It wouldn’t be a bad idea if we paid for GP appointments?

in Australia some of our doctors are free called bulk billing and some you pay and get a rebate. I think my last gp appointment was $120 and we got $85 back. Specialists always cost and they are rarely bulk billing.

my doctor bulk bills children and pensioners but charges everyone else.

No problem paying but I would make it universal.
Sick of subsidising things for those who have more income than a fulltime minimum wage worker that pays there way

The 60 appointments a year was for all staff. The phenomenon of frequent attenders is unlikely to magically go away due to changes in online booking. Also, anecdotal evidence, an experienced ambulance call handler friend of mine says that around 75% of ambulance callers are non-emergencies, the worried well, people with mental issues. Some people deliberately refuse to hang up, blocking the line for others. So, I reckon, if anything, the frequent attendance phenomenon has got worse. It’s easy if it’s all free. People abuse free stuff.

I see no point. In my family, I'd pay - but I last saw the GP 3 years ago.

DP, who sees the DR very frequently, due to his various disabilities, would pay nothing I'd imagine due to his higher rate PIP. The kids wouldn't pay as under 18. Of approx 150/200 appointments in the past few years, we'd pay... £5. I imagine many people with complex health needs would be the same.

Where are you getting your information from to back this?

In my experience, the nurses at GP surgery routinly give follow up appts to people who are cognitively impaired and then wonder when they don't turn up. This is then recorded as a no show, previously there would have been home visits for this.

This was in 2021 though how gp surgeries are run now is vastly different. Now you have to fill in an online form, you are then triaged and then the dr decides on whether you get an appointment and what sort of appointment

But what do you call inappropriate use of a&e when they send you away because they think there is nothing wrong with you but they turn out to be wrong this happens a lot. I don't know about other peoples local hospitals but you can't even go to our a&e without being triaged first so anything not a&e worthy gets sent to urgent care, ooh gp or even the pharmacy

This isn’t unusual in other countries and it helps to assign value to the appointments and makes it less likely people will miss the appointment.

All hell would break loose if it was seriously considered here though, I would imagine.

YABU because it would be the usual already financially stretched suspects that end up paying whereas the chancers that are already at the GP every 5 minutes demanding paracetamol on free prescription would no doubt be exempt on some pretext.

Plus all monies would disappear into a black hole and nothing would improve.

Actually yes, but also this: https://www.thetimes.com/uk/healthcare/article/just-10-of-patients-account-for-40-of-appointments-with-gps-3jm7rrnr7?utm_source=chatgpt.com

The above was an article in the times about 10% of people taking 40% of appointments. These ‘frequent attenders’ had on average 60 appointments a year. If we assumed the 10% were mostly the over 60s and those on benefits, charging for the rest would still be a big win for the NHS.

HOWEVER the original study that prompted the news report did attempt to look into the nature of these frequent attenders. Here’s a quote:

‘Our analysis suggests that frequent attenders are identified across all parts of the UK and that deprivation, practice size or regional variation are NOT drivers for the number of frequent attenders by practice. There is evidence from Europe that frequent attenders (and particularly persistent frequent attenders) are more likely to be female and older, present more social and psychiatric problems, receive more prescriptions of psychotropic medication, have more medically unexplained physical symptoms, and more chronic medical conditions.3 17‘

Also this:

’A systematic review focused on children also found that frequent attendance in children was associated with presence of psychosocial and mental health problems, younger age, school absence, presence of chronic conditions, and high level of anxiety in their parents.18’

So, erm, it is highly likely the frequent attenders are the worried well (physically, that is).

Where is your evidence it isn’t already?

100% agree with OP. I believe there is research that shows people value a service more when they are required to pay even a token amount like 50p. I also think, for this reason, all schools should charge a token amount for clubs run by teachers.

They already get shit tonnes of our money for not seeing patients. If I was doing an actual in person cash transaction with one of them I'd expect a damn sight more than the "fill in an online form that's available for 25 minutes a week and wait two years for me to refer you to a specialist" level of service that we get from the muppets at the moment.

In Jersey you need to pay to see the GP too. Perhaps pensioners / those on benefits can be excluded but if working people had to pay then that money could directly go to something that people could see tangible improvements - like in a local area, that money could pay for more staff in local A&E dept or whatever really. I’d be happy to pay if I could see my money was being well spent.

That is not correct. In Australia we have Medicare (very similar to the NHS) and bulk billing (you do not pay/no out of pocket fee) for services. GPs can however decide to charge an additional cost on top of the bulk billing fee. The difference is we can choose whichever GP we want to go and see, you are not zoned, and you can choose a bulk billing GP. I do not pay to see a GP. I can also always get an appointment.

I think this is a good idea. If we paid it may be valued more.

100% agree

The thing is that 20% of patients use 80% of appointments and those 20% tend to fall into a category we would deem exempt from paying eg children, disabled people, older people etc. so it wouldn’t drum up as much income as you think. I think a lot more walk in clinics would be a better idea with nurses etc or a GP you can walk into. Tons of appointments booked in for babies and children to have chests listened to and ears checked - could probably be a nurse checking those. More often than not, it’s viral.

additionally the reason GPs are clogged is because of our ancient referral system. You find a mole on your body that looks funny. Instead of in France or Germany where you lookup a dermatologist and make an appointment direct and they triage you, in the UK you have to make a non-urgent GP APPONTMENT WHICH YOU WAIT AGES FOR, the. They refer you to the hospital to the dermatologist, who the. Gets you in for an initial triage but it’s unlikely any tests or scans will happen that day so another appointment is made and because of waiting list and admin time (the NHS still largely running on a lot of slow admin practices like letters) this process takes months.

in Germany, find mole, call dermatologist, get seen, scans tats done, all in a week or two. No GP required.

The poster is correct though. A lot of elderly do sit on their money and also waste doctors' precious time going to see them at every opportunity.

Great idea , might give people a boot up the back to stop being so unhealthy, ie overeating, unhealthy eating, excessive drinking, smoking. Why should the rest of us pay for their bad decisions. £5 is minimal, in Ireland people pay 12 times that to go to the doctor.

People aren't on state pensions at 60.

I can't believe that this still happens and why it hasn't been brought into line with pension age.

I live in a country where people pay for GP appointments - a lot more than £5 - and we're not all dropping dead. Children are free, people with a limited income pay less, but people still see a GP when they need to in most cases. Having free appointments for absolutely everyone seems madness to me.

I agree. It would be a foot in the door that could balloon to goodness knows how big.

Like some kind of government equivalent of the charities that assure you that they only want £2 a month, but before long, they 'discover' that it's not nearly enough so they constantly badger you to ramp up what you pay them dramatically.

Only when it's your health and government-levied fees involved, it isn't as simple as just saying "No more" and cancelling your direct debit.