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Feminism: Sex and gender discussions

GP cash incentive to promote long acting contraceptives

58 replies

EarthSight · 14/09/2020 22:29

www.theguardian.com/society/2020/sep/14/gp-cash-incentive-linked-to-fall-in-uk-abortion-rates-study-finds

My experience with GP healthcare is that I sense that many GPs, wishing to keep to their tight 10 min slots, seems to want to prescribe contraceptives for anything and everything. Sometimes I feel like they view the female body as something abhorrent in it's pesky complexity, it's cyclical nature, so it's simpler (for them), to just prescribes contraceptives.

Now that I've seen they apparently had cash incentives to do so, how can we ever know how many GPs recommended these, allowing the cash incentives cloud their judgement instead of focusing on what was right for the woman? How many cases could there have been where there was option a) b) or c), but only option b) was mentioned or encouraged?

Some might say 'but was the cash incentive ever really big enough to make a difference?'. I would say yes, hence why they offered it in the first place to individuals who are already well paid compared to the general population.

I'm not against contraceptives, but I am against lazy healthcare who treat women's bodies are troublesome.

OP posts:
Melroses · 14/09/2020 23:31

I was on the COC for many years.

When I changed doctors, I could see my notes online. Apparently I was counselled on LARC on more than one occasion. I used to go for a review once a year, and the dates did not even line up with that. Hmm

Strangely I cannot remember any of the occasions, but I do remember endless questionnaires on my lifestyle (converting to low fat spread) and my alcohol intake. And if I smoked - over and over.

Graphista · 14/09/2020 23:10

@StrawberrySquash I've had a LOT of pressure to "consider" mirena coil even to the point of implication that I would have "difficulty" getting pain relief prescribed for the endo.

There are numerous threads/posts on here by women who've had that experience and if you google you'll find more.

Just because that's not been your experience doesn't mean it's not happening.

Graphista · 14/09/2020 23:06

@Babdoc you're erring dangerously close there if not actually saying that such decisions are necessary due to certain women being morally ineligible to make their own decisions on contraception!

Whatever the patients background they shouldn't be pressured to having an invasive form of contraception that cannot be stopped immediately if it causes them illness or distress (which many patients HAVE reported) AND they shouldn't be facing the obstacles they are in having them removed - even if it's only because they've changed their minds! Certainly if they're in pain/distress!

Whatever happened to bodily autonomy??

Sayings "it's not that much money" is a nonsense - if it weren't an effective incentive it never would have been introduced in the first place!

Plus we're constantly getting told on here that gps DON'T earn £100,000 high salaries - so what's the truth there? Starting salary is £60k Ish and if they're not working full time they won't even get that.

Please don't insult our intelligence by claiming all gps are altruistic saints! It's just not true

StrawberrySquash · 14/09/2020 23:04

The incentives were not linked to actual uptake of the methods.
I think this point is important to note. I've certainly been asked, but not pressured. It felt more like a tick box exercise, TBH and I think LARC can make a lot of sense for some people, so information is a good thing.

Babdoc · 14/09/2020 22:53

According to the article, each practice would receive a measly £700 for a whole year of offering long acting contraception to all eligible patients. GP salaries are over £100,000, so I think you’re misguided to believe they’re doing this for the money!
The truth is simply that implants and coils are far more effective than the pill or barrier methods for teenagers (who forget to take them regularly or use them incorrectly) or women with chaotic lifestyles such as addicts.
An implant protects a teenager for three years against unwanted pregnancy, with no further action needed on their part - it’s an excellent way to reduce the abortion rate.
Do give doctors credit for trying to do the best for our patients. If we were motivated by money, we would have gone for careers in investment banking, not slogging our guts out in the NHS!

Graphista · 14/09/2020 22:48

I have been talking about this on here for YEARS and certain posters inc ones claiming to be hcps even gps have accused me of exaggerating and even lying!

Well now it's there in clear black and white in a mainstream publication!

It's an outrageous policy which does women a huge disservice.

It's a massive conflict of interest in my opinion straight off!

There are quite a number of threads/posts on here by women who've been manipulated into accepting insertion of the mirena coil in particular who've had an absolutely HORRENDOUS experience both of the coil and in terms of huge obstacles in getting it removed.

I found some "allusions" to this scheme in various medical publications (lots of "ifs buts and maybes" though) and to what I believe to be fact that there are further incentives to insert and NOT remove these devices.

I'm not saying they don't have their place, for some women they can work very well and can be very helpful

BUT the way the whole situation has been handled smacks of medical coercion, there's been a huge lack of honesty on the whole matter and some women have been physically harmed permanently.

The patients needs MUST be the priority at all times and as soon as you introduce financial incentives for anything medical I truly believe that goes out the window!

Medical misogyny generally is a massive problem not just in the Uk but certainly is a factor in primary care here.

There is also financial DISincentive to gps referring patients to specialists

My own personal history is of long undx endo, many years of suffering and loss (mc) before finally getting a dx basically by accident due to needing surgery for last mc and surgeon seeing it!

Unfortunately we are socialised "not to make a fuss" PLUS if you DARE to complain about a gps actions you can very easily find yourself "black balled" and struggling to be registered with one - again denied on here, officially not meant to happen but it can and does!

Makes me so angry

EarthSight · 14/09/2020 22:47

I think you do have a say, but I've heard I.U.Ds can be costly so once they're in they probably have to really justify why they're discontinuing it and some women might feel pressured to carry on when they din't want to.

Injections are great if they work well, but if they just don't agree with someone for whatever reason, then there's no pulling that out if the body. It can be a tough ride for a few months if you happen to not like it.

I find it amazing that hormonal contraceptive care isn't tailor-made to each women's body. There are different pills and other things to try of course of various strengths, but I don't think any GP tailor makes doses to suit individual women.

OP posts:
Whatwouldscullydo · 14/09/2020 22:34

Equally isn't it difficult to get coils and implants removed?

Like once they are in you have no say about whether they stay in your body or not.

I'm sure I've read many a thread here from women desperate to get their contraceptive removed

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