Should GPs be paid for performance?

Doctors could boost their pay by up to €9,000 a year under a new bonus scheme that aims to reward the most efficient practices around France.

From next January, they will be set targets and assessed against 30 key public health criteria, including vaccination rates against seasonal flu, cancer screenings and ongoing care for people with diabetes or high blood pressure.

GPs will also be rewarded for prescribing generic medicines instead of more expensive brand names, and for using computer software instead of paper forms.

Do you think this is a good idea? Will it save the French social security system money by encouraging GPs to be more efficient? Connexion newsletter readers share their thoughts below...

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This is a retrogressive idea. Treating doctors like factory workers on a production line will do nothing for the confidence one has in a GP and one wonders why the proposers of such schemes do not pay more attention to the latest medical research. The scheme will encourage GPs to offer more vaccinations when so many are coming under suspicion as being if not actually detrimental to health then a least not effective. As for cancer screenings the controversy goes on as to whether they are a good or bad idea. So who will be the biggest benefactors of this scheme.. perhaps the drug companies?

Mary Welland

I don't agree at all with GPs getting rewards for doing a good job! They should do a good job because they are good doctors, because that is their profession and they should be good at it or else do something else!

Looking after people's health should be taken very seriously, not only done because you get more money if you do it properly! The modern idea that people have a salary but then earn more if they do their work well is very weird! It almost means that their pay doesn't mean they have to be good professionals, the bonuses do!

Moreover we now know that one should be very careful before getting a vaccine or letting our children get one. Will a doctor be objective about it if he earns less in case he gives you the advice not to get the vaccine? The same goes for cancer screening! I have got informed and decided against it.

Once a gynecologist told me that he absolutely agreed with me but then a naturopath told me he was not allowed to say that even if it is what he thinks! Meaning... You go to the doctor but you can't trust his advice because in the end he is only advising you to do something so that he is better off financially.

This is the reason why nowadays, unless I can't solve a health problem myself, I never go to the doctor! I avoid them like the plague because I know that mostly they will lie to me and probably advise me to do things they would never do themselves and would never let their own children do. Even as far as paying them to prescribe generics I
don't agree, it sounds like blackmail. They should prescribe generics because they have the best interests of the patient at heart!

And 9.000€ is a lot of money! I am sure most GPs will do a lot of things they don't agree with only to get that sum of money. Unfortunate but true! There are countries where they are paid a lot of money to get everybody on statins, or to declare people as being diabetics without that really being the case but well, for money they will do a lot of things which are not correct and even go against the patients' best interests.

Therefore I am against giving doctors extra money to get them to do anything at all! They are professionals and should do whatever their professional code requires with all integrity and not because they are bribed! Anyway, it should be part of their normal work to detect illnesses before they become severe, if they don't they should be punished, not rewarded for doing what they should be doing anyway!

And as far as medical deserts... I am sure the oldest among us still remember the time being a doctor was a job of passion and dedication, not something you did in order to get rich. Even remote villages had a dedicated doctor who did a very rewarding doctor. Maybe we should go back to the way things were before being a doctor meant earning a lot of money!

Francisca Rigaud

Until French doctors stop prescribing "holidays" in the alps for "the cure" and other lavish treatments for sometimes relatively minor conditions, the French health system will continue to run at a huge loss. This is paid for by those of us who pay our taxes and CRDS in France.

Prescribing generic drugs may save tuppence halfpenny but cutting out the over-prescribing of drugs such as Paracetomol and Ibuprofen will save a lot more.

We enjoy one of the best health systems in the world, but it needs to be made a whole lot more efficient if it is to survive.

Dick Smith

If French GPs are to be set targets to earn more money, lets hope it does not in anyway reduce the amount of time they spend with a patient, as they have so got it right compared to the UK!

Wendy Scholefield

Although generic medicines can be as effective and far cheaper than brand names they are sometimes definitely not as good. In these case only the brand name should be prescribed. I know from my days in medical practice.

Dr Bernard Juby