GPs should have to take financial responsibility

• Published in: BMJ Vol. 341; no. oct14 1; p. c5613
• Main Author: Ruta, Danny
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 2010; BMJ Publishing Group LTD
• Subjects: Budgets; Competition; Consortia; Hospitals; Opportunity costs; Performance management; Physicians; Population
• ISSN: 0959-8138; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.c5613

Because only by getting doctors to acknowledge that NHS resources are scarce, that every clinical decision has an opportunity cost, and that they should take financial responsibility for a finite envelope of resources can we shape a state funded healthcare system that reflects the health needs of the population rather than the interests of doctors, primarily hospital doctors, who have always wielded most of the power in the NHS. In effect the white paper's proposals force the group of doctors whose interests are arguably most closely aligned with the needs of the population to consider the opportunity cost of their clinical decisions so that they can maximise health gain for that population and reduce health inequalities with the resources available to them.