The government recently announced that GPs will be paid £55 for each new patient diagnosed with dementia as part of its bid to increase rates of diagnosis. Whilst the focus on dementia is positive, the prospect of payments for diagnoses has understandably caused a great deal of concern amongst doctors, patient groups, and the general public.
In September this year the chief executive of NHS England, Simon Stevens, said that the health service was “committed to pushing up dementia diagnosis rates” in the light of statistics which show that only a little over half of those suffering with dementia receive a formal diagnosis. This means there may be an estimated 400,000 people with undiagnosed dementia. The health secretary Jeremy Hunt has described this as a “national shame” and has committed to raising diagnosis rates to two thirds of people suffering from dementia by March 2015.
A formal diagnosis of dementia can enable those affected, as well as their families, to access invaluable early treatment and support, so an increase the number of diagnoses appears to be an important and legitimate aim. However, many feel that the introduction of payments for individual diagnoses is one step too far. The chair of the Royal College of GPs, Dr Maureen Baker, said:
“GPs are witnessing a rapidly increasing number of people affected by dementia and the devastating impact that this dreadful disease has on patients, their families, and their carers. We need to ensure that any interventions are in line with patients’ wishes and financial incentives to increase dementia diagnosis don’t lead to inappropriate actions being taken”.
Meanwhile, Dr Iona Heath, a former president of the Royal College of GPs, went further and said the scheme was an “intellectual and ethical travesty”.
Whilst GPs are rewarded financially for other activities, such as medical checks, this is the first time payments have been offered for diagnosing a specific condition. The scheme pays GPs who have signed up to it £55 for each new patient diagnosed with dementia between October 2014 and March 2015 and it is felt by some that this payment has the potential to divert GPs from acting solely in their patients’ best interests.
The British Medical Association’s GP Committee has said that the problem with dementia is not diagnoses, but providing sufficient support. There is a rising number of people suffering from dementia in the UK and it is estimated that there will be 850,000 sufferers by 2015, and as many as one million by 2025.
The recently introduced Care Act 2014 has been welcomed as it brings much needed clarity to the existing laws and also builds on the ‘best interests principle’ of the Mental Capacity Act 2005 by putting the patient at the centre of the decision making process. However, the government may be in some danger hre of undermining the doctor-patient relationship, key to encouraging people to forward and seek support and guidance, thereby defeating the very aim they set out to achieve.
There is no doubt that dementia can be a devastating diagnosis. Advice from a competent family lawyer can be invaluable when it comes to helping older people ensure they have control over their affairs should dementia affect them in the future. Planning ahead is very important and legal arrangements such as Lasting Powers of Attorney can be put in place for when they are needed, thereby addressing a common worry amongst older people who are concerned but who do not wish to hand over control prematurely.
