Ahmad,
Well I'm glad you aren't *my* medical adviser!
The reason why we don't penalise the overspenders and poor prescribers is
that the strategy we use actually works, big time. It ain't theory, this
year it is forecast to leave us with a 600k underspend, and if we have
another year as good as the last two, the PCGs will have some money to spend
when they inherit the prescribing budgets. No-one is at each other's
throats, and we are making serious progress with one of the lowest
prescribing inflation rates in the country despite being in an area of quite
severe deprivation.
We aren't subsidising the NHS with good will and personal income, and we
stopped doing so precisely one year after my arrival at Durham, when we
first converted the overspend to an underspend.
You are of course, free to pursue any strategy you like, but bear in mind
that there are only 17 underspent HAs where prescribing is concerned. I
would suggest that any system of penalties you can think of (a) won't make
you personally very popular (b) may be difficult to get a PCG to accept (c)
won't work as well (d) may get you on TV for reasons you might not be so
comfortable with!
Why not try it? What about the Risk association for depriving overspending
practices of money?
Andrew (-:
> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of Ahmad Risk
> Sent: 06 April 1998 13:38
> To: [log in to unmask]
> Subject: Re: PCG and practice drug budgets (was Branded drugs)
>
>
> On 04/06/98 08:26:18, "Andrew Herd" <[log in to unmask]> wrote:
>
> >If you don't reward progress by the overspenders, the situation
> simply gets
> >worse.
>
> You still haven't answered my question:
>
> If the quality of my prescribing is good and I am always at or below
> budget, why should I reward those who are not?
>
> Isn't this pathognomonic of the whole NHS? That we keep on subsidising
> it with good will and personal income?
>
> Why can't you just penalise the overspenders and poor subscribers? ;-)
>
> The PCGs will either have to do that or raid other resources to maintain
> that dogma that says we, doctors, have to keep on shoring up the
> system.
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