Productivity And Prejudice - NHS Alliance

Main Category: Primary Care / General Practice
Also Included In: Public Health
Article Date: 29 Feb 2008 - 3:00 PDT

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Yesterday's report from the National Audit Office on the GP contract contains a wealth of valuable information and is right to say there is a need to focus on outcomes.

However there is a lack of an appropriate definition of what productivity means in practice for the NHS. Consequently the report risks encouraging further anti-doctor prejudice.

In fact, the cost to each tax payer of their general practice team - complete with GPs, nurses, receptionists and other staff - is £120 per year. That is less than the cost of a television licence.

Healthcare is too sensitive and too complex to rely on definitions of productivity that depend merely on activity. The NAO report refers to hours worked and numbers of patients seen in a given time, for example.

Increasing working hours would result in over-tired doctors and risks to clinical care and patient safety. That was not unusual under the previous contract when GPs were responsible for out of hours care. Increasing the numbers of consultations is likely to result in poor care: missed symptoms; less compassion and dignity for the patient; loss of personal care.

NHS Alliance chairman Dr Michael Dixon said:

"Good healthcare depends on a range of factors that are not easy to measure, while those that can be measured may be counter-productive. For example, 'improving' hospital productivity by increasing bed occupancy rates to levels close on 100% was one factor in increased rates of hospital acquired infections such as MRSA.

"Hopefully the NHS has learnt that lesson and will be reluctant to impose such short sighted measures on primary care.

"We need less prejudice about doctors' hours and pay, and more understanding about what good healthcare means. Frontline clinicians and managers, who understand the delivery of excellent healthcare, should now be involved in a national debate about how NHS productivity can be sensibly and sensitively defined and measured."

Notes:

1. The NHS Alliance is a collaboration of professionals who put patients first. Values based, it is the only organisation that brings together clinicians with managers and board members, PCTs with GP practices, and NHS primary care with its patients. The Alliance membership and its hard working national executive is fully multi-professional.

NHS Alliance