[1QuirkyKiwi]

Originally Posted by Toughy

What you are saying about how GPs are paid is not really true. Here is a link that explains how docs in the UK are being paid under the new contract.

http://www.bma.org.uk/press_centre/p...p#.T2jtiBHy_Qg

How general practice is funded

Almost all funding in the current contract is practice-based. This means that payments are made to the practice and not to individual GPs. Expenses - for example, rent, utility bills and staff wages - are taken out of this funding pot and the amount remaining, after the cost of providing clinical services has been taken out, makes up the pay available to the GP partners.

The funding formula is extremely complex and funding is distributed to practices according to the weighted needs of their population - for example a practice with a large elderly population, and therefore a greater workload, will get more funding than a practice with a relatively young, healthy population.

GP practices receive their funding through several major streams, though the main ones are the Global Sum, the Quality and Outcomes Framework (QOF), and Enhanced Services:

Here is an abstract from Health Affairs (www.healthaffairs.org)

Quality Incentives: The Case Of U.K. General Practitioners
Peter C. Smith and Nick York

Abstract

The United Kingdom is implementing major changes to the national contract for general practitioners (GPs). A central plank of the new arrangements is an ambitious scheme to reward high-quality care. Each general practice will be scored on 146 performance indicators according to the measured quality of care it delivers, and its accumulated score will determine the magnitude of the quality payment it receives. About 18 percent of practice earnings will be at risk. This paper describes the incentive scheme, discusses its potential benefits and risks, and draws out the implications for evaluation.

One of the things that has happened under this new contract is the significantly increased number of folks being diagnosed with diabetes. It has been written up in several medical journals.




It is my understanding that New Zealand has a two-tiered payment system, although I have not done recent research on their system. (I lived in NZ in early 2000 and received health care there...)



There are plenty of inaccuracies about how nationalized health care works in other countries being said in the US. I just hate seeing more put out there.

My cousin works for the same NHS I’m talking about and has done for many years. He has known of the financial incentives being paid to GPs. Several Locum Doctors have been prosecuted in recent years for misusing funds.

In NZ Primary Care (GPs) and medications on the list of the New Zealand government agency require co-payments, but are subsidised, especially for patients with community health services cards or high user health cards; low income families and the disabled. Surgeries and other medical treatments are paid for by health insurance schemes for members privately. Those that can be for treatment, do.