On Sat 21 Sep, Helen Breslauer/Robert Frankford wrote:
> > On Thu 19 Sep, Ahmad Risk wrote:
> >
> > > As for collection at the Surgery, a swipe card linked to the
> > > paymasters will do just fine! No cash, no admin, no crime,
> > > no fuss!
> >
> > Trims replied: Okay, so let's think this through.
> >
> > Who devises, designs, implements, and pays for the swipe card
> > system?
> >
> > If benefits recipients just have to present their card (as in
> > Australia) where's the disincentive?
>
> What happens in any card based system when the patient is truly sick,
> unconscious, demented, unable to obtain a card, had their house just
> burned down etc, etc? It's a serious problem, which we have here
> in Ontario. The bureaucrats who plan health systems assume that
> everyone is just like them, planning appointment well in advance
> and presenting their cards as they arrive well in advance for their
> appointment.
>
> If only life was so easy
But it gets worse. What about the effect it would have on clinical
behaviour? There may be significant incentive to drag back those
hypertensives for their "essential" monthly review. An extra 1000
consultations per year x 5 pounds = quite a lot of money.
Presumably the co-payment would be considered part of net intended
remuneration? Could we anticipate a rising consultation rate and
static income - precisely what we're trying to avoid?
Our Aussie colleagues may correct me, but I believe this is how it
feels in their fee for service system.
Trims.
--
Dr Ian Trimble email: [log in to unmask]
Sherwood Health Centre
Elmswood Gardens Tel: +44 115 962 4516
Nottingham NG5 4AD Fax: +44 115 985 7899
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