quickly in order to take more blood
The Quality and Outcomes Framework (QOF) has become
a 'game' to secure maximum points, according to Civitas,
and in this case, points mean prizes: lots of cash.
Since this system of bonuses was introduced, general
practitioners have seen their salary rise to over £100,000.
Civitas argues that "there are many reasons why
high quality care for patients, particularly the elderly
with complex medical conditions, may not fit well with
what is mandated by the framework. This opens it up
In one survey, 75.9 per cent of nurses said they felt
the QOF was undermining the patient-focus of the NHS.
I know I do not seek a doctor unless I need to and a
big part of this is due to my lack of confidence that
I will receive a compassionate never mind competent
We have clearly seen that the 'target' culture does
not benefit society. Since it was introduced into police
forces, easy targets are picked off and the difficult
and more serious ones often put on the back burner.
The same seems to be the case here. While healthy people
are being poked and prodded, there are fewer resources
to help the sick. Similarly, in today's police forces,
brownie points are awarded for performance and so crimes
are invented that law-abiding citizens can be arrested,
DNA taken and the 'crime' solved while some real criminals,
who would otherwise have been apprehended with the freed-up
resources, still roam free.
Civitas finishes by saying, 'Do we really want GPs
to be a set of what the cultural critic Raymond Tallis
has termed "sessional functionaries robotically following
guidelines" or do we want professionals able to work
for their patients?'
We want the latter of course, not just with doctors,
but teachers, police officers, judges, politicians and
journalists, but we seem to settle for the robots because
stepping outside the PC box and into normality can lead
to repercussions in this crazy world.
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