Coming Soon: Britain’s Got Surgeons – and You’re the Judge
Forget scalpels; doctors now need five-star ratings to get paid. Welcome to Britain’s Got A&E, where your appendix removal might hinge on Sharon’s opinion of the yoghurt.
Years ago, I was awarded ‘Columnist of the Year’ by a panel of judges who to this day, I suspect were either high, misinformed, or had me confused with the other bloke who writes about sourdough and swearing. What do you mean I’ve said this more times than Keir Starmer’s mentioned his working-class roots and his dad’s factory job? I digress…
But still, it was flattering to be publicly rewarded for something I’d done, even if that something was moaning about bad coffee and near-death experiences in NHS car parks.
Which is why this week’s government plan has a certain twisted logic to it; pay NHS doctors and hospitals based on performance. That’s right. We’ve officially entered the Britain’s Got Talent phase of healthcare; except instead of pressing buzzers, we’ll all be tapping stars on the NHS app while eating digestives and recovering from colonoscopies.
Now, on the surface this sounds like a radical, innovative, patient-empowering idea. But then again, so did NFTs and look how that turned out.
Under Sir Keir Starmer’s ten-year NHS masterplan, presumably scrawled on the back of a Wetherspoons menu during a particularly optimistic lunch break, hospitals will only receive full payment if patients say their experience was a good one. If not, a chunk of the fee will be docked and redirected to an “improvement fund,” which sounds suspiciously like a swear jar for underperforming wards… or an MP’s pension fund!
This means that somewhere in Aberystwyth, a surgical team could flawlessly perform a life-saving triple bypass, only to lose funding because Sharon from accounts didn’t like the yoghurt at breakfast.
Because here’s the thing about performance-based pay in healthcare, it only works in industries where the outcome is clear and not based on Barbara’s opinion about bedside manner or whether Dr Ahmed smiled while diagnosing her with gout. It’s like giving a Michelin star to a restaurant based on whether the waiter complimented your earrings; not whether the fish was fresh or your pudding was still alive.
So what about departments where a “great outcome” is someone dying with dignity rather than screaming into the fluorescent lighting? I’d imagine the mortuary staff won’t be racking up many five-star reviews. “Brian was cold but peaceful. Two stars—room for improvement.”
It’s performance pay, but not as we know it.
This system will apparently be trialled first in maternity wards, which let’s face it, are already underfunded, overstretched and staffed by humans who look like they’ve just come out of a hostage situation. You now want to tie their funding to a post-birth survey? After a 38-hour labour, I’d rate a three-star hotel as “satisfactory” if they offered me a biscuit and a working toilet. Objectivity is going to be, shall we say, fluid.
Who exactly is designing these surveys? Are they going to ask relevant medical questions or will it be like Uber?
Q: Did your appendix removal arrive on time?
Q: Was the theatre clean and free of surgical leftovers?
Q: Would you recommend this operation to a friend? - (My GP loves a good survey after every patient visit! )
The plan also includes giving bonuses to staff who shorten waiting lists, which feels a bit like paying a magician based on how quickly they can saw someone in half. Shorter isn’t always better, something I tell Mrs G regularly; unless you’re queuing for a Gregg’s.
Meanwhile, the NHS Confederation is already nervously waving red flags, warning that “patient experience is determined by far more than their interaction with a clinician”. Translation; if Margaret’s operation was textbook perfect but the vending machine was out of KitKats, someone’s going to lose funding.
Wes Streeting insists this is about “giving patients power and control,” which I assume means more swiping, more rating, more blaming; and ultimately more underpaid staff quitting after being judged less favourably than a Costa barista.
So what’s next? Will paramedics get performance bonuses if the patient doesn’t scream too loudly during CPR? Will oncologists need to juggle or do TikTok dances to get full payment? Should GPs invest in softer chairs and essential oils? Just getting an appointment in a few days would be nice!!
Here’s a radical thought. If we really want better care, how about we start by fully funding the basics, such as more staff, equipment and functioning fax machines; before slapping the NHS into a reality-TV format? Rewarding excellence is a noble idea. But this isn’t a sports day. People’s lives aren’t medals to be won or stars to be tapped.
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Chris Geiger, Author of The Cancer Survivors Club.
Daily Dose of Disbelief!
Bsky: @chrisgeiger.com
Bsky: @thecancersurvivorsclub.com
Bsky: @dailydoseofdisbelief.com
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