Sir – We should all remember that the Nuffield Orthopaedic Centre’s “serious financial problems four years ago” (Report, September 9) occurred despite excellent management, largely because the Department of Health introduced a defective payment by results scheme biased against the specialist hospitals.
In an extreme case, under that scheme “business” could have been done more “profitably” in a non-specialist NHS or independent sector hospital by amputating a patient’s leg and receiving £9,279 for doing so. Saving the limb cost £19,960 but earned the hospital only £1,934, a “loss” of £18,026. Which did the patient prefer?
The moral? Reorganisers: please ensure that clinicians will be able to do what is right for patients, even if it means challenging absurd schemes generated by departmental officials far from the front line.
Geoff Feasey, Former member, NOC Network and Patient Liaison Group, North Leigh
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