Politics - Sue th bastards!

The following was published on healthcare.republic@haymarket.com - 21/6/07

GP leaders have condemned as illegal a PCT plan to cut up to £35,000 per practice from global sums if GPs do not meet generic drug prescribing targets.

LMC leaders believe East Riding of Yorkshire PCT has taken legal advice over whether it can impose a system that would see GPs' income docked for failing to prescribe efficiently.

The plan envisaged PCT assessors visiting practices and asking about rates of generic prescribing, focusing on statins.

If practices were found to have 'overprescribed' expensive non-generics, a cash amount equivalent to the perceived overspend would be withheld from their core pay.

The PCT has said that if practices prescribed as many generic statins as the most efficient 25 per cent of PCTs in England, it could save £1.4 million a year, or £35,000 per practice in the area.

The PCT's move follows an Office of Fair Trading report in March that called for the GMS contract to be altered to force GPs to prescribe more generic drugs (GP, 2 March).

Speaking after the conference, East Yorkshire LMC member Dr James Laing said the PCT believed all GPs were overprescribing expensive statins.

'The PCT wanted to identify each patient where you had "overprescribed" and then withhold the money from global sums until you start saving the money,' Dr Laing said.

Speaking after the conference, BMA clinical and prescribing subcommittee chairman Dr Peter Fellows said the plan was 'illegal'.

A spokeswoman for East Riding of Yorkshire PCT said it worked with practices to encourage a 'developmental approach to improving prescribing behaviours'.

(Healthcare.republic@haymarket.com)

COMMENT

It is the opinion of this magazine that any practice which has monies withheld by their PCT for the reasons described above should immediately and without warning sue the PCT. And the more practice which do so, the better. It is time that arrogant, dictatorial PCTs were taught a severe monetary less.

The real reason behind this Stalinist action, which does nothing to foster good relations between the profession and the administrative body, is the overwhelming incompetence of the present Secretary of State, Patricia Hewitt with whomn the buck firmly stops.

The NHS is, despite the good lady's spin and obfuscation is heading towards bankruptcy and PCTs are being leaned upon to save whatever cash they can at whatever cost to patients.

Let there be no doubt about it, those doctors who are not prescribing generic medicines, especially statins, are doing so in the best interest of their patients whether the PCT or the SoS cares to acknowledge that or not.

Other sections of this magazine deal extensively with counterfeit medicines and the cheaper and nastier the source of those medicines the more likely they are to be counterfeit. That applies particularly to generics which may be sourced from virtually any bookwoods part of the globe.

Such are the downward financial pressures exerted by the NHS on the profits of pharmacies that they are more or less compelled to obtain their supplies from the cheapest source wherever and under whatever conditions those drugs may be made. These are then passed on to patients by PCT diktat on GPs as money saving generics.

The PCT doesn't give a tinker's cuss what the effect of the possibly defective or counterfeit generic has on the patient. Just so long as they can balance their books to satisfy the politically, but not patient-motivated Mrs Hewitt. Defective pills can kill, maim, make unwell or just plainly waste money by not working.

Indeed, branded medicines may also be counterfeit but there is a far increased likelihood of their being detected thanks to the anti-counterfeit measures adopted by the manufacturer who has a lot to lose, including his reputation, if a product has to be withdrawn following the detection of a counterfeit version.

Whereas, the back-street, dirt and grime generic manufactory, XKMJ of Povya Pradja, Slovenia or wherever, really may not give a damn.

So, doctor, the GPC say that the PCT have no legal grounds for withholding money and countrydoctor says (and GMC may possibly agree) that you may harm your patients by prescribing generics from a source over which you have no control, so

.......... Sue the bastards!

(22/6/07)