Doctors, and consultants in particular, are easy pickings for governments bent on the privatisation of health care. This is because it is perceived that they are a pampered elite, whose incomes far outweigh those whom the government can make envious of them. It is a form of the policy of stigmatising the poor and disabled, for what is the difference between labelling them as lazy scroungers, and a doctor as a rich scrounger? Same policy. Different words.
A major stone was cast at doctors in 2012, when the Department of Health declared: ‘reports commissioned by the Government highlight the need to change doctors’ current contracts, both for consultants and for junior doctors, to make them fit for purpose to support the modern NHS. The changes will promote higher quality medical education and research, motivate doctors to achieve excellent results for patients and ensure that contracts remain fair, affordable and fit for the future … Using these reports, the Government will look at medical pay as a whole, including the £5.5 billion spent annually on consultants’ pay and the £3 billion spent on the pay of doctors in training, so that it can offer national terms and conditions that are affordable and fit for purpose … Recommendations accepted by the Government include: Rewards for clinical excellence should be linked to performance including patient feedback. Progression through the current consultant grade (£74,000 to £100,000) should be based on performance and contribution rather than time served’.
This is triple-fermented ‘market speak’ – ‘affordable and fit for the future’, ‘affordable and fit for purpose’; mixed into a cocktail of envy – ‘£5.5 billion spent annually on consultants’ pay’, £3 billion spent on the pay of doctors in training. The true devil is disguised as pay being based on ‘performance and contribution’, and it is this which informs us of the hidden motive behind government ‘reforms’, which is privatisation of all servives provided by doctors, and the means with which they will bring this about – making them processors of insurance forms, as in America.
Daniela Drake (www.thedailybeast.com/articles/2014) reported on the sorry plight of American doctors: ‘Nine of 10 doctors discourage others from joining the profession, and 300 physicians commit suicide every year … Simply put, being a doctor has become a miserable and humiliating undertaking. Indeed, many doctors feel that America has declared war on physicians — and both physicians and patients are the losers. … What worries many doctors is that the Affordable Care Act has codified this broken system into law … forcing everyone to buy health insurance … As Malcolm Gladwell noted, “You don’t train someone for all of those years in [medicine]… and then have them run a claims processing operation for insurance companies.” Processing the insurance forms costs $58 for every patient encounter … Yet physicians have to go along, constantly trying to improve their “productivity” and patient satisfaction scores—or risk losing their jobs. Industry leaders are fixated on patient satisfaction, despite the fact that high scores are correlated with worse outcomes and higher costs. Indeed, trying to please whatever patient comes along destroys the integrity of our work. It’s a fact that doctors acquiesce to patient demands — for narcotics, X-rays, doctor’s notes—despite what survey advocates claim. And now that Medicare payments will be tied to patient satisfaction—this problem will get worse. Doctors need to have the ability to say no. If not, when patients go to see the doctor, they won’t actually have a physician — they’ll have a hostage’.
This explains what is really meant by ‘Rewards for clinical excellence should be linked to performance including patient feedback’.
The UK government envisage a system where all doctors are independent contractors employed by businesses, which are responsible for providing doctors in shifts around the clock.
Following the American experience, in the UK, the contactual agreement between the hospital or G.P. service (as businesses) and the business providing doctors will have a strict set of rules, regulations and policies, which are designed to protect such businesses from litigtion, placing all the blame on doctors, who would be held in a choke-hold – comply or go.
Doctors of all degree are a cornerstone of the NHS; reducing them to being skivvies of insurance companies and hospitals owned by corporations, under the consumerist front of ‘patient feedback’, is a road to the knackers’yard.
Whatever the shortcomings of some doctors, whatever the justifiable complaints some people may have about the care they or a relative as received, it is a seperate issue to join in a political campaign against them.
Do not be enticed by the bait of consumer power associated with patient satisfaction scores.
Do not turn doctors into hostages of the NHS as a marketplace.
Do not expect them to offer a 24/7 supermarkt service, which is only designed to spare employers from workers attending a weekday appointment.
Do not believe the statistical lies being peddled about weekend death rates at hospitals.
They do not include the total number of doctors and nurses who work weekends.
They do not tell you that the University College London researchers who reviewed all admissions to the National Health Service Hospitals in England during 2009 to 2010 pointed to several reasons that contribute to higher mortality rates among people admitted to the hospital on weekends, such as reduced nurse staffing ... and also patients admitted during weekends may be in more critical health conditions otherwise their admissions may have been postponed to a weekday.
When such a fundamental and massive data error passes unchecked and results in false deductions it must cast doubt on the whole process.
The emphasis on ‘spot the consultant’ is a tactic of envy.
The end-game of American healthcare and insurance corporations is to own doctors as commodities they can extract profit from.
To all doctors, unite and fight, do not become a claims processing operation for insurance companies.
To all health care workers, unite with doctors to fight against all health care becoming totally marketised, that is, Americanised; the irony being that such a system as utterly failed the vast majority of Americans.
lenin nightingale 2015