Bioethics Blogs

Paying GPs for Dementia Diagnoses

A GP in Guildford has recently revealed that the NHS is to pay GPs £55 each time they diagnose dementia in a patient. Writing on the medical website Pulse, Dr Martin Brunet, called the incentive scheme a “bribe,” put in place so that the government can “hit its target to raise diagnosis rates.”

The ‘Dementia Identification Scheme’ requires GPs to count how many patients with a dementia diagnosis there were on their register at the end of September, and to compare this with the number at the end of March 2015. They will then receive £55 for every extra patient. The full service specifications can be found here.

Dr Brunet writes:

No-one is against correctly diagnosing dementia, but NHS England have either not considered the ethics of this new policy, or are so blinded by their goal that they don’t deem ethics to be important – either a lack of moral insight, or a failure of moral leadership.

We are used to being paid for things of course, like asthma reviews and statin prescribing, and we are well aware of the problems this causes – but at least patients can opt out if they don’t like it.

They can refuse to attend a review, decline our offer of a statin or politely take the pill packet and store it unopened in the kitchen cupboard. They cannot opt out of a diagnosis.

The point of making a diagnosis is something the doctor does alone. The patient can contribute, of course, they provide evidence and we certainly want to know what they think, but the moment of judgement is for the doctor and is enormously difficult for the patient to challenge.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.