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Original poster

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

232 replies

MushMonster · 21/01/2023 08:40

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.

OP posts:
DomPom47 · 21/01/2023 12:08

Stunningscreamer · 21/01/2023 11:36

If it's not us, then who's going to pay for it then?

Jamie Oliver has tried this with improving healthy evening. He practically became public enemy number one. People who it's aimed at think it's patronising and say they can't afford fresh ingredients.

We lost a lot of our overseas doctors to Brexit. When I was last visiting people in hospital there were a lot of overseas doctors but I think a lot have probably gone back now. We need to train our own doctors but our wonderful government would rather award over priced contracts to their mates than fund medical training places

totally agree with funding more social care but that's definitely been an issue since the 90s at least and no one ever seems to resolve it. I think it's because it's an easy thing to cut to 'save money' until the knock on effects arise. Successive governments are short termist and don't plan for the future.

yes we can cut waste but this is a perennial issue and doesn't address the problem of underfunding

I agree about the number of managers but that's also something that never seems to be resolved either.

Show quote history

It is a depressing and sad state of affairs. The Tories will do very little to try to fix the NHS whilst they are in power.
Labour will win the next general election and throw money at the situation rather than do any long term planing and real change.
Tories will then come back into power and we will have a totally privatised health care system.

Dippydinosaurus · 21/01/2023 12:10

It won't work nurses aren't going to be walking around with card machines to collect the fee. Who is going to deal with aggressive people who won't pay. Nurses? The money will just disappear into general taxation it won't be put back into the NHS

Everyonehasavoice · 21/01/2023 12:12

With more over 60s than births and the likelihood that this isnt going to change the uk is becoming top heavy. Like many countries.
If less people are paying into a system that needs to support more, raising taxes is inevitable
Pensioners that still work will now have to make contributions, before they were exempt.

But I disagree with charging at source, especially for A & E. It will be the middle earners that suffer the most. Not to mention parents, who let’s face it give up so much and are providing the country with future tax payers. Can you imagine the cost of appointments on being pregnant and then taking kids to the doctors.

AlpineSnow · 21/01/2023 12:13

It's worked out well for my parents. They've had use of the NHS their entire adult life thanks to generations before them and have used it a huge amount for many years. They're in their 80s so won't have to pay but they've always voted tory so have left a nice legacy for their grandkids of no free NHS.

Tremblingtigers · 21/01/2023 12:21

Qazwsxefv · 21/01/2023 11:41

@Tremblingtigers

i think most GP practices are triaging now by phone or E consult. It’s really really unpopular with the general population though- it’s the reason people think GPs aren’t doing any work although GP consultations have gone up compared to pre pandemic- and very hard to do safely and correctly, and something the current GP cohort has not been trained to do as it wasn’t the model in use when they qualified (nor are they training us current trainees either which is bizarre but the royal college is part of the problem imo)

Algorithm based triage is what 111 do and it is utterly useless, it really is. Maybe better algorithms exist but I’m not sure that they can ever truly weed out the time wasters from the sick. So much of seeing if a person is truly sick comes from a second sense that is hard to quantify and even harder to do over the phone and even harder than that to put in an algorithm. It’s a really hard balance between discouraging time wasters but not discouraging those who need to be seen. Better basic health education of the population would really help.

I feel a lot of it comes from fear of litigation And risk avoidance. Slightly off topic but ambulance call outs for elderly falls. Carers won’t help up those who have fallen because they are worried if they do it and the person has a neck fracture they will be sued. So the person waits on the floor in the cold and gets muscle damage and kidney failure waiting for the ambulance which then has to wait to drop them off in a and e and can’t go and help a person with a heart attack and then even if they do have a neck fracture because their frail they are not able to have surgery so it’s just left and then they need a hospital bed for a week to deal with the kidney failure and the. another ambulance to get them home again.

this isn’t me blaming the carers - I was a care assistant to pay for medical school - no way am I making the call if a person is able to be helped up for minimum wage knowing the family and my employer will put all the blame on me if something goes wrong.

and since this has turned into a rant - why can’t people get old and die anymore. We don’t live forever and at a certain point the body gives out. Medicine can’t fix this but we spend so much time prolonging the death of people and making them suffer.
So many families who are angry and upset when I broach the subject that their 98year old relative is in the last few years of their life - but of course they are most people don’t make it to 98!. Families who want all the investigations to know WHY their 98yr old relative is struggling to walk or is more tired - because they are old! Families who after being told their 98yr old relative had a terminal illness complain about a DNACPR order because they want them to have “a chance”, a chance for what I want to say, a chance to die again in a few hours or days because they have a terminal illness. Dying is probably shit (I haven’t done it but it looks like it is) so why oh why would you want someone you love to die more than once? Until we accept that life is a terminal condition we will continue to have a care crisis…..

Agree with a lot of this, particularly around the carer crisis (which includes a societal problem of undervaluing and so under paying care). And health education and literacy would be brilliant. I feel like a lot of the issue is that we’re trying to marry up and society which is being pushed in an increasingly individualistic and libertarian direction with a socialised health system. I’d rather break the former than the latter!

When I talk about algorithmic triage I don’t really mean 111 or map of medicine style flow charts - I mean using rich data from shared care records and combining that history with machine learning based ongoing analysis of outcomes so it’s constantly improving to triage or to support telephone triage. I’m sure it’s wouldn’t be perfect and it’s obviously not currently possible but that’s what we should be aiming for. It’s all very well to say doctors need to see the white of patient’s eyes to understand whether they need care, but that only works if there are enough doctors, with long enough appointment times, and patients can access care in a timely way.

MichelleScarn · 21/01/2023 12:40

Do people think that if this isn't successful, the idea to add additional charges on for use of public health that this won't leach out to other areas of public services we already pay for via different taxes etc?
Want your bin collected, well yes you already pay council tax, therefore by virtue of that you can pay a 'top up fee' to get this now, or you can go to the tip and pay per access.
Want the roads gritted, same again. Only a few examples I can imagine being implemented and of course yet again if you don't think it's wonderful to do and pay for this you'll be scolded for being a dreadful person!

SilverGlitterBaubles · 21/01/2023 12:49

£20 charges will not bring more GPs, doctors, nurses or care workers. It just opens the floodgates to more privatisation and a health care service run for profit.

renonovice · 21/01/2023 13:28

I feel like a lot of the issue is that we’re trying to marry up and society which is being pushed in an increasingly individualistic and libertarian direction with a socialised health system.

exactly!

Idratherbepaddleboarding · 21/01/2023 13:59

BeyondMyWits · 21/01/2023 09:16

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?

We wouldn’t be able to find it, that’s the problem with this model. Of course, as always those who don’t work would get as much treatment as they like for free and those of us that do would just have to not visit the doctor. Then all you’ll end up with is an ill workforce who are less productive.

Myotherpetisamouse · 21/01/2023 14:29

So for those who don’t want to pay to see the GP, presumably you don’t want taxes to go up either ? So what’s the solution?
Everyone loves to complain . No one wants to pay more. How is it to be fixed? If you want more investment where does the money come from? It has to come from tax revenue, there’s no magic money tree . The NI contributions aren’t enough.

Everyonehasavoice · 21/01/2023 14:33

Myotherpetisamouse · 21/01/2023 14:29

So for those who don’t want to pay to see the GP, presumably you don’t want taxes to go up either ? So what’s the solution?
Everyone loves to complain . No one wants to pay more. How is it to be fixed? If you want more investment where does the money come from? It has to come from tax revenue, there’s no magic money tree . The NI contributions aren’t enough.

Just because I don’t agree with paying to see a gp does not mean I disagree with tax increases.

ArseInTheCoOpWindow · 21/01/2023 14:36

I’d be happy for my tax to go up. I have a lot of medical issues. Stumping up on a pay as you go schedule would break me.

Im like the person above. Earn just enough to not qualify for any free prescriptions/eye care/ dental care. Earn just enough so we have to contribute to student loan. Just enough.

MarshaBradyo · 21/01/2023 14:39

I can see if you get more out of it you’d be ok with tax going up. Especially if it means going up for other people.

The harder part is all those who pay more already but use it less.

Everyonehasavoice · 21/01/2023 14:45

MarshaBradyo · 21/01/2023 14:39

I can see if you get more out of it you’d be ok with tax going up. Especially if it means going up for other people.

The harder part is all those who pay more already but use it less.

That’s how the system works though…it’s not a pay as you go.
Like house, life etc insurance…you may never need it but you pay anyway.
How do you know you won’t need it a lot in the future.

We all pay for future security.

MarshaBradyo · 21/01/2023 14:51

Everyonehasavoice · 21/01/2023 14:45

That’s how the system works though…it’s not a pay as you go.
Like house, life etc insurance…you may never need it but you pay anyway.
How do you know you won’t need it a lot in the future.

We all pay for future security.

Show quote history

I don’t want a US system and one reason I wanted Sunak to get leader first time was the NI change, which got reversed. Even Labour were against that though.

However if I could ask for things in return for that NI increase it would be that it goes to social care provision and people taking care of own health more.

Lightningrain · 21/01/2023 14:52

There’s no simple answer to it but it’s clear the current system doesn’t work and things are only going to get worse with an ageing population.

To the people shouting about the Tories do you really think Labour could fix this? Nobody that gets into power wants to make drastic changes because they don’t want to upset the voters, and they’re potentially not there long enough to implement any big reforms. People are kidding themselves if they think the NHS would be fit for purpose had Labour been in power for the last few terms.

We all praise the NHS and are proud of what it’s been in the past but it’s just not able to support our increasing and ageing population going forward. There aren’t enough staff, enough beds and so many hospital buildings are in need of refurbishment. We’re supposed to be a world leader in medicine but our system is in chaos.

renonovice · 21/01/2023 14:53

I don't understand why the health & social levy/NI was reversed particularly for the pensioners still working.

Myotherpetisamouse · 21/01/2023 14:59

renonovice · 21/01/2023 10:34

@Stunningscreamer

I earned about £8 an hour working in a shop in the late 90s. The same job probably pays £11/12 now if you are lucky, that doesn't mean I'm earning more money though. I'm earning less because £8 was worth more. The true equivalent of that £8 is £14/£15.

Im struggling to be convinced of the £8 for shop work in 1990s
in 1987 I was earning £1.80 as a KP in my final year of school and when I finished my professional degree in 1993 I started on £11000 which on a standard week of 40+ hours (as it was and still is ) works it at £5.20

renonovice · 21/01/2023 14:59

The harder part is all those who pay more already but use it less.

I disagree, imo it's better for society to have that safety net. I don't have problem paying more if say CB wasn't means tested or childcare was better funded etc.

renonovice · 21/01/2023 15:04

@Myotherpetisamouse yep I did but as I said late 90s & it was in a posh part of London. When I left uni in the early 00s starting salaries & manager salaries were very similar to now.

I remember someone not believing me when I said my parents paid 40k for their house in the mid 80s & it's now worth close to 2m, because there house cost a lot more & is worth less 🤷🏻‍♀️

Felix01 · 21/01/2023 15:06

Our health system isn't as competitive pay wise compared to other countries. We are losing staff who want to work abroad. There's tough decisions to be had , pay higher taxes or accept we will have to contribute to our healthcare.

nationallampoons · 21/01/2023 15:06

If that's the case I would like my contributions and tax to be heavily reduced. Might even get to see a doctor for once

JenniferBooth · 21/01/2023 15:51

So lets get this straight. The person who "cared" so much about the spread of Covid in care homes that he brought in a vaccine mandate for care workers and swore blind that its all about the health now wants people to pay for GP and A&E visits

cptartapp · 21/01/2023 16:25

But those who use the NHS most (elderly, disabled, children) would all likely be exempt. Leaving all poor sods in the middle yet again.

Cath667 · 21/01/2023 16:36

Myotherpetisamouse · 21/01/2023 14:29

So for those who don’t want to pay to see the GP, presumably you don’t want taxes to go up either ? So what’s the solution?
Everyone loves to complain . No one wants to pay more. How is it to be fixed? If you want more investment where does the money come from? It has to come from tax revenue, there’s no magic money tree . The NI contributions aren’t enough.

I agree. Everyone objects to paying more but we need to pay more if we want better services.