Leading doctors in the UK have come out in force against government plans to give GPs cash for diagnosing extra cases of dementia, voicing “serious concerns” over the scheme and calling for its “immediate withdrawal”.
In an open letter to NHS England chief Simon Stevens, published by the British Medical Journal, more than 50 doctors question the ethics of offering a direct financial incentive to diagnose of the disease, warning that it “sets a dangerous precedent that needs to be urgently reconsidered”.
There must be “absolute surety” that doctors have no other motivation than the patient’s best interests when making a diagnosis, and the involvement of a financial reward “undermines this confidence, and with it the basis of trust inherent in the doctor-patient relationship”, the argue.
The also caution that diagnosis of dementia is subjective, and that to be misdiagnosed with the condition “can have truly tragic consequences”.
The new Dementia Identification Scheme is a six-month, £5-million NHS England initiative designed to boost diagnoses of the condition, given that a massive number of cases remain unidentified. The optional service will issue GPs payments based on the net increase in their dementia registers at the end of March next year, in a bid to get two-third of patients suffering from the condition a diagnosis.
But the initiative was besieged with criticism right from the start. The Patients Association said it was “a step top far” that put “a bounty on the head of certain patients”, while the British Medical Association advised doctors to think 'very carefully' before taking up financial incentives. Some doctors suggested a total boycott while others said they plan to donate proceeds from the scheme to local dementia services, according to the Telegraph.
According to the letter’s signatories, the scheme “may have good intentions, but it has crossed a line that should never be crossed and contravenes good medical practice”.