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

How's that worked out for NHS dental provision?

I don’t think you’ve thought this through.

There may be times where someone is on a low income and can’t prove it but may need to see a doctor. For example, getting a fit note. At the point they get the fit note, they may not be eligible for benefits or for sick pay…cause the fit note may be required first before any of that kicks in. So you may validly get someone unwell, with no projected income needing a fit note from their GP and not being able to afford the appointment fee. You obviously say someone’s last £5 should be spent on food as opposed to GP fees.

presence of chronic conditions

This kind of dents your 'worried well' theory, I'd have said...

I don’t agree with paying to see, however I do agree with being fined if you don’t turn up, or cancel same day (unless there’s a bloody good reason)

there was a post on here recently where someone had half the appointments she was to see cancelled and some comments when asked why where it’s stopped raining and I needed totake the dog out!

Which would single out those who are disabled, with chronic health conditions etc and have no choice but to use the GP regularly.

I've often thought they should put donation boxes in hospitals, GP surgeries etc. I'm sure many people would donate willingly.

It should always be free at point of contact.

In Ireland, we pay €60 per GP visit, €25 to the nurse for bloods if needed. Its 100 euro for a and e if you go directly not going through the GP.

I suspect the people who would be exempt from charges are pretty much the same people who are most likely to make unnecessary appointments or miss appointments now. So charging wouldn't really help much. It would just put off those who fall through benefits gaps etc at the moment.

I haven't read the entire thread (but I will!). Anecdotally it is said that some people use the GP for a pastime, and will go for the "outing" and for trivial matters". I said anecdotally.

I've often thought that instead of free GP all day every day, that everyone should be allocated a number of free visits every year, say four or six whatever. Then anything after that is charged unless it is follow up for a complaint discovered at one of the free visits.

You have no idea why someone is sat in a waiting room. Also you need to be triaged now to even get to that waiting room

The other side of this is that if we were paying we would feel justified in raising our expectations: asking the doc to listen properly, give a long enough appointment to deal with our problems, speedy referrals. In other words we would make the same demands as private patients.

I've lived many years in the UK and had my kids in the UK. I come from New Zealand. I cannot understand why GP's are free. Many times in the doctors waiting room it seems that people have "come in for a chat" with the GP - often people who are older or lonely.

In New Zealand our hospital care is free, but our GP's charge, based on your earnings. Some places are free or almost free to those with low incomes, and we have high use cards as well. We also have a free 24/7 healthline that you can ring to guide you through whether you need care or not.

It seemed odd that I, as a City worker in London, got free GP care despite my income, when that money might be better spent on supporting someone who had very little. But health systems are highly emotional and expectations differ.

We have homeless people and foodbanks here too. However the majority of people still manage to access healthcare when they really need to and A & E is free. We also pay a fee to call out an ambulance, except for accidents, and no-one thinks twice about calling one if they need to.

Our health system is in a mess at the moment as many others are, but from what I read on MN and hear from friends it's still better than the "envy of the world" NHS. I recently went to a new GP, one who is very thorough. I only saw him because my BP was slightly high and he sent me for more tests over a couple of months than I'd had in the previous 65 years! On my yearly review recently they were all done again - even though nothing showed up in the first ones.

I'm really sorry to hear about your child. I hope they continuing to improve. The NHS has helped me hugely too. I also didn't opt to be disabled. I was born into it. However, interestingly, it's the one minority you don't have to be born into and I think people don't consider that when they propose solutions like paying for healthcare appointments. To a degree I understand why. It's very hard to understand "otherness" unless it directly impacts you. It would be remiss of me to claim I understand the aggressions, microaggressions and discriminations other minorities face because they're not my story. However, I will never deny they exist or try and make life harder for those minorities.

I've got a medical condition under investigation, seems to keep involving blood tests that are a sideline to the main issue. (Possibly another issue) and the Gp's keep asking me to book doctors appointments. Personally, if I have to, because its just test results, I do say I'm happy for a phone call. But it would be costly if I had to pay everytime I had an appointment. Personally, I'd rather I didnt have too. And the time they rang me at the dentist, because I had an appointment I hadn't even booked or knew about! (That was over a scan result)!
So, it would need some working out.

The nhs has plenty of money its how its run thats the problem throwing more money at it will make no difference

I think in the short term possibly, as it might put people off going to the gp. In some cases this will be the right thing and it'll redirect them to pharmacists who are under utilised in comparison, but I think in the long term it could delay people going to access support for what needed dealt with urgently - therefore becoming a more expensive problem overall. I also think this would create a slippery slope where the price will slowly inflate until we've essentially got a privatised healthcare system. To be honest, I think we need more transparency as to where and how money is being allocated and how its actually being spent out of public purse than what we currently have. There's a lot of systems taking large chunks of public money that need significantly overhauled to make them more efficient and cost effective. I do think there's room somewhere for a private wing of the NHS but it should be done to protect access to free healthcare as opposed to just to generate money for healthcare if that makes sense. We can't let ourselves get to the point where people need insurance for healthcare as we know from watching others struggle that insurance providers cannot be trusted to do this ethically.

I get the analogy, but the reason why it doesn't work for me is that by definition the people you're seeing in coffee shops can afford takeaway coffee and sometimes cakes and things. I don't think you're wrong that that subset could afford a fiver to see a GP, I could myself, ditto coffee shop food and drinks. But you won't see people in there for whom that fiver's needed for one of the week's main meals, or to keep the electricity on.

If any moves were made towards charging for GP appointments I think they'd need to be means-tested, and even then I think it'd be a worrying development. I don't think it could be applied to anyone with any kind of chronic illness as it'd quickly become unaffordable for them, and then you're in the territory of evaluating whether a person fell into that category and could have the payment waived. So I do think any form of charges would have to be administered extremely carefully, and even then some people would inevitably fall between the cracks and end up (as is the case in some other countries) struggling to afford to see a doctor. That would undermine everything the NHS is supposed to stand for and would be a real step backwards imo.

I agree!

Yes, I love my German healthcare. Especially, for my pregnancies.

Absolutely! I remember one particularly bad February when my kids were small everyone in the family was sick and we ended up out of pocket to the tune of €700.
i think a nominal fee would be good to stop time wasters but pensioners should probably get free care.

FWIW, I was shocked the first time I got a German payslip. Mandatory health insurance costs close to 20% of your gross income, half paid by the employee, half by the employer. Self-employed pay the full 20% alone. Pensioners also pay - a standard sum for low income, percentage-based over a certain, quite low threshold.

The system has problems, mostly relating to decisions made 40 plus years ago which are showing up now, but there’s still a high standard of care in most cases. And tests.

I do think their should me some charge monthly or something towards medical care meaning GP appointments maternity dentists

In my area you can't even get GP appointment for love nor money unless you go private had to use a private dentist last year which I had to go to q emergency after severe pain for a week came out costing me £1400

What has changed is that we have 1000s more people coming in, health tourists who refuse to pay ( with no consequences)
A rising obesity issue which we didnt have 20 years ago. A huge increase in people taking illegal drugs, and a massive mental health problem which we didnt have 10/15 years ago. People going abroad for weight loss surgery, and cosmetic surgery coming back with issues that the NHS ends up having to try and rectify.
So how can we remedy all of this?