The long wait

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DAVID Cameron’s latest defence of his NHS reforms, and the decision to further empower GPs, looks even more hollow when the financial ramifications of inaccurate waiting lists are taken into account.

If some GP surgeries cannot complete a basic accountancy procedure and keep their records are kept up-to-date, how can they be expected to spend £65bn each year on the commissioning of key services?

Unknown to many, doctors are paid £64.50 a year for each patient on their books – it is a relatively straightforward, and equitable, way to help fund some of their work.

Yet closer inspection by the Audit Commission has now led to nearly 100,000 ‘phantom’ patients being removed from these lists – including one individual who had passed away in 1969 and another 157 who died before 1980. There were other anomalies – 20 patients registered at one property. While this would not be unusual in the case of a nursing home, it does point to record-keeping that is sloppy at best.

Of course, this system is not totally fool-proof. It relies on the co-operation of patients, or their relatives, to inform their GP of any change of circumstance. And, while there will always be some individuals who see their doctor sparingly, a non-attender dating back more than four decades should have been spotted before the auditors examined records.

The sum saved from this latest review, £6.1m, is not a significant one at face value but its importance should not be under-estimated. Because of the way funds are allocated, it is those GP surgeries with the correct procedures in place that are being punished because of their desire for accuracy. And that cannot be right.