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Sunday, 21 June 2009

To the NHS, you are merely a number

If you've visited your GP recently, you may have seen the NHS 'It's your choice' logo before. Please don't snigger at the irony.

Anyone who chooses to enjoy tobacco (and who doesn't lie to their doctor to avoid the rigmarole) will have endured, at some point, the lectures from their GP when visiting their practice for anything from an in-growing toe-nail to a broken tibia.

The problem is that, to the NHS, you are just a number.

PSA Targets (from the Department of Health Public Service Agreement, 2004):
• Reduce adult smoking rates to 21% or less by 2010 (currently on target nationally)
• Among routine and manual groups to 26% or less by 2010 (currently not on target nationally)

Ever eager to be the bully's best friend, the Lib Dems think we aren't being hectored enough.

The Liberal Democrats have called for an end to the smoking cessation element of the quality framework (QOF).

[Norman Lamb MP] described payment for telling patients to quit smoking as 'crazy'.

'There should be payments when people actually quit, and nothing less,' he insisted.

Really? Like these paid by Warwickshire PCT, for example?

GPs and Pharmacies are reimbursed for service delivery (inflation still to be applied for 09-10):

£10.50 for each client setting a quit date
£40 for each client still quit at 4-week follow-up
£10.50 for each client not quit at 4-week follow-up. No additional payment for those not followed up at 4 weeks.
Pharmacies only - £3 per supply of NRT

So, these paid-for stages, what happens in them then, I hear you ask.

Contact 1: Plan strategy for quitting, including assessment for drug therapy including carbon monoxide test, access to nicotine replacement therapy, Zyban® or Champix®

Contact 2: Possible quit date
Ensure access to NRT, Zyban® or Champix®. Carbon monoxide test

There seems to be a lot of reference to NRT and Champix there. Not much about willpower and Allen Carr, though (note 500+ reviews and a 5 star rating). I wonder why?

Could it be that other PCTs are like Warwickshire?

Joint working with Pfizer around targeting of clinics/drop-ins

Joint working with Pfizer to develop more effective recruitment campaigns in N&B, also targeting health professionals to refer more and more effectively.

If it surprised you to learn that your GP is being paid bonuses for giving you the third degree, perhaps it won't be as astounding to know that Pfizer profit from NRT in general, and are the sole supplier of Champix.

Of course, if you stand your ground and state categorically that you don't wish to quit, there is always the ultimate threat from the healthist lobby.

Well, the smoker prevalence simply MUST come down to that arbitrary 21% ... one way or another.


Anonymous said...

Just who goes round counting the numbers ? I estimate that 6 out of every 10 people that I know are smokers. None hardly ever buy cigarettes in the U.K. and many just don't tell the G.P. that they smoke (or the insurance company)
So how these figures are reached is a mystery.
In other wrds 'a load of bollocks'

Dr Benson Hedges said...

If you want to see what they have planned then

the link will take you to the following



TheBigYin said...

Dr. Benson Hedges lol, I love that nick.

Thanks for the link too, we now have a stored copy.

Helen said...

I'd love to know the true figures for smoking prevalence as well.

I'm similar Anon. I socialise in a group of 9, and only one is a non-smoker - who doesn't give two-hoots if we're smoking either.

Wouldn't it be funny though if the LibDems proposal went through? Millions could swamp the surgeries for their 'quit smoking' advice, clog up the system, and just light up and laugh when they walked outside.

It would serve them right after milking the tax-payer for so long, making millions with their links to Big Pharma, and treating their fellow country-men with contempt.

This is just big business for all those involved. It stinks.

Alan Wallace said...

Have you noticed all the "services" available at your Doctors recently? Here's a selection - Well Woman, Well Man, ABC (for patients who've had heart surgery), Travel (vaccinations for foreign travel), Diabetes, Over 75s, Asthma & COPD, Influenza vaccinations, Smoking Cessation, Dietician, etc etc etc.

Surgeries get paid a fixed fee for everyone who attends or uses these services. It's big business. I was at a smoking cessation climic that had 4 groups a week, with 8 in a group. Minimum £320 a week. It's similar numbers for other "services". Surgeries are making thousands a week out of these services. It's supposed to pay for specialised practitioners but it doesn't work like that. They use the same practice nurse to cover all or most of the services. She gets paid a fraction of what the services generate - the rest goes straight into the Doctor's pocket.

My mother's a District Nurse. The District Nurses traditionally had an office in every practice. These have all been withdrawn and the District Nurses kicked out so the space can be utilised for extra service provision.

They've turned Doctor's Surgeries into money-making enterprises.

Screaming Banshee said...

I was pressured by my doctor to have a smear test done. Something I have been avoiding for the last 7 years. For people who don't understand it is not a pleasent experience which is why I have avoided the whole thing as best I could. I know I am due to have one and my doctor was only thinking of the money, but he should have done it with a bit of respect instead of bullying tactics.

What makes it worse I decided to quit smoking in January (think the smoking ban is a disgrace) but gave up for me alone. I did it cold turkey and I have been very pleased with myself. Whilst I was at the doctors my doctor asked if I was now an ex smoker, which I thought was a bit quick. I thought I would have been classed an ex smoker after a year at least. He then told me I was over weight and if I could give up smoking cold turkey then I could lose weight without any problem. I am between a size 14/16. I have a bit of a stomach, but I feel good about myself and my partner likes me the way I am too.

You can imagine I was not happy at all with the docotors appointment and will be thinking again before I go to see him. I will wait to see his partner who has a better bed side manner and treats me like a human being and not a pound sign.

TheBigYin said...

Screaming Banshee my wife went for a smear many years ago after getting a letter to do so from the doc. She said it was a thoroughly nasty and horrible experience and ever since then she puts the yearly letters in the bin. I only go to my doctors when I need to, not when they want to make money out of me.

I used to be able to phone my doctors surgery on a direct line but now they changed from a six digit number to one with double that then I go through purgatory as I go through the usual routine of press this that number etc to get told I'm in a queue..all this takes a good five minutes or more costing me a fortune and no doubt making my doctors some extra cash. I also got the obligatory phone call asking if I smoked and would I like to come to their ceasation classes..well you can guess what I told them.

We, the public are beeing fleeced at every turn.

Screaming Banshee said...

I had gone to see the doctor for a total different reason.

Something flashed up on his pc and then I got it with both barrels.

Anonymous said...

Dick, I wonder how just how much the damge the drugs companies are doing to the health of the people, I know they do some good work, but how much are smokers blamed for their mistakes. They make plenty of them, google Pfizer cover-ups, then every other BIG Parma company. Here are just a couple-
Employee who lifted the lid on Pfizer's drug marketing scam gets £15m payout
Warner-Lambert was heavily promoting a drug called Neurontin, which had been approved as a treatment for epileptic seizures. But it wasn't stopping its marketing efforts with the drug's approved use. Instead, Dr Franklin was expected to argue for the product's use as a treatment for manic depression, attention deficits, even migraines and alcohol withdrawal.
When Dr Franklin found evidence of side-effects in some children he was ordered not to tell doctors. "I was the individual paid to lie to doctors," he said. "I got involved in something I didn't realise was wrong at first." He collected evidence, including documents and tape-recordings of voicemails, and took them to lawyers in Boston, who launched the massive claims for fraud that led to this week's settlement.
Pfizer admits to having study linking Celebrex use to heart dangers
I have read about the dangers of statins a couple of weeks back, my fiends husband has every bloody side effect, she asked the doctor to take him off of them, he had scans and they could not really come up with anything, then asked my friend if she would like him to go onto alzhiemer pills, errghh, he did, but for an unknown diagnosis.
He lost his speech ability (slurring, confusion,) lost his ability to write, but the fact he kept on trying, without being prompted was a good sign.
He has improved over the last couple of weeks, but he is not back to normal. We are hoping not taking the statins is going to work.
She was never told about the side effects, although it would have been on the packet, but I cannot work out why the doctors did not even consider the problem might have been the pills before sending him for a brain scan.
I am more angry than her about all this. If any of your readers are on them, and they have had strange things going on with their bodies or minds, speech ect, I hope this may help some-one quicker to work things out.
Dick, sorry about the long post and rant, but it is the first opportunity (your article) thank you, I have had to vent my spleen about this one

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