One of the things that I’m learning from my CCG, is that away from the sharp end of patient care, where if you’re lucky enough to have an excellent GP like me, you are valued because you are a human being and a patient, to anyone further up the chain you are just a commodity.
Considering our CCG repeatedly tell us that they have no money, they have no control over how money is distributed to GPs etc, they are very, very keen to tell us how much we are all worth.
In fact, they know how much each and every one of us 2,418 patients are worth down to the last penny.
It is no lie to say that NHS funding is a minefield. When the CCG repeatedly told us when we met with them, that we didn’t understand, they were not wrong. The fact that they did spectacularly well at doing very little to help us understand did not make it easier, so please accept my apologies for any inaccuracies in this post.
What was clear is that there used to be two tiers of funding for GPs. One was called PMS (unfortunate acronym). The other is called GMS. Apparently PMS was a much more complex way of working out what doctor gets what money for what patient. GMS, as I understand it, and do correct me if I am wrong, is a more level playing field.
As such, it was decided that PMS should be phased out. GPs who were being paid on the PMS scale were given various options by which they could level their money to GMS standards. This is supposed to represent fairness and equality across the board for everyone.
I will not get into the figures that talk about how much more expensive it is to manage the health of a pensioner, or someone with a long term, chronic condition, than it is to look after your average hale and hearty person. That’s an argument for another time. This levelling is just the way it is.
One of the things the CCG do say they do, is try to make everything level for us. There was a lot of talk about fairness.
My doctor, they are keen to tell everyone from the milkman to the prime minister, is not being fair, because when PMS was a thing, he had it, and he had more money than other doctors in the city. He is, in fact, the third highest paid doctor in the city, per patient. He still has PMS funding, because he has chosen to lose his extra money in incremental chunks, year on year. This was an option that was offered by the NHS funding body, and he took it. It was perfectly acceptable for him to do this. Although you might be excused for thinking that it was akin to eating babies if you talk to those people who think it’s unfair of him.
There are other doctors in the city with PMS funding. We did not go into the fairness or unfairness of their salaries, specifically not the two people above him, or anyone else below him but still above what is now considered to be fair.
What is considered fair in the current market is about £70 per head.
That’s what all of us are supposed to be worth to the NHS funding bodies. I hope you’re feeling a warm glow about it. How special we all are.
I’m more special than you. This is what’s unfair. Currently I’m worth about £97, as are my 2,417 special friends.
I do feel blessed.
We are a valuable commodity to those people who see us as units to be moved around and cost savings that can be made.
Funding, you see, travels with patients.
To my current GP, I am worth £97. When he closes his surgery and I register with another GP, I will be worth about £70, because ‘fairness’, and all that.
What of the other £27 I hear you ask?
The CCG do not set GP funding rates. The money travels from NHS England, through them, to the GPs. I am not sure why this is, if as the CCG say, they don’t have any control over what happens to that money. If this is so, why don’t NHS England cut out the middle man and pay GPs directly?
I can’t possibly be expected to know. I’m just a valuable commodity, not a clever one.
The fact is, that they don’t. So, when there is an extra £27 per person kicking around that has already been allocated to me and my friends, but will not go to my new GP, who gets that extra money?
I’ll let you guess.
I’m sure it will be used fairly.