'Stop the marketisation of health', says RCGP chair

RCGP chairwoman Dr Clare Gerada has condemned the marketisation of healthcare in her keynote speech to the RCGP conference in Liverpool.

Dr Clare Gerada: GPs will move away from being advocates of patients (Photograph: Alex Deverill)
Dr Clare Gerada: GPs will move away from being advocates of patients (Photograph: Alex Deverill)

Dr Gerada went beyond her recent criticism of the Health Bill reforms to complain that the wider culture of caring in the NHS is being gradually eroded.

She told the conference that the profession was coming under increasing pressure to replace ‘the language of caring with the language of the market.’

Harsh terms such as ‘demand management’, ‘clinical and financial alignment’ and ‘risk stratification’, were turning the emphasis away from patient care towards business-like objectives, she said.

Dr Gerada said that while GPs had a duty to spend public funds effectively, there was a danger that patients would become ‘commodities’ in the new health marketplace.

‘In this brave new cost-driven, competitive, managed-care world, I worry about the effect the language of marketing is having on our clinical relationships.

‘It’s changing the precious relationship between clinician and patient into a crudely costed financial procedure. Turning our patients into aliquots of costed tariffs and us into financial managers of care.’

Dr Gerada said that while GPs did make good commissioners of care, because they had their fingers on the pulse of the nation, they had to tread carefully in the new world being created by the NHS reforms.

‘Which is why I believe that big decisions – decisions like whether to close hospitals – should be the responsibility of governments, not GPs.

‘Governments should have ultimate responsibility for decisions about rationing healthcare, not GPs – guided and advised by us, for sure, but finally the decision must be taken by a publically accountable body, not an individual doctor or a group of doctors.

‘We don’t shirk our responsibilities. Governments shouldn’t shirk theirs either. Rhetoric about putting doctors in charge doesn’t convince me.

‘In this brave new world it’s the market – led by CEOs, share-holders and accountants – that will be in charge, not doctors. We mustn’t allow ourselves to be compromised.’

Colin Cooper

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