Value for money – or a rod for our own backs?
As I write this article, stock markets are jittery and there are serious economic concerns not only for the Eurozone, but also the global economy. The relatively flat economy in this country is one of our major concerns, with government spending being significantly cut back in order to reduce our debt burden. This means that the big beasts of government spending, such as defence, welfare benefits and healthcare are all under intense scrutiny to find where savings can be made.
In the past we have always said that GPs represent good value for money, but I sometimes wondered if this fell on deaf ears. I think most people would agree that the last administration were fairly generous towards the healthcare budget, but there was a suspicion that they were trying to sideline GPs and bring in competing services such as Darzi centres. In this new economic climate, however, GPs do not seem to be sidelined as much, if at all (although our pay and pensions are not surprisingly under the microscope). Perhaps the realisation within the current government that GPs represent good value for money and are a cost-effective solution has finally hit home. That does not mean that our situation is safe, though. Indeed, far from it.
I commented in a recent column that GPs could, in certain situations, be replaced by other healthcare professionals, such as nurses (click here). So, GPs do not have a monopoly on the provision of primary healthcare - and nor should they. Nevertheless, it was with interest that I read this article in the univadis GP News service, (click here). The article reported that "better management of chronic disease by GPs has led to 'material' reductions in hospital costs", going on to explain that "higher-quality primary care is significantly correlated with lower hospital costs, driven primarily by a reduction in emergency hospitalisations and outpatient visits".
This all sounds good and I am sure that the transfer of some healthcare activity from secondary to primary care will continue. But primary care can only absorb and deal with so much before additional resources, such as manpower, expertise and money are needed. There is the argument that the money will follow the patient, but in these belt-tightening times, will that happen? If the resources fail to meet this kind of demand, there is a risk that primary care could be become overwhelmed - and I wonder who will then get the blame?
Dr Harry Brown, editor-in-chief univadis
By Dr Harry Brown