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

The main argument against this is that it's a tax on the sick. If you're healthy, happy days you don't have to pay, if you have poor health then this would soon add up. And the people who are the sickest also tend to be the poorest, because it's hard for them to work if they're sick.

https://www.theguardian.com/lifeandstyle/2025/nov/20/medical-bills-healthcare-costs-medicare-australia-public-health-expensive

Would it be possible to bring in a system that understands people's needs and limitations and doesn't expand health inequality?

How might it change the relationship between GP and patient?
I suspect if people are paying at point of use they might raise their expectations.
Might it change how GP's practise too?

So instead of cracking down on/educating/disincentivising the people (of all ages) who abuse a valuable system, we should remove it for everybody?

Do you genuinely think that ALL health problems that people suffer from are caused by poor choices and them effectively 'choosing poor health'?

Do you also object to public buildings being made to pay to instal wheelchair ramps, because the people who need them "probably made poor decisions and so it's their own fault really"?

There is no point in moaning about the NHS but never changing anything.

All of European countries have a self funded element to it and they have much better health outcomes than we do.

If people had to pay for their healthcare to some extent they may actually start taking responsibility for their health.

People need to be less entitled and start thinking differently about their health. I would hate to end up dying of a cancer in my 50s that I would have survived if I was French / German / Swedish etc.

But that might happen to me, or any of you. Statistically speaking it will happen to several people reading this thread. So think about whether you want that to be you?

I don't know which country you live in, but in the UK, we have a lot of homeless people and others who are dependent on food banks to feed their children.

It's one thing to look in a shop window and see lovely things that you simply accept you can't have, because you can't afford them; but basic healthcare should not be like that.

It's a bit like period poverty: nobody is regularly spending hundreds of pounds a month on necessary supplies, but there are girls who have to miss out on school and have to forego their basic dignity because they and their families simply cannot afford the cost - even though, to many, that cost would be dismissed as 'only a few pounds'.

I'm guessing you are in good health OP I don't see my GP every week but in September I had 3 GP appointments, 1 appointment with Physician assistant, 1 senior nurse and about 3 appointments with a health care assistant and a phone appointment with a different GP and 2 trips to urgent care.

So 11 x £5 = £55.

I've also had times in my life when I did not have £5 to my name.

Then the surgery has to have some way of taking payment, which means they may become a target for thieves looking for money.

The staff have to be trained to take payments. And what to do if the system goes down.

, Then what do they do with that money?

I have no problem with charging for missed appointments, hairdressers , vets and dentists for this, but charging a £5 or £10 fee would just penalise the poorest, and would probably cost more to operate than it would raise.

It was a post war system and was fine then but treatments/medicine have been revolutionised. Technology eg MRI is expensive to buy, staff, maintain. Medicine is v.staff heavy. People not turning up? It's on them but if you miss your flight on holiday what happens? I know it's a simplistic view but there has to be a collective will to improve the system. That should be across the Govt, all the politicians without bias and the medical services. What it shouldn't be is a sell off of the services to pfi or overseas companies like EdF or Centrica. No, there won't be competition. It will be a cartel of investors.

Totally agree. We have to find a way to make people appreciate the NHS and not take the piss. There was another thread this week from someone who was pissed off that they'd be removed from a service after missing 3 appointments. She admitted that if she'd known she would have been removed, she would have found a way to get there. Basically she saw it as a choice to not go despite the waste of time through cancelling at short notice. The numbers of missed appointments is huge, a small fee would hopefully go some way to making people think about whether they really need it and, if they do, to actually turn up.

You are forgetting that we do already pay for our NHS. Not just for ourselves and our own families but for everyone else who is unable to pay. I have no issue with this but chucking more nominal charges in won't help.
I think the answer lies in correcting the utterly dysfunctional management and the deskilling and demoralisation of clinical staff (eg Drs being replaced by ACPs and nurses being replaced by HCAs, staff retention and appalling levels of burnout due to stress).
I've spent 35 years working at the coalface, I wouldnt recommend the NHS as a place to work anymore (let alone be a patient) and could write a book about the behaviour of the managers I've worked for, including one director who moved to another country and just showed up occasionally on teams to check that everyone was still working hard.
Speak up guardians work for the Trust, they are paid to avoid legal action against the Trust and are about as useless in supporting staff as a chocolate teapot.

Probably because we don't do preventative work and the food is worse now. Think of in the old days when you had actual school nurses and food made with real ingredients, rather than random chemicals so it lasts well and is cheaper to make.

So what happens if you cannot afford the upfront fee before claiming the rest back, as in you try to pay and the computer says no? Do they just not get treated?

I dont know whether things have changed but when I did home care 20 odd years ago there were many clients who had repeat prescriptions for stuff like aspirin and calcium tablets etc. These prescriptions never seemed to be reviewed and I used to be astonished, when opening a cupboard, huge stockpiles of these medications that weren't being used. The amount of money wasted must have been phenomenal . Im not sure if it still happens (my guess is it does) the NHS must be losing millions purely on repeat scripts that just keep coming month by month and nobody seems to monitor it

On the face of it I wouldnt mind paying. Id happily pay more for a convenient appointment that lasted 15 mins.

but I actually think by the time you've exempted under 18s, certain benefits and pensioners, and people with chronic illnesses who need regular reviews you've probably hit 80% of a gps workload.

When I'm in France, I get a same day appointment with my doctor. I'm happy to pay for that. The system works well. GP and specialist care (including emergency care and diagnostics) is excellent and prompt.

I don't have to fill out an online form or jump through any other of the hoops that I have to in the UK.

I think we should pay too and appointments shouldn't be a rushed 10 minutes. Even 15 minutes would be an improvement. If you dont want to pay you can get the 10 minute appointments.

Why are they free for those on benefits who are on more money that many working people?

Actually no. We’ve rapidly moved to a situation where a few of us are paying for everything. I think there needs to be a more honest conversation about this. Many have private healthcare anyway do get their GP appointments that way without burdening the NHS.

We used to have a €10 quarterly fee for any practice we went to in Germany in that quarter (a lot of what would be GP work in the UK is covered by specialist Drs and many go straight to the specialist practice. Children go to a paediatrician.)

Apparently, it cost more to administer than it actually raised.

We are an aging and, overall, sicker population now. We just can't afford to give everyone free, timely, appropriate treatment anymore and people are dying because of it.

If you think the NHS should continue to do almost everything and be entirely free at point of use to everyone, I do think you need to explain where you’re going to get the money to fund it. This is not 1948, when the average person popped their clogs in their 60s after a short illness. We have a hugely ageing population, millions of people living for decades with multiple chronic conditions, a massive Covid-induced backlog, many more medical interventions available to us and new ones coming online all the time, not enough working-age taxpayers, and the costs of medical equipment and drugs are going up and up.

My dad, who’s in his late 80s, has probably cost the NHS around £20k in the last year through appointments and prescriptions alone (no actual procedures) - and he’s not an appointment-chaser, he only goes to the doctor when he’s summoned. Meanwhile, when I was having gallstone attacks last year the GP kept fobbing me off with blood tests (basically a displacement activity to delay referring me to a specialist) and eventually told me I’d be put on a two-year waiting list for surgery, while experiencing unbelievable levels of pain that would soon have stopped me working (and thus paying tax…) I paid to have the surgery done privately, using up all my savings in the process. Yes, I’m privileged to have been able to do it. But yes, I’m deeply fucking pissed off that I had to, after decades of paying in and taking barely anything out.

The political problem we’re facing is that working age taxpayers — the people who use the NHS least, broadly speaking, but who pay for all of it — are getting absolutely terrible service from it. Can’t get appointments outside working hours, can’t see a specialist for two years, wait in chairs at A&E for 12 hours, getting a GP appointment is like playing the National Lottery … their support for the principle of a free NHS is going to fall away, which is when political parties will start to sit up and pay attention.

If you don’t want a payment-based NHS, you have to engage seriously with the problems that we have. Something is going to have to change. If it’s not co-payment, then what? A bit of gentle exhortation to stop wasting doctors’ time isn’t going to cut it (not least because time wasters, annoying as they are, aren’t the reason we’re in crisis).

I sort of get where you’re coming from, but as others have said it would put the people who need it the most off from going. There’s also the secondary issue that people who wouldn’t be willing to spend £5 would end up costing more money long term. For example, I have to go annually for a check up to continue receiving my contraceptive. Sure I’d pay for that (even though it’s the GP themselves that require this visit) but many wouldn’t. This would lead to more people getting pregnant without the correct access to birth control. This in turn would cost the NHS more money dealing with pregnancies. I can think of other examples too - people wouldn’t want to pay to stop smoking, they’re more likely to need expensive treatment etc etc. So whilst it’s not a bad idea in principle, I just don’t think it would work in practicality