Yet another example of foolishness within the healthcare sector has been highlighted through this story on surgeons being offered bonuses by a hospital trust for successful operations. Although the trust concerned has been careful to suggest this will only apply to specific procedures where outcomes can be easily measured, this sends completely the wrong message to both surgeons and their patients about the value and importance of their work. The government is of course refusing to take a position on the trust's scheme, other than to say that it is not official government policy.
The purpose of incentivisation, when properly applied, is to spur the recipient into stretching their performance boundaries to greater heights. Quite frankly, if a surgeon is not already performing to the highest standard possible, they should be removed from their position. This is not a sector such as finance, where the non-maximisation of revenue merely means an institution will walk away with smaller profits. If surgeons are not doing their jobs properly, it is their patients who will suffer real physical consequences. Equally, it stands to reason that no matter how principled the person concerned, if a system of incentivisation starts appearing, it will become far more tempting to perform those operations that yield the best chance of income augmentation (i.e. the 'low hanging fruit') to the detriment of more difficult procedures that do not.
I am sure that both surgeons and patients will not welcome this implied assault on surgeons' current performance as well as the implication that a fistful of pounds will make a huge difference to the service they provide. If you want healthcare to operate more like the free market, I'm fine with that. But let's not waste taxpayers' money tinkering around the edges and paying people to do the jobs they already do to the highest standard possible.
