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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:
FaffingForEngland · 16/09/2020 09:44

There are under 25 clinics, but certainly in our area as an example, the majority of clinics are open to all ages. I agree about timings, although again our local service offers evening and weekend appointments. Maybe we are just lucky here.

Not sure about trusts, as SH services are commissioned by local authorities rather than trusts as it is a PH function rather than NHS, although trusts may actually deliver the service. We should be lobbying our LAs for improved services, although I don't expect we will get very far.

Batshitbeautycosmeticsltd · 16/09/2020 13:50

Very lucky. Many areas here have no such services anymore. It's the first to get cut probably, as of course, most users are female. I'm past the age of needing contraception but have plenty of friends who source contraception privately due to not being able to get a GP or appointment, no family planning clinics, GPs who tell them certain brands are no longer prescribed by the NHS (usually more expensive versions of the combined Pill) or what they want is unavailable but how about a Mirena instead.

FaffingForEngland · 16/09/2020 18:00

I've just had a quick look on the local SH website as it's a while since I worked with the service, but I am able to order the pill online (either sort) and/or free condoms, all delivered by post. Appointments are available for injections, the implant and coil fittings. No walk in service, but that's just because of covid.

Batshitbeautycosmeticsltd · 16/09/2020 18:02

@FaffingForEngland

I've just had a quick look on the local SH website as it's a while since I worked with the service, but I am able to order the pill online (either sort) and/or free condoms, all delivered by post. Appointments are available for injections, the implant and coil fittings. No walk in service, but that's just because of covid.
That's great! If only that were true across the boards. Loads of threads on here from women who are not able to get a coil or implant fitted/replaced or removed.
Standrewsschool · 16/09/2020 18:15

Doctors are encouraged to complete QOF targets, which means they get paid for fulfilling certain services. That’s not new. The money doctors get for basic services is actually quite small apparently, and they need all these extras to make the surgery viable.

FaffingForEngland · 16/09/2020 18:17

Agree that it should be across the board. We need to lobby LAs on this. If my county can do it, every county should be able to.

Graphista · 16/09/2020 18:31

Sexual health clinics offer contraception. That's why they aren't called GUM clinics these days. GU medicine and contraception services have been amalgamated into integrated sexual health services.

I get what you’re saying and personally have for a long time preferred to go to sexual health clinics for gynae matters...

BUT there are 2 factors you haven’t accounted for

1 there’s still a HUGE stigma to going to/being seen at “the clap clinic” in most areas the location is known to locals and difficult to access via public transport and ime often in an obviously different location to other primary care services or even where I am currently the nearest hospital. It’s not even in the same part of town as the hospital! So if you bump into someone you know it’s outing and embarrassing for many

2 they’ve been hit VERY hard by the cuts possibly more than other areas of medicine I’d say. Our local one when I first moved here was open 5 days a week 8-6, it’s now only open 2 days a week 10-3 and you can’t just walk in any more, you have to make an appointment and it can take quite some time to get one and certain times are allocated to certain clinics which may well not be convenient for many patients.

Now yes “inconvenience” is one thing but I’m also thinking of all those shy teens and domestic abuse victims who may need to access the services outside the times designated for whatever reason they’re attending and are now no longer able to.

Also where I am is very much mostly rural residents and the sexual health clinic while relatively close for me personally covers I believe residents as much as 25 miles away (as the crow flies) and some of those residents have to get a ferry to the mainland first it’s quite a trek! Not something they can necessarily undertake discreetly

Postal services to the islands are quite hit and miss too and for vulnerable patients might not be a safe method of accessing contraception in terms of their home life

Another issue where I live (and before anyone says yes I know it SHOULDN’T be) is LACK of confidentiality. It’s a VERY small town and everyone DOES Know everyone! Not so much an issue with the gps but there have certainly been issues with certain practice nurses and admin staff! Yes it’s been dealt with afterwards, but by that point the damage was done!

I had the experience of a member of admin staff from my sisters surgery (we don’t even share a surgery) revealing my sisters last pregnancy to me in the bloody supermarket before she’d even had her first appointment relating to the pregnancy! It was unplanned and for all that staff member knew my sister wasn’t planning on continuing the pregnancy. I’ve also had someone from my and dds surgery call and tell me her pill prescription was ready to collect, now dd and I have an open and close relationship so I knew she was sexually active and on the pill BUT the person calling didn’t know that!

Made complaints on both occasions but both incidents if damage had been caused by those breaches of confidentiality it’s too late to undo that damage by that point.

@standrewsachool but by finding primary care in such a way bias and conflict of interests comes into play.

If gps come out better financially by “encouraging” patients to accept a specific type or brand of treatment then it affects their decisions on what to recommend to patients

The nhs is SUPPOSED to be protected from the influences of commercial pharmaceuticals and medical manufacturers yet practices like this make a nonsense of that.

What is recommended to a patient should be primarily based on CLINICAL best practice NOT on govt backed promotion of certain treatments/products

Given how hard the sell is on mirena in particular is happening I feel confident that someone somewhere has had a backhander!

Because it's not just hormonal iud's being pushed but a particular brand! There are other types and brands of hormonal and non hormonal iuds plus other LARC which doesn't get anything like the constant hard pushing mirena does!

You'd think they'd learn from the mesh debacle apparently not!

Graphista · 16/09/2020 18:34

@Standrewsschool that should say "funding" not finding in the start of my reply to you

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