Sajid Javid states patients should pay a fee for GPs and A&E visits

[MushMonster]

Just woke up this morning to this

www.google.com/amp/s/amp.theguardian.com/politics/2023/jan/20/sajid-javid-calls-for-patients-to-pay-for-gp-and-ae-visits

I so wish we could get early elections.
I had more than enough of this lot!
They will use the strikes to push in policies like this before we can chuck them out, following Thatcher's model to the letter.

I work for the NHS and personally I agree with introducing some form of pay as you use system.
The reason being he current system has already effectively broken down and the NHS was never designed for the needs (and wants ) of the modern day population.
Also I’m afraid people do over use and abuse the current system- our service runs at a 15- 20% DNA rate and we have to offer three appt before we can d/c back to gp.
People need to attach a ‘financial’ value to the services which are available as this totally reframes the way people see healthcare (it actually needs to be viewed as something very valuable so people take more responsibility for what they decide to use. £10 is s total drop in the ocean of the real cost of any NHS service and is nothing like the system in the states but a little closer to the system in many European countries where people have much easier access to things like gp appts.
The caveat being exemptions for children and people on low incomes.

That would be me paying again. I earn just enough...

just enough to not qualify for any help, or benefits, just enough to have to pay for prescriptions (I prepay monthly )etc. I have a heart condition, not quite bad enough to qualify as a disability, but bad enough to hold me back to earning just enough...

There's no money to give... where do we find it?

Thank god he's standing down before the next election

It’s €80 to see a doctor in Ireland. It would be interesting if someone from there could come on here and let us know how it works and what they feel about it.

Disgusting

So people have to pay, which means they delay seeking treatment. We know in terms of cost effectiveness (yes I know quality of life is also important to normal people but this government clearly couldn't give two shits about that, so talking in pounds Sterling might resonate!) that prevention is most cost effective, followed by early diagnosis and treatment, with latter stage treatment being the most costly. Except burials, which are a) cheap and b) probably able to be outsourced to a mate. Two years from now what little of the NHS is left will be long gone.

Yes.

NHS systems aren't sufficiently well run for us to be able to start fining people who don't attend appointments. If I or one of my DC were fined/any other negative consequences for missing an appointment that we hadn't heard about, I would absolutely cause more than the cost of the fine kicking up a stink about it. It's probably not a particularly large group of people who, if fined, would accept and pay rather than either ignoring it or challenging it.

People never take into account that any kind of payment system has to involved not only administration but some process for dealing with incorrect charging decisions. This isn't free.

That was never a thing. Lets not keep pretending thats why people voted to leave the EU because we all know it wasn't and it's embarrassing.

There are many good insurance based schemes around the world. If we have to go down that route (and thats a huge if), then I don't trust this government one iota to put in place anything like those good ones seen on the continent. They're corrupt and untrustworthy and we can't take 2 more years of them

Not from Ireland, family there. They also have a parallel system for exempt people and have massive waiting lists, so it's clearly no panacea.

www.irishtimes.com/health/2022/09/09/numbers-waiting-for-hospital-appointments-hits-new-record/

This says over 600k were waiting for a hospital outpatient appointment in September 2022, which out of a population of 5.1 million is an astounding figure.

How much would the administration of such a scheme cost?

The heavy users of the nhs (elderly and those with serious illnesses) would presumably get it free, so the impact on the NHS would be small.

Plus we already fucking pay for the nhs through taxes.

Want to fix the nhs? Fix social care.

That’s interesting, so it hasn’t helped.
I guess one of the concerns with us paying is that the central funding could end up being reduced by the same amount…

As soon as people pay for something (directly) they have expectations of quality and service levels.

You see it with private education.

You see it with universities.

People will not easily accept paying £66 (or whatever) AND waiting 5 hours, for a service that is sometimes poor quality, lags behind international standards and where the workers are (understandably) sometimes stressed, rushed and rude.

It won’t stay a nominal fee will it.
look at Uni fees? Unis don’t benefit from higher fees, quite the opposite. So why would hospitals be different

I understand that sometimes people dont get notified of a medical appt (although I have to say its never happened to me in 47 years!!) but I have patients who ring up and blatantly lie about not being told- how do I know- because I myself have personally written to them text them and left voicemails for them. Then there are the people who don’t update their personal details with the gp so how can they be surprised when their appt info gets sent to the wrong place!!

Absolutely, but obviously the person who was responsible for the decision to require covid vaccination for care workers and therefore pushed an already teetering system off the cliff isn't in a political position to admit that. He's got some fucking cheek.

Also I’m afraid people do over use and abuse the current system- our service runs at a 15- 20% DNA rate and we have to offer three appt before we can d/c back to gp.

my DD had orthodontic treatment at our local hospital. It's worked really well, and have no complaints about the treatment. However the appointment system was not fit for purpose. We would receive a letter informing us of her next appointment. At the bottom it said if you can't make this apt call this number to cancel or rearrange. I had to do this on a number of occasions as the appointments were always in school time and also necessitated me taking a day off work. On at least 2 occasions where I called to rearrange, we were reprimanded at the next apt for being a DNA. Im pretty aggrieved to be included in their DNA stats when I followed their own guidance on how to cancel or rearrange and I definitely wouldn't want to pay a fine for it!

Sajid says that the NHS in its current form is 'unsustainable' and surely everyone must be able to agree that statement is true?

I think major country-wide, long term decisions like the NHS, pensions, Brexit etc. should all be removed from party politics and reformed through cross-party working groups. Our current position means that no party wants to take decisions that will knock their position, so they are all pushed further down the line.

NHS reform has to happen. It is not even a matter of throwing more money at it, it needs to be completely re-designed.

A lot of us pay through taxation. I'm not sure it would save money, people will put it off & store up bigger problems.

I think we do need a system like that. Many countries have it, including in Europe. I’d be happy to pay a set fee for GP appointments an A&E visits, but not in their current state. I would expect some sort of overhaul first. I wouldn’t want to pay for a phone appointment, or weeks long waiting times, or 10 hour A&E waits. I would want access to GP appointments at weekends and good walk in options. If we’re going to pay then we need to have decent services to reflect that.

I agree about NHS reform, but this is not one reform I would make.

We don't have enough GPs. Paying for an appointment isn't going to magic up any more GPs.

And the biggest users by far of the NHS are people past retirement age, most of whom presumably wouldn't pay, as they don't pay prescription charges currently.

It won't make any difference to the level of service.

The single most important piece of this "can we afford the NHS?" debate is that having a non-functioning health service is TERRIBLE for the economy!

People on waiting lists/can't get a GP appointment (or can't afford to pay, in Javid's immoral travesty of an 'idea') will stay ill for longer OR get sicker and die instead of recovering.

They then become economically inactive, don't pay taxes, and the economy stalls.

There are massive numbers of working age people who are long-term sick at the moment, because of the Tory nonsense policy of destroying the NHS so that their mates can get rich off the privatised replacement.

It EXACTLY as cynical and short-term as selling off the Royal Mail - one big payday for their cronies, then years of a once-excellent system falling to ruin. Great job guys!

It would be one thing if privatisation worked and the past 12 years of Tory policies had improved EVEN ONE THING in the UK. But nope. It's so cynical it's mind-blowing.

Anyone voting for this needs their head examined.

Get rid of the NHS, bring in a system like they have in Europe. Forget inheritance as older people will need to contribute more for say care in the home, no blanket free prescriptions at 60. It's not possible to fund revolutionising it by income tax alone as we have an ageing population

Exemptions would be high among main users here anyway

Although I agree with pp many countries do use it