Viewpoint: political gimmicks won't improve dementia care

Writing for GPonline, BMA deputy chairman Dr Kailash Chand argues that 'political gimmicks' aimed at improving dementia care are adding to GP workload without benefiting patients.

Dr Kailash Chand: warning over dementia gimmicks (Photo: Wilde Fry)
Dr Kailash Chand: warning over dementia gimmicks (Photo: Wilde Fry)

‘A GP's got to do what a GP's got to do’ – the adapted John Wayne quote is increasingly the norm for general practice, with GPs expected to carry out virtually any work that needs doing.

Public Health England now plans to make GPs screen patients for their risk of dementia and tell them their 'brain age', another unnecessary addition to primary care workload.

There is no evidence whatsoever that screening would accurately indicate someone’s chance of  developing dementia in later life.

Health checks for future risk of dementia will at best confuse patients and at worst create unnecessary fear without any foundation. The only beneficiaries are going to be big business.

Medicine being devalued

In my personal view such screenings devalue medicine and lead to patients being needlessly worried, as GPs waste time on people who are not sick.

Precious GP time should be concentrated on lifestyle advice, about smoking, drinking, sedentary behavior and poor diet, that will not only reduce the risk of dementia in later life but will help other  conditions such as heart disease, stroke and many cancers.

This dementia policy originates from the fact  that only half of the estimated 850,000 people living with dementia in the UK have been diagnosed. To boost diagnoses over the next six months in England, the NHS has decided to pay doctors a financial incentive of £55, which in itself, in my view is unprofessional and unethical.

The introduction of a financial incentive for a diagnosis has never ever happened as part of the GP contract and sets a dangerous precedent. What next?

I know from experience that many caring GPs hold back from early diagnosis because they know there’s no support afterwards. An unacceptable long wait to get to a memory clinic is already far too common.

Threat to doctor-patient relationship

There is a real possibility that, the referrals to memory clinics will increase sharply. A financial incentive like this undermines the very basis of trust inherent in the doctor-patient relationship. A culture of over-investigation and over-treatment is now one of the greatest threats to the survival of universal health care.

There is plenty of evidence to suggest that a third of all healthcare activity brings no benefit to patients. Political interference is distorting the priorities.

Dementia costs the UK economy £23 billion a year, more than cancer and heart disease combined. Despite these figures, dementia research is desperately underfunded. Funding and resources for social care are peanuts. Social services can`t cope with existing problems let alone new patients with mild dementia.

With a quarter of a million people developing dementia every year and numbers set to soar, dementia is one of the biggest health and social care challenges the UK faces. What is needed is money and resources to improve social care, and investment in research to find new treatments that actually modify the course of the disease. Political gimmicks like screening or paying GPs for diagnosis, will not fix the huge problems associated with dementia.

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