Sludge and Ordeals in Primary Care

[摘要] COVID-19 has stretched resources andadded complexity. Frayed systems arecoming apart at the seams. For patients, atwhat is usually perceived as the most basiclevel, getting an appointment with a GP isnot as easy as it once was.Some patients may experience this asan ‘ordeal’, a term being used in politicalscience to describe high friction interactionswith the state.1 In the UK, the welfaresystem is replete with these ordeals and,usually, the architects consider it a featurenot a bug. A good example is the transitionfrom Disability Living Allowance (DLA) tothe Personal Independence Payment (PIP),which added to the ordeal of receivingbenefits for people with disabilities. Muchlike benefit sanctions, there is no evidencethey improve outcomes and may well havenegative economic effects, irrespective ofany moral concerns.

[学科分类] 卫生学