‘OK, so what would you do to improve the NHS then?’
As doctors I’m sure most of us have had this question hurled at us at parties and gatherings with non-medics. It usually takes me off guard and I end up rambling on about the politicians leaving us alone to do our job and not micro managing, which to those not working in the NHS seems a bit vague and woolly.
Recently though a patient showed me the invoice for a relatively minor ophthalmological procedure they’d had performed at a private hospital. Now in addition to answering a question that’s bugged me for years (why do ophthalmologists have such long arms – evidently from carrying their money bags to the bank) this also gave me an idea; how about we start informing NHS patients what their care would have cost?
Supermarkets are in the habit of telling us ‘how much you saved today’ on the bottom of till receipts, so what if we did something similar for healthcare?
We could highlight the cost of in-patient care on discharge summaries
We could start by printing the price of drugs to the NHS on FP10 prescriptions. This would be easy. The scheme could then extend to highlighting the cost of in-patient care on discharge summaries and out-patient visits on the bottom of appointment letters.
Waste in the health service is huge and in part this is due to patients having no idea how much things cost.When prescribing an expensive drug, I often show the patient the cost as it flashes up on the screen and more often than not they are horrified, then thankful they don’t have to pay for it.
Part of the problem with anything that is free at the point of use is it is not valued. A newspaper that costs 20p is more likely to be read than a free one. Humans have pretty basic inbuilt systems for assessing value and worth and one of the reasons there are so many missed appointments at GP surgeries and hospital clinics is they are not valued.
When something is given numerical worth, even a nominal one, it suddenly makes it seem ‘of value’. Take the £1 deposit on supermarket trollies and 5p charge on plastic bags. These are simple ways that assigning a monetary value has changed behaviour radically; trollies get returned and bags reused.
Some will no doubt caution that this would make some patients feel uncomfortable, but I would argue this would be offset by how much we would gain by better educating patients about the true cost of their care.
And let’s not forget if we were in the USA, these would be real invoices not nominal ones.
Dr David Turner is a GP in North West London