£55 for diagnosing dementia.

Think you're all worrying unnecessarily, I've never heard of the questions being that difficult.

Totally unethical.

Also, potentially dangerous as it act to encourage a diagnosis that may be wrong (and you would be stuck with it). There have been a couple of cases of wrong dementia diagnoses highlighted in the media recently.

I feel very strongly about this. A few years ago my DH developed a variety of symptoms that might be associated with dementia - memory loss, confused thinking, anxiety etc. A range of blood tests showed nothing. He certainly would have failed some of the dementia tests involving memory. It was not until he had returned to the doctors several times that a different doctor ordered a broader set of blood tests and found that his folate levels were dangerously low - under 2, resulting in all these symptoms. Within days of treatment with folic acid he started to improve and the symptoms had cleared up within a month.

Folic acid deficiency is not taken seriously IMO except when it involves pregnant women.

Were he to go to his GP today with those symptom I wonder, with the emphasis on dementia diagnosis that this £55 has highlighted, whether he would have been landed with a badly mistaken diagnosis.

They will be now, posie, with the lure of a £55.00 hand-out if the patient gets them wrong...

This is all part and parcel of the privatisation of the NHS. It's management consultants coming in and treating everyone as if they work in a business, for the money, instead of the NHS, for what it stands for. The BMA have already said GPs don't want this, patients clearly don't want it. But you can bet whoever suggested it is on a big fat management fee.

LIz46, don't suppose you can remember the name of that book about GPs, targets and payments? (Not a test )

Or has anyone else got any sources? I want to know when my GP is testing me for stuff they'll get money for. It's not exactly transparent.

My mother was certainly never asked to count backwards in 7s. I can't see how that test would help and many elderly people, who may also have some age related memory loss rather than dementia, placed under the stress of a test, would not be able to do it.

I just cannot see how the government sees this will help. Do they think the it will encourage the doctors to make calls on patients? Most of the people mentioned on this thread had relatives who could encourage the person to go to the doctors for the initial test. There must be many who are not in that position.

Do they think the doctors will pass it on to memory clinics where, in our case, the diagnosis was made? The waiting time for ours for undiagnosed patients continues to get longer as does the time between checks on progress.

Do the think the doctors will pass it on to the many unpaid relative/friend carers who, certainly in the initial stages, will be unlikely to be able to claim the Carer's Allowance as they will not need to care for 35 hours a week. Or will it go to those who get to the stage where it is a 24/7 watch with very little support. Or those who do reach the 35 hours (no other benefit is set at 35 hours, 30 hours is seen as full time for claiming) but are pensioners so cannot actually get any money even if they are eligible as they are already receiving a "benefit" in the form of the state pension.

Hopefully they may invest in the "named carer" plan that is to be set up for vulnerable patients. We had the letter, filled in the form saying "yes please" but I wonder how long we will have to wait for it to happen. It will support me supporting Mum so I welcome it but she is a physically fragile 94 so I hope they don't take to long.

Who, please tell me who, actually came up with this idea

I also worry that unscrupulous relatives with aged parents may latch on the diagnosis (which may be wrong or confusing with normal older person's forgetfulness) and see the potential for extra benefits or they may not be unscrupulous just unworldly and 'believe the GP'

Alchmillamollis, I asked my husband to look it up and it is 'sick notes:true stories from the gp's surgery' by Dr. tony Copperfield. (It says it is the pseudonymous creation of two practising gps). All the events are based on truth but obviously they have to be careful not to identify patients.

Could we expect a dramatic rise in cases diagnosed in the run-up to Christmas (or similar non-Christian festivals)?

whatamess - your description of your OH's incident highlights extremely well why this is such a dangerous departure. Clinical assessments and decisions should be based entirely on medical factors and not on financial incentives - it really is quite quite wrong and the BMA should be shouting this from the rooftops.

Encouraging a higher diagnosis rate for an illness where the resources to treat it properly are lacking is meaningless.

Gracesgran there is DLA available for the sufferer who requires either
Frequent attention for help with bodily functions
Or
Continual supervision to prevent danger to themselves or others

Good post Willshome

I heard on the news last night that most dementia patients have to finance their own treatment.

Sadly, it would seem that this is not a new venture (from an article dated 2008):

Dozens of incentive schemes have been uncovered which allow GPs to profit by slashing the number of patients they refer for hospital care.

Oxfordshire primary care trust will pay its GPs an extra £1 for every patient on their list for time spent discussing case details with colleagues, and a further £1 per patient on their list if they cut the number of referrals by an average of four per week. For the average practice, with an average referral rate, that could mean as much as an extra £12,000 income. 80 of the county's 82 GP practices have signed up.

The average family doctor, with a patient list of about 2,000 patients, stands to make between £6,000 and £9,000 if they achieve all the targets, on top of a performance-related pay system which already gives the average GP an income of £110,000.

Dr Alistair Moulds, a GP from Laindon, Essex, has refused to sign up to a South Essex scheme which pays the average GP practice £9,000 to hit targets to reduce pressure on hospitals.

Twenty-four practices have already signed up to the Essex scheme, which began in August, while all 62 practices in Wiltshire have agreed targets which could boost average GP income by £6,400.

Specialist doctors fear serious health conditions could go undetected and allowed to worsen.

www.telegraph.co.uk/health/3223309/Doctors-paid-thousands-not-to-send-patients-to-hospital-for-treatment.html

Then there are the links to the pharmaceutical industry (not easy to cut & paste that much info):

www.theguardian.com/society/2013/apr/05/drug-companies-pay-doctors-40m

That last link, from what I can make out, says that doctors receive financing to attend meetings if they discuss certain products during a talk AstraZeneca only supports "a limited number of doctors to attend international conferences in connection with contracted services", it said, which means they would earn fees for speaking rather than being sponsored to listen.

All very worrying.

What is dementia? Is it forgetfulness when all other causes have been ruled out?
My husband could not answer those questions the week before he was diagnosed with a brain tumour. That specialist said his memory was okay, which was surprising as it hadn't been for over five years since he was diagnosed with cerebellar ataxia.
His response to being asked the questions again before his diagnosis of the tumour was, "Oh, bloody hell, not again! Go and read your notes."

His mother now has dementia. It is obvious to all who visit her in her care home, but they do not see any point in having an official diagnosis, as it will only stress her more.

I think DLA is for those of working age who are disabled Galen although I am not sure what happens if you are on it as you reach state pension age. I think it is being replaced by PIP. The pensioner equivalent is Attendance Allowance and my mother does get that.

It's the Carers Allowance that you can't receive if you are getting your state pension, even if you are eligible although you can get a Carer addition if you receive either of the Pension Credits. Obviously you have be caring for 35 hours or more.

You wonder if it could be any more complicated

nhap.org/unethical-offer-cash-dementia-diagnosis/

Money would be better put into care.

This is an interesting statement from Dr Louise Irvine, of the National Health Action Party . She's a GP standing against Jeremy Hunt in South West Surrey in the general election.
“It’s offensive to offer money to GPs to make medical diagnoses. This is ‘cash for diagnosis’ and is unethical. GPs don’t need to be bribed to do a job they’re already doing, of diagnosing and treating or referring patients. In reality, GPs don’t diagnose dementia. It’s a complex condition and requires specialist diagnosis following appropriate investigation by a consultant. The money would be better spent being put into social care to support people with dementia or provide respite for carers.”

Says it all really. Anyone got a vote in Jeremy Hunt's contituency?

Oh you beat me to it durhamjen! She's right though isn't she? Sometimes it seems like all the politicians can come up with on the NHS is gimmicks, without asking doctors or patients what's needed.

Totally unethical. If diagnosing dementia is proving difficult for GPs then mandatory training is the answer not bribery. (Hasn't this been done before with cholesterol testing?)

alchemillamollis Here's an article about another book you might be interested in – though it's unlikely to cheer you up. www.theguardian.com/society/2011/may/22/plot-against-nhs-leys-review

On the lighter side, I spent six years looking after my mum who had dementia (including getting her diagnosed when the time was right). Like most carers I used to say "God bless Aricept", which probably moved the condition back about two years (though it doesn't work for everyone). We had a good time on the whole, though it had it's moments! I loved on the memory test that one question (which always gave me a bit of a problem!) was "spell 'world' backwards". She usually got it but one day she started "D-E-L..." the psychiatrist and I looked at each other in alarm. "...R-R-I-H-W"! Another one was to write a sentence, any sentence. One time she wrote, with a certain amount of scorn I think: "Are you happy in your work?"

One excellent thing they did at the carers group I went to was make us all take the memory test. No one got it all right – certainly without a lot of thinking – proving that it's not an either/or test just an indicator. As the NHA lady said, GPs can't diagnose dementia it has to be a psychiatrist. They'll be inundated now – creating another crisis!

Liz - I downloaded the book onto my kindle and had a good laugh - and cry - my OH was a GP - he got out before it got quite so bad, but the writing was on the wall. Micromanagement of a professional service is immensely costly and totally unnecessary.

You'll be pleased to know that GPs themselves are pretty steamed up about this too. www.bmj.com/content/349/bmj.g6424

I feel sorry for GPs who have to cope with this crazy 'bribe'. They must feel thoroughly undermined with all the interference they haven to put up with. No wonder fewer young doctors are going into general medicine.

As a family we all realised my mother was developing dementia but she was completely plausible whenever the GP and Domiciliary Psychiatrist talked to her. It was hard to diagnose as its development was so slow.

As I said on another thread, I think this is an insult to GPs.
As Willshome says, this condition should be in the sphere of psychiatrists, and can only be diagnosed after observation and various types of test over a long period of time.
To think that a GP would want to hang this label on someone after an interview in the surgery shows how little the originator of the idea knows about the whole subject.

When I took Mum to see her GP, she was swiftly passed on to the memory clinic which seems quite correct to me.

When she was asked to remember the address, ever Mrs Bucket, she asked who lived there!