Breast Screening – what should go into new information: Click on Rapid Responses to this article (Nigel Hawkes – Citizens’ Jury disagrees…’) for patients’ comments: bmj: http://www.bmj.com/content/345/bmj.e8047
Some people may be surprised to hear that, despite research showing the ineffectiveness and harms of breast screening, (the latest- The New England Journal of Medicine: (n engl j med 367;21 nejm.org 1998 November 22, 2012. Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence.Archie Bleyer, M.D., and H. Gilbert Welch, M.D., M.P.H.) – and although GPs are signposted in breast cancer leaflets as sources of support for decision-making …GPs may be paid for recruiting women to breast screening.
To verify this, I telephoned the Royal College of General Practitioners on 26 November 2012 and asked, ‘Are GPs paid for recruiting women to breast screening’ They told me no-one there could answer my question and I should direct them to the General Medical Council. I was amazed, since they are all GPs, but they were adamant.
I rang the GMC and a rather bemused man apologised that the RCGP had passed me to them and said I should ring the NHS – ‘no, the Department of Health’.
The Department of Health said no-one could answer my question straight away but someone would get back to me within 3 days.
In the event, someone rang back the same day with: ‘GPs are not paid nationally, by the government, to recruit women to breast screening, ie it is not in the GP Contract. But if a Health Authority feels recruitment is low in their area, they may want to pay GPs to get them to encourage women to take up screening and this is done under ‘local enhanced services’. He said this also happened in other health related services if there was a similar problem
I asked if they had any idea how many GPs would be paid for doing this and was told ‘We do not hold that information’.
If you already know about these payments you may not be surprised to hear that hospitals are being paid to put patients onto the Liverpool Care Pathway – which is an end-of-life pathway; food and fluids are withdrawn and patients are given large doses of morphine. I watched part of a programme about this last Monday night 26 Nov – Newsnight. Apparently, there have been many complaints by relatives as this is being done against their wishes. The patient’s wishes may not be known, especially if they are unconscious! One way to free up hospital beds?