Doctors offered 7,500 'bribe' to stop sending their patients with pneumonia or heart problems to hospital
GPs to be paid not to refer patients to A&E in bid to reduce admissions
Controversial scheme could hit elderly the hardest'An unethical waste of taxpayer's money' says Dr Laurence Buckman

Sophie Borland


01:41 GMT, 3 January 2013



11:42 GMT, 3 January 2013

GPs are to be offered ‘bribes’ of around 7,500 to slash the number of patients they send to accident and emergency.

Under a controversial bonus scheme that will hit the elderly particularly hard, they will be urged not to refer those with pneumonia, severe influenza or heart problems to hospital.

Patients and senior GPs have labelled the scheme a ‘perverse incentive’ and an ‘unethical waste of taxpayers’ money’.

Doctors will be offered financial incentives to reduce 'avoidable' admissions to A&E

Doctors will be offered financial incentives to reduce 'avoidable' admissions to A&E

Laurence Buckman, chairman of the British Medical Association’s GPs’ committee, said: ‘I don’t want a single patient walking into my surgery and saying my grandma’s dead because you refused to admit her. So we’re not going to admit people with pneumonia I think most doctors will be horrified by this.’

The scheme will be brought in across England this year by the NHS Commissioning Board, which has been created to oversee GP services. As part of Government health reforms, family doctors are in the process of setting up local clinical commissioning groups (CCGs) to replace primary care trusts.

Each group will be set targets to improve patients’ health and the overall quality of GP services.

If these are met surgeries will be paid bonuses of 5 for every patient on their books, which works out at 30,000 for an average GP practice.

But it has emerged that a quarter of this extra money – an average of 7,500 – will be based on GPs reducing ‘avoidable’ admissions to A&E.

Dr Laurence Buckman, chairman of the British Medical Association, labelled the scheme 'an unethical waste of taxpayer's money'

Dr Laurence Buckman, chairman of the British Medical Association's GPs' committee, labelled the scheme 'an unethical waste of taxpayer's money'

From April, GPs will be monitored for the numbers of patients they refer with pneumonia, severe flu, urinary infections and heart failure – which largely affect older people.

The NHS claims that many such admissions are avoidable because patients could be looked after at home, or better cared for early on so they don’t become so unwell in the first place.

GPs will be paid the money if they reduce these admissions or ensure they don’t increase.

They can then decide whether to plough it back into patient care or pay themselves and their staff a bonus.

But Dr Buckman said: ‘This is an inappropriate, unethical waste of taxpayers’ money. Patients might suspect that I was doing things to them in order that I would get money. I don’t want to be paid because someone was admitted or not admitted, I want to be paid because I did my job.
‘I wouldn’t dream of participating in such a scheme.’

He said refusing to admit patients went completely against the Hippocratic Oath, which obliges doctors to carry out their duties ethically and responsibly.

Dr Beth McCarron-Nash, a GP based near Padstow, Cornwall, said: ‘It’s a perverse incentive. I do not believe doctors should be given financial incentives not to refer or treat. A GP puts the person sitting in front of them as the priority. If they need to be referred, they are referred.’

NHS officials believe GPs should improve the care of the elderly and other patients with long-term conditions such as heart failure so they do not need to go to hospital.

But GPs point out that if patients develop pneumonia or suffer a severe angina attack they have no choice but to refer them.

Over the past six years, GPs’ salaries have soared to 110,000 on average, even though they no longer have to work evenings and weekends.