Working as a part-time salaried doctor often means that I am one of the last to find out about policy and payment changes in general practice. However, it did not take me long to find out about the payment that has been offered for diagnosing dementia.
The vast majority of GPs have suffered reduction in their earnings over recent years and for this reason it is not surprising that some GPs have considered this payment to be a relatively easy way of making some more money.
However, dementia is not a relatively easy diagnosis to make and it certainly does have significant implications when the diagnosis is made. As there does not need to have a specialist confirmation of the diagnosis of dementia for this payment to be made, there is real concern that a diagnosis of dementia may be made inappropriately for some people. This undoubtedly will have massive detrimental effects on both the patient and their family.
It is therefore no surprise that leading doctors and health campaigners have written an open letter to NHS leaders calling for withdrawal of this scheme. The letter points out that diagnosing dementia is difficult and subjective and that there is a real possibility of misdiagnosis. In addition, it is extremely difficult for patients to opt out of a diagnosis. Receiving payment for a diagnosis of a condition can undermine confidence and adversely affect the doctor-patient relationship, the letter states.
Since 2006 there has been a sharp rise in the diagnosis of dementia in England. This is thought to be mostly due to increasing awareness and diagnosis of the condition and better recording, rather than a large increase in actual prevalence of dementia. It is not known whether this payment scheme will lead to even more cases being diagnosed.
Interestingly, a recent poll has shown that over three quarters of GPs agree that practices should boycott the plans to pay money to diagnose dementia. Surely this money is better used towards caring those people who are already known to have dementia or to fund more research to find new treatments?