Please stop and consider. Don’t act without thinking…

Well, that’s interesting. I woke up this morning with a reasonably good idea of what I wanted to blog about today and then, on turning on the TV, promptly heard a news report that made me think and I changed my mind.

So what was it? What was this momentous piece of news?

According to the report I saw, Clinical Commissioning Groups (CCGs) nationwide are offering GP practices thousands of pounds in payments for hitting targets and reducing the number of patients that are sent for scans and tests, referred to clinics or told to go to A&E.

And what’s wrong with that? It sounds like a great idea. If fewer people are sent to the hospitals for tests and treatments they don’t really need, surely that will mean that the consultants and specialists will have more time to see and treat the patients who really need them.

Well yes. I do think it’s a good plan. In theory. Having spent many hours in crowded waiting rooms only to be told, when I finally did see a consultant, that I did not really need to attend the hospital and that I should go back to the GP. I know the frustration. Surely this is a good idea and will free up the consultants to treat the people who actually need them.

Well, thinking about it, maybe not.

As a disabled person who is in receipt of welfare payments, I know, first hand, the value that the Department for Work and Pensions places on reports from hospitals when determining eligibility for those benefits. In order to qualify for any payment whatsoever you have to produce files and files full of paperwork from medical practitioners, practically every time, to prove you are genuinely sick or disabled and not trying to scrounge and get money you are not entitled to. If GPs are going to be paid not to send people to see specialists how are we expected to get those reports we need? What are we supposed to do when our adviser at the job centre says ‘prove it’? If our GPs are getting paid to keep us away from the hospital will they be the people providing us with the reports. And will the DWP accept those reports from the GP without the backup of another piece of paper from the hospital? Somehow, I don’t think so. They don’t place much store on GP reports at the moment so why are they likely to change? Somehow I get the feeling that the DWP advisers will say no hospital report, no benefits.

And what about showing why we need support from Social Services and proving why we need a care package? If we can’t get medical reports from the hospital and from specialists how are we going to show how our disability affects us and what we need? How am I supposed to show what equipment I need if I don’t have reports from specialists? How am I expected to prove that the wheelchair I should have has to have certain functions in order to allow me to have as much independence as possible.

My specialists have known me for many years and have seen how my condition has changed. They know more about me and my disability than I know myself. If I am no longer able to be referred to see them when my GP and I think things may have altered what happens? Who pays if something is missed and I get worse? The CCG, that’s who. When I need to have more expensive treatment because things weren’t nipped in the bud because no-one saw them before they got serious, it’s the CCG that has to pay.

This idea sounds good in theory but I believe that more thinking and more research needs to be done before it is rolled out nationwide. The DWP need to say exactly what evidence they need in order to approve benefit payments. Social Services departments need to say what evidence they need in order to authorise care packages. NHS equipment providers need to make sure they have sufficient specialists to be able to judge exactly how someone’s illness or impairment affects them and what they need. Let’s not change things just for the sake of changing them. Let’s look at the possible effects first and then, only change things, when we have ironed out as many possible drawbacks as possible. I’m not saying don’t do it, just don’t rush into something that, for some, could be life changing. Please stop first, and consider how sick and disabled people’s lives might be affected, before implementing something as potentially life changing as this.

  1. Claire Martin said:

    You make a good point, Poppy, but also I think we may end up going the way of the USA and into defensive medicine. If a GP doesn’t refer and a patient can show negligence, the NHS will be saddled with legal expenses. Just look at the conflict of interest, too. At our reunion, one of our school friends who has become a GP told me about being incentivised to increase the number of dementia patients on her list. Good job we don’t live near her any more. The pair of us would be certified before you could say boo to a goose.

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