‘Don’t Make Us Pay For Scotland’s Obesity’

Doctors have demanded that targets for dealing with obesity – which earn them cash – should be cut from their contract. GPs from across Scotland agreed yesterday that “lifestyle issues such as obesity” should be excluded from their incentive pay scheme because they can do nothing about it.

The stance, adopted by Scottish General Practitioners Committee (SGPC) at a conference in Glasgow, could prove hugely controversial. The vote was passed as figures were published showing the average UK family doctor earned £100,170 during the first full year of their new pay package.

Surveys reveal that two-thirds of Scottish men are overweight or obese despite the millions spent trying to change eating habits and pressure is growing on politicians to make a difference to the nation’s diet. A programme which offers weight loss plans on the NHS and which is run by GPs has already been launched in some of Scotland’s most deprived communities.

However, doctors at the British Medical Association GP’s conference in Clydebank said there was no evidence that medical intervention at surgeries made any difference to obese patients.

Dr Dean Marshall, chairman of the SGPC, said: “If you take alcohol there is some evidence that if a GP says how much do you drink’ and it is over recommended levels, it does something. People realise they are drinking a bit too much and do something about it.” In contrast, he said, there was no evidence to suggest that talking to patients about their size had an impact.

The existing incentive payment scheme for GPs rewards them for keeping a register of patients with a body mass index in excess of 30.

Dr Murray MacPherson, representative for NHS Greater Glasgow and Clyde, asked doctors at the conference: “Hands up who believes the obesity register has improved patient care in their practice? If there is no evidence for its inclusion, why is it there?”

However, the issue did divide the delegates, with some doctors arguing it was reasonable to include obesity in the incentive scheme, known as the Quality and Outcomes Framework (QOF).

Dr Marshall stressed it wasn’t a case of doctors not talking to patients about diet but described the current situation as “a target for target’s sake” because it fitted a political agenda.

Dr Hamish Meldrum, chairman of the BMA’s General Practitioners Committee, said including obesity in GPs targets over-medicalised a social problem, suggesting people could visit their GP and get something to make them less fat.