NHS London is the Strategic Health Authority for London, England. A paper leaked in April of this year openly acknowledged NHS London’s new mandate for cost containment through health care rationing, this, despite it’s stated mission to “deliver world-class care.”
Among the cost cutting measures:
1) Panels were established across London to monitor the rates at which General Practitioners refer patients to hospital. Local health trusts were instructed to cut GP referral rates to the levels of the lowest 10% nationally at an estimated annual saving of 25m pounds.
2) Consultant to consultant referrals are also to be limited, effectively denying second opinons. In an earlier draft paper Hammersmith and Fulham reportedly found that a fifth of consultant-to-consultant referrals were “clinically not necessary.” Trimming back referrals accross London is expected to save another 7 million, though the administrative burden is estimated at 1.6 million.
3) Emergency care practitioners in emergency departments will “redirect” 40-70 per cent of patients back to GPs or walk-in centres. If they treat those who could have been treated non-emergently, they will not be paid.
The British Medical Association condemned the plan. Hamish Meldrum, the chairman of the association’s GP committee, said that they left patients in limbo, with no one clear where the responsibility lay if the condition worsened or the patient died.
From the article:
“The plan, which is still in draft, was produced by the London Transition Team, led by John Bacon, a senior NHS manager. It is typical of the action being taken nationally to save money by reducing referrals, or, putting it more plainly, treating fewer patients.
There are serious questions about whether such systems will work. say two experts in general practice in this week’s British Medical Journal.
Myfanwy Davies and Glyn Elwyn, of the Centre for Health Services Research at Cardiff, say there is little evidence that referral management centres work to improve the quality of referrals or save money.
They say that the centres have “appeared overnight in an evidence-free zone”.”
America’s costs for publicly funded healthcare are similarly spiraling out of control. How closely should we look at London’s model? Should healthcare be rationed? If so, how?
This entry was posted on Sunday, August 13th, 2006 at 5:03 pm and is tagged with emergency care practitioners, strategic health authority, hammersmith and fulham, british medical journal, british medical association, consultant referrals, gp referral, john bacon, referral rates, health trusts, health services research, cost containment, myfanwy, transition team, draft paper, opinons, administrative burden, health care rationing, emergency departments, elwyn. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback.
Leave a Reply
Please take time to enjoy the archives: March 2011 (1) November 2010 (1) August 2010 (1) February 2009 (1) December 2008 (1) October 2008 (1) September 2008 (1) August 2008 (1) July 2008 (2) March 2008 (1) January 2008 (4) December 2007 (1) November 2007 (2) September 2007 (1) August 2007 (3) June 2007 (1) May 2007 (1) April 2007 (3) March 2007 (1) January 2007 (2) December 2006 (2) November 2006 (1) October 2006 (4) September 2006 (4) August 2006 (7) July 2006 (4) June 2006 (17) May 2006 (15)