I’m regularly accused of moaning about cuts to the NHS without suggesting any solutions. Well I’ve had a little think and have come up with a few money saving ideas. If you’re reading Jeremy Hunt feel free to use any you like:
Not only would these changes save the NHS money, but they would also improve GPs’ workload
1. Ban FP10 prescribing for any over the counter medication costing less than £1. I refuse to believe there is anyone out there who cannot afford 25p (yes that is what they cost at the supermarket) for a packet of paracetamol. If any of my patients can convince me they really do not have 25p to their name I will gladly give them the money out of my own pocket.
2. Home visits from now on will only be for the bedbound and dying. They waste huge amounts of time and more often than not the patient could have come to the surgery. Provide more transport to get patients to the GP surgery the way hospital transport is provided to get them to outpatients. The irony is many ‘housebound’ patients can drag themselves up to the hospital to see a ‘specialist’, it’s just they don’t value seeing us enough to make the effort.
3. Sick notes – why are we medicalising what are often work performance issues? Let’s adopt a model like some Scandinavian countries whereby nobody gets paid for their first day off sick. This would do away with hangover and pre-Christmas shopping ‘sick days’. If you are genuinely too ill to work you won’t mind giving up a day’s pay, if not take some paracetamol and drag yourself in, it’s what we doctors do. (Ok so I might let ITU and SCBU nurses have the day off if they have an infection).
4. £1 deposits to be paid for all GP and hospital outpatient appointments. These deposits would be returnable on attendance at the appointment or cancellation. This deposit could be collected electronically through a central body, minimising extra admin work for surgeries. If you doubt £1 would make a difference, look at how a 5p charge has changed carrier bag usage. It might cost more to adminster initially, but long term it would change behaviour and encourage patients to value the service.
5. Finally, double investment in family planning clinics and sex education in schools. We have the highest teenage pregnancy rate in western Europe and the social and medical costs of this are huge. If you do this Mr Hunt, I will pledge here and now to work one shift a month in a family planning clinic for free.
Not only would these changes save the NHS money, but they would also improve GPs’ workload and make general practice more appealing to would be family doctors.
On second thoughts no, scrap those ideas, just close some A+E departments and cut GP funding.
Dr David Turner is a GP in west London
