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.

So, l should have carried on being in pain until l was unable to work? And not pay any tax?

It enabled me to return to work and health. How is that not a treatable condition? If l was unable to work l would be trying to claim PIP. Why is it any different from a broken leg?

trainee GP here. I’m on the fence about fees. I definitely don’t think it will increase funds because it will cost too much to administer it will probably break even but I do think it might increase capacity which is for me the bigger issue - charging may increase appointment availability

Time wasters come in two catergories

1. people that just don’t turn up
2. currently too many people make appointments for utter tripe - sore throat for an hour or two, generic muscle ache after exercise, wanting a letter for them to jump out an airplane with lower insurance etc. This is different from those that don’t actually have a problem but genuinely think they do - like someone who dosent know if the rash they have is serious or not (top tip though do try wiping off your “rash” with soap and water first as I have seen more than one “urgent non blanching” rash that was felt tip)

in a standard day I’d say there are two of the first category and two of the second

in a standard day there are also about four “urgents” I squeeze in at the end of the day of actually sick people causing me to go home late (UNPAID)

a fee might stop the above and so give me space to see the urgents in paid time

the issue would be that a lot of the time wasters would probably be exempt so it may not work

Are you suggesting l paid for it, to carry on working so l could pay my taxes?🫤

And how, I wonder, would this be administered? Thousands more pen-pushers, and millions spent to recover the money? Turning people away from treatment if they can't pay, like they do in the States?

The man is living in cloud-cuckoo-land.

Another thing that is a bloody waste of money.
I've worked every Saturday this month so 6 days a week, podiatrists don't work weekends as a rule, they are paying me double time £300 a day so I can whittle down the GP routine referrals. The urgent referrals are different.
These referrals are costing the trust a small fortune in staff overtime.
Everyone of them the patient turns up and doesn't know what they are seeing me for.
GPs are just referring willy nilly to get people off their backs instead of trying to get to the root of the problem, firstly they can't get to the root of the problem because they are not seeing people face to face so can't tell if something is gout, a flare up of arthritis or vascular problems, you need to actually take a look. You can't do that on the phone.
Patient waits 5 months for an appointment with us by the time they get here they can't remember what they were referred for and the problem has cleared up. This is a gigantic waste of money. We simply cannot go on spending our budget like this.

It works plenty of other places and like others have said they have a lot higher taxation system as well.

but many of those countries have higher GDP than the UK & less wealth inequality. It's not as simple as pay more tax & introduce a European model.

People make that assumption in the context of the right wing, billionaire class shill government that we have. It's not that other options don't exist, it's that we know full well we wouldn't be getting any of the more social democratic models.

GDP per capita

although sometimes the utter tripe comes from 111 so it’s not the patients fault, we would need to fix 111 to make this work

e.g baby refered to A and E with a paper cut (bleeding and baby sets off an algorithm that ends up with an unneeded A and E visit)

@notimagain your input would be interesting in terms of how your system works. The NHS has become such a sacred cow in the UK that we can’t have a rational conversation about sensible reform without it descending into a bunfight.

And this is is why we’ll end up with the cruel and horrendous American system.

The same people who say that they don’t want to pay for NHS at point of delivery also don’t want to pay higher taxes - square that circle Mr Starmer 😢.

There is also a massive piece of education needed around how our taxation system works. A previous poster said they pay 50% of their income in tax. That simply isn’t true. It’s not how the tax system works. We all have a non taxed portion of our salary and then we pay more on the next portion and the higher rate is only paid on the salary you earn above the threshold. These basic misunderstandings mean people think we live in a high tax economy and we really don’t.

Those saying give me the money back and I’ll pay for myself are going to be in for one hell of a shock when they find out what that will actually buy them by way of insurance unless they’re very young and very fit 😢.

It’s an idiotic idea. There’s already this model in place for prescription charges in England and something like 85% of prescriptions aren’t charged for for due to income or other exceptions. Because guess what, high users of health service tend to have lower incomes, or chronic conditions etc.

So he’s either advocating pricing poor people with the highest need out of services which will mean escalating care needs, or that similar provisions are in place to protect people and so the scheme won’t generate much revenue but will create a huge administrative burden.

The NHS needs reform but this is a ridiculous suggestion.

I was on about £10k then. I'm self employed now and earn a mid-20s salary.

How does that make any difference though? The point is people used to pay a lot more income tax as a proportion of their salary. From memory I don't think the personal allowance was as high as it is now, as a percentage of income.

Discredit the NHS by starving it of resources, flood the media with stories of a&e queues and GP appointment difficulties, soften up the electorate for more privatisation.The Tories exist to further the interests of its members and to keep the wealth of the country in the hands of the few. Stripping the country's assets is what they do.

£40 to see a GP in the channel islands - very few time wasters or no shows. I think it’s a good idea for us to all pay a tenner unless on benefits. It will make people think about using a precious resource.

Wouldn’t better data and (potentially algorithm based) triage help here, rather than changing the principle of free at the point of use?

@Qazwsxefv true but dial that back and question what idiot thinks a paper cut even requires a call to 111. The crap that people approach HCPs for is mind blowing.

We seem to have lost all ability to think for ourselves as far as medical matters are concerned. There was a poster last week who was claiming it was ok to call an ambulance if a patient couldn’t afford to pay for hospital parking 🤬.

If I am paying taxes for the nhs and then asked to pay on top of this I would rather not pay the taxes and just get private health care.

Broadly, under this proposal, the people who would have to pay to make an appointment are the people who never miss them.

Yes I think so now and I’m someone that would have to pay.

Seriously, they can't remember why they're having an appointment. What the hell. Why don't they cancel it then?

I'd never just go along just to see, there would have to be a pressing reason for me to use any NHS services.

There is also a massive piece of education needed around how our taxation system works. A previous poster said they pay 50% of their income in tax. That simply isn’t true. It’s not how the tax system works. We all have a non taxed portion of our salary and then we pay more on the next portion and the higher rate is only paid on the salary you earn above the threshold. These basic misunderstandings mean people think we live in a high tax economy and we really don’t.

The issue is lack of wage growth over the last 20 years & the cost of housing which has fuelled intergenerational inequality. Plus add in pension & student loan contributions.

A 30k salary in 2000 is about 50k allowing for inflation. Many of those 30k jobs are still paying 30k

Question about the Irish model! What happens if you attend A&E with a genuine emergency? Or a perceived genuine emergency? My child is disabled and can get into respiratory problems quite quickly; I’ve taken them to A&E and we’ve ended up in PICU, and I’ve been been sent home as it’s just a cold. I’m good at assessing my kid but I needed a medical professional to check her sats and listen to her chest and decide if she needs emergency care or not. Our GP and consultant has told us to not go to primary care, if we’re worried it’s straight to A&E. Would we be charged?

Until you need critical services which the private hospitals don't offer.

You don't get to opt out of what services you pay for. Personally I wouldn't be subsiding MPs gourmet lunches, but I can't choose to do that.

And go fewer times anyway

@Stunningscreamer it's makes a difference because the value of money going down & assets going up. You can't compare the value of one salary from years ago to now.

The point is people used to pay a lot more income tax as a proportion of their salary.

when did people pay more tax as a proportion of their salary? When is the last time income tax bands for the higher rate moved?