The letter, addressed to NHS chief Simon Stevens and published in the BMJ, accuses the DES – which rewards practices with £55 per additional dementia diagnosis – of ‘crossing a line that should never be crossed’.
The authors claim that the scheme, although it may have been based on good intentions, ‘contravenes good medical practice’ and could put ‘particularly vulnerable’ patients at risk.
Deputy BMA chairman Dr Kailash Chand, GPC prescribing lead Dr Andrew Green, and former RCGP president Dr Iona Heath are among the co-signatories.
GP boycott plans
The letter follows a suggestion last month that practices should consider boycotting the scheme from GPC deputy chairman Dr Richard Vautrey. He said the scheme appeared to be based more on ‘chasing government targets’ than providing quality care.
Part of the letter, written by GP Dr Martin Brunet on behalf of the co-signatories, reads: ‘Helping people affected by dementia to achieve a diagnosis is a worthwhile goal, but the means of achieving this must have a sound ethical basis.
'The introduction of a financial incentive to the making of a diagnosis has broken new ground in the national GP contract and set a dangerous precedent that needs to be urgently reconsidered.'
The letter adds that there must be 'absolute surety that doctors have no other motivation than the patient’s best interests when they make a diagnosis'.
'A direct financial payment like this undermines this confidence, and with it the basis of trust inherent in the doctor-patient relationship,’ it warns.
