‘Survival bonus’ could deter surgeons from complex operations

Daily Mail
By David Derbyshire
21.07.2008

Surgeons will get cash bonuses for saving lives under a controversial NHS scheme.

Britain’s largest hospital trust is planning to pay doctors every time a patient survives the operating table or leaves hospital without picking up an infection.

Patients groups reacted with horror to the proposals, warning they would deter doctors from carrying out complex operations or taking on high-risk patients such as the elderly.
Operating room

The payments would be linked to mortality, infection and cost-effectiveness.

But Katherine Murphy, from the Patients Association, said there was a danger that complicated cases would be overlooked because they would not guarantee the best results.

‘Doctors already have a duty to provide high-quality care,’ she said. ‘I think good doctors would be insulted by the idea that they will only do their best on the operating table if there is extra money in it.’

Her comments were echoed by Professor Ellis Downes, a consultant gynaecologist at Chase Farm hospital in north London, who described the idea as ‘offensive’ and ‘ incredible’.

‘As a highly-trained professional, I do my very best for my patients and I do not need financial inducements to persuade me to operate even better,’ he said.

‘All our patients deserve the highest level of surgical care we can give them. It’s a bit like saying to an airline pilot, if you don’t crash your aeroplane we will give you more money.’

Dr Jonathan Fielden, chairman of the BMA consultants committee, said: ‘The outcome of an operation is based on multiple factors, including the severity of the illness and the relative health of the individual.

‘Other members of the medical team would also have fundamental roles in the care a patient receives and the outcome achieved.’

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