Should GPs charge for letters?(96 Posts)
GPs are semi-independent contractors to the NHS.
They were trained at huge cost to the taxpayer.
Most of the older GPs made precisely Zero financial contribution to their own training.
They do not have to provide out of hours cover.
They earn SO much that many of them can afford to cut their hours to part time - and STILL have a handsome standard of living.
That part time working is a major cause of the 'shortage of doctors at the NHS coal face', and of the 'hard pressed' feelings of (presumably other?) NHS staff.
(Ironically therefore, it could be that if the GPs salaries were halved, there would be more GPs working hours available to the NHS?).
The GPs final salary NHS pension arrangements are fairly legendary ....even within the NHS.
Do the GPs refund the NHS for the use of resources used to provide a letter??????
E.g. if a Typist is a full time member of surgery staff funded entirely by the NHS, then would it not be a FRAUDULENT activity for the GP to use the typist's time for 'private earning' purposes for the GP???????
If the GP wants to charge for a non-essential letter (e.g. for a holiday company) then that may be a fair charge if the GP tells the patient in advance that the letter will incur a charge.
For any ESSENTIAL letters (e.g. medical letter for a court) the GP should regard that as an important part of the 'doctor-patient relationship' which the GP is already well paid for via the state funded NHS by the patient's taxes. The GP should NOT charge for essential medical letters.
Also, most patients earn a small fraction of what a GP earns, and many unwell patients may have an impaired earning capability and so may be on only £70 per week benefits.
Therefore, the GP should not assume that all patients are able to pay £25 for a letter.
If that letter takes the GP about 10 minutes,
then he/she is paying themself at the rate of about £300,000 per annum for that letter...... on top of their already excellent salary.
But who would decide what is essential? My GP had to write a referral letter to a consultant for me, that is obviously essential as within the NHS.
Of course GPs should charge for letters. Their work is to diagnose and treat medical conditions, not write letters for holidays/schools/courts.
The money doesn't go into the GP's pocket! You are paying the surgery for an extra service
I'm a GP in Ireland so a bit different but Court letters and legal reports come outside of the remit of our NHS equivalent so I think it's reasonable to charge for them.
Also I type my own letters, as do most GPs.
Unless it is within the NHS then yes they should charge
How is a medical letter for court "essential" to the health of the patient?
You should probably have a moan about how much GPs earn now too....
The NHS only pay for your final year of university now - well they are for me anyway.
That's an expensive letter though most GPs I know don't charge more than £10
Fees for those sorts of letters go to the practice, not in the GP's pocket. That then funds the work of the practice as a whole.
Yes but they should be upfront about it when approached
There's a BBC news article about it here. As the chap from the BMA says:
"The NHS provides general medical services. Letters for patients for third parties are not a health service," Dr Holden said. "This is not money into the doctor's pocket. This is the gross turnover of the practice. Who's going to pay the secretary to type the letter? Who's going to pay the receptionist to sort it out?" The GP is the only member of staff in the practice who generates external income, whether from the NHS or private sources, he added. "Anything you do that is not part of the NHS, you have to recuperate your time and your overheads from somewhere - there is only one place and that is from the patient."
It's pretty much universally known that GPs charge for some services, like that type of letter.
And here is the BMA guidance on carrying out and charging for non-NHS report work.
The fees for this sort of thing go into the pot of money that helps to run the practice.
When we didn't charge, I was asked to do several of them a day. A significant drain on my time that took me away from seeing patients. The vast majority that I am asked for are medically unnecessary e.g. requesting better housing for a non-existent medical problem or one that doesn't impact on housing. We charge to deter the requests.
^E.g. if a Typist is a full time member of surgery staff funded entirely by the NHS, then would it not be a FRAUDULENT activity for the GP to use the typist's time for 'private earning' purposes for the GP???????
If the GP^
you clearly have no idea how GP funding works
I think you misunderstand how GP's are funded. They pay for their own surgeries and staff from surgery funds that come from numerous sources one of which is payment from the NHS for seeing/having a list of NHS patients. The NHS won't pay for these letters therefore the customer/patient has to
As to expensive - I remember seeing evidence of cost in the 1980's that a letter cost about 25 quid by the time someone had written, typed and printed etc can't be massively different today even if GPs doing it themselves - given their salary etc
Of course they should charge. They are not a fucking secretary.
You're suggesting that because they are paid a good salary they are there to be performing monkeys for the public.
Thankfully i've never been charged which i'm grateful about as im only on esa at the moment.
Court letters are essential for some.
When you apply for a certain benefit and someone you meet for an hour, declares you well, your gp who has known you your entire life can write what they actually know about your health?
Maybe it would be better if there was a standard charge for these things.
As a teacher, I was often asked to sign passport photos and never charged- nor did any colleagues that I'm aware of.
I would have thought a sliding scale of charge with a ceiling of perhaps £15-20 would be reasonable depending on what you want the letter for. Passports etc are not essential, but letters to consultants surely must be.
I imagine that most doctors will dictate letters and many of them will be quite standard.
The money doesn't go to the GP individually! It goes to the practice to help cover the time taken away from seeing patients in order to do non-essential (to NHS) admin, such as letters to solicitors/insurance providers/schools/DWP - extras not necessary for treatment, that patients request.
Letters to consultants are not charged for.
There are many inaccuracies in your post which demonstrate a lack of understanding as to how GP practices are funded.
For starters, they pay to have OOH covered so they don't have to work those hours.
"Do the GPs refund the NHS for the use of resources used to provide a letter??????"
Receptionists are paid by the GP, who allocates the salary and can allocate private and NHS work as the need arises. You clearly don't understand how funding at GP practices works so I'd suggest having a good look at that and then coming back and apologising for all the mistaken beliefs you had before.
I think many PT GPs are PT because they work so many extra hours that it comes out to being at least a normal FT job if you work 60%. There is a huge amount of admin - referrals, reading test results and consultants' letters. When you have a GP appointment you are seeing the tip of the iceberg in terms of their work.
Much like watching a teacher teach a lesson.
I think you have a very limited understanding of the role of GPs, NHS core duties, and the way all of this is funded.
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