Would you pay to see the doctor?

[justasking111]

The IMF has said that the government will need to raise taxes. One way is NHS charges. This will be means tested I should add. It's being covered in the financial times, telegraph and others but hidden behind a pay wall. I don't know how to archive, if anyone else does please do.

I don't know which one I would choose, it's a thorny problem.

https://www.telegraph.co.uk/business/2025/07/25/raise-taxes-working-people-charge-for-nhs-imf/

Well when the alternative is getting sacked for being absent without it being authorised then I'm going to continue to struggle to get there and work even if I know it's futile because I'm going to be neither use nor ornament, because without being able to afford to access the GP for the sick note the time I take off after 7 days is either certified by a GP or unauthorised.
Particularly problematic if what I have is infectious, considering I work with vulnerable people.
Still that'll teach me to be poor won't it.
🙄

Get rid of the triple lock. Simple. It costs £5 billion.

We have an app to book appointments. But when you log in to the app it just says no bookings available. That's what it always says. So we could replace the app with just a piece of paper really. An NHS saving!

That's very poor of them. My GP has a form Anima or something - just started this month, before it was econsult. It opens from 7, closes during lunch and sometimes at random times (if they have too many requests and need to look through them first). It's okay other than the fact they book your appointments now, so you say when you are/aren't available and then they just book you one. You can request to see a particular GP (if your happy to wait longer) but they sometimes ignore that. Though the say they are trying to fix elements only new so teething problems. But better than having to phone at 8.

To the previous poster who said anyone can see a private GP. Well not really in our area being rural. I've googled and the nearest one is 40 minutes away by car over the border in England. Perhaps in urban areas it's common.

I was going to create a thread on this.

I'm in two minds. Most of the GPs I've dealt with around here in Brum (three so far) have been pretty woeful. Things like trying to give anti depressants instead of hormonal treatment even when already backed up by a private diagnosis and with several years evidence of it actually working etc. Also trying to suggest protocols that are objectively worse just because 'that's how the NHS do it' even when there's no cost difference.

My fears would be things like them insisting my upcoming medication review (five min phone call) was done as a face to face appt to generate more money. I also think mumsnet represents a generally middle class demographic and lots of people (e.g. the builders I work with) would just put off seeing the doctor and then cost the NHS more in the long run. Men are particularly bad with health avoidance as it is.

Again, not the point of the thread but I am a medical secretary in a department of about 20 secretaries - 3 are men.

Also, while we are on about it - medical secretaries do not generally make appointments - there is usually an appointments team for this and they are responsible for appointment letters going out. Having said that I did make three appointments yesterday and definitely sent the letters out. Will be interesting to see if any of these patients don’t receive their letters. (However I did phone the patients to let them know).

No. I already struggle to pay for the NHS dentist charges and have to do without some months if I need treatment.
I earn an above average wage for the UK but low for where I live. I'm a public servant. I live alone and rent a flat from a social landlord. After bills there is simply nothing left.

Absolutely not. Free at the point of delivery.

Agree with this.

Tragically amusing 🙈😂

As someone who has constant infections and is often sent to hospital for these from the gp surgery paying to see a gp would mean I spend more time in A&E . I also don't have the money to pay each time I see a gp.

I think this is a bad idea and would rather taxes be raised personally. I might feel differently about it if everyone had to pay, but it being means tested will mean that it’s just one more thing that the squeezed middle will have to pay for when huge swathes of society can access it for free. And I think there are people in the squeezed middle that will genuinely struggle to afford it.

A bit like when I needed counselling and MIND was offering means-tested counselling, which meant as someone who earns reasonably well on paper (but as a single parent with bipolar disorder recovering from domestic abuse in an expensive part of the country and going through an expensive family court process, I did not have any disposable income) I was offered this at the highest face-value rate, which was simply unaffordable for me at the time. So I wasn’t able to access it.

I would also add that as someone currently working as an NHS GP, I would move to work in private practice in order to access a better salary and working conditions, if our patients are having to pay to see us anyway.

Does your GP not have an on-line system where you can request a fit note?

Also, what illnesses have you suffered from that mean you have needed to take time off sick?

I had a look at our Welsh NHS contract for GPs. It seems that legally they're allowed to do private work but not on the premises. They won't have access to medical records then. That seems petty to me. I remember many years ago at our surgery that the senior partner saw private patients on the premises and had access to the patients notes.

I think there are elements to this which many wouldn't consider when you factor in certain jobs. For example, I've had ailments in the past which would be considered relatively minor in the whole scheme of things but which have stopped me sleeping well.

I remember coming in one day when I was supposed to be covering on one of the trucks and driving a 40 ton mixer around central Birmingham for what turned into a 13 hour shift when I'd already been awake over 24 hours. If I'd called in sick due to tiredness or mentioned the specific ailment it'd have definitely not been viewed favourably or as a good reason to let the end customer down.

I think it's whilst they are working at an NHS GP surgery. So they can do private work but not whilst they have am NHS shift. Same goes for surgeons I think, they should be able to access a patients medical records if they are seeing them privately. I'm in England so might be wrong but this is my understanding.

The fact of the matter is that healthcare is already two tier. Dentists are a clear example, however, it extends also to MH care and to a lesser degree physio. I have back issues and can put my hand on my heart and say that a private physio has been head and shoulders above the NHS one I saw. Similarly £350 spent with a gynaecologist and their advice re HRT and dosage turned my menopause symptoms round and cut through the claptrap I was advised by my GP.

When dd was 15 she she was quite unwell. Harming by cutting and o/d, anorexia, depression, anxiety. CAMHS were woefully inadequate, offering six sessions of group therapy and closing the case when I said that was unacceptable. The GP told me to get her a counsellor off the Internet. Had we not been able to afford private care, I've no doubt she'd have escalated, dropped out of school, dashed her life chances and certainly wouldn't have gone to Cambridge and qualified as a teacher. At 27 she has recovered and manages her anxiety and the underlying ADHD that caused the issues. CAMHS only wanted to seek family problems and shift blame.

Fortunately, BUPA paid for a private adolescent psychiatrist, we paid for therapy in excess of £500 and the ADHD diagnosis and support. Had we been reliant on state support, I am pretty sure dd would have ended up as an in-patient due to escalation and her life chances would have plummeted.

I imagine experiences such as the above are replicated throughout the NHS system and am awareness people in their 50s who need knee/hip replacements and have lost their jobs due to waiting lists.

Brief explanation

Wales, your GP cannot see you privately for the same services they provide under the NHS, due to restrictions in the GP contract and regulations. This means that if a service is covered by the NHS, your GP cannot charge you for it privately, even if you are willing to pay, as long as it's within NHS working hours and on NHS premises.
Here's a more detailed explanation:
NHS Regulations:
New contractual regulations, introduced in October 2019, restrict GP practices from offering or advertising private services (that fall under the NHS primary medical services contract) to registered patients or anyone else during NHS working hours and on NHS premises.
Separation of NHS and Private Work:
For GPs who wish to offer private services, there must be a clear separation between their NHS work and their private practice. This includes not conducting private consultations during NHS working hours or in NHS facilities.
No Charging for NHS Services:
GPs cannot charge registered patients for services that are covered under the NHS contract, such as consultations and prescriptions.
Private Services Outside the NHS Contract:
GPs can offer private services outside of the NHS contract, but these must be distinctly separate from their NHS work. For example, they might provide services to a care home under a commercial contract, but this would need to be outside of their standard NHS duties.

Drs have extremely lucrative side-jobs that don't actually involve 'private work' - that assumes seeing and treating the patients.

DVLA forms, medical reports, insurance reports, travel letters, passport forms etc.

They're not allowed, to my knowledge to charge that during their NHS shifts but they just work an hour or more extra unpaid by the NHs filling in forms and DVLA for example is £40 odd quid and doesn't take long. You could bang out several in a hour.

@justasking111 some of the GP's at my old practice work privately from the local private hospitals, one has a private and local skin care clinic, one is a director of a small private facility that accepts NHS patients (conflict of interest) and one has the GP/health contract to provide services to the local boarding school. They all work part-time for the NHS. 32000 patients receiving very poor GP services. I moved practices to a smaller one with more full-time GPs and it's like a different world. I can get appointments and the staff are helpful.

I could afford it but even if means tested there are lots who couldn’t the cost of living is squeezing lower incomes that may be just over the level that the free appointments kick in. So you may have people putting things off u til they can afford it, this in turn means they end up maybe more ill and in hospital.

@justasking111 I didn't know that about Wales and GP's. I've never gone private before in England but thought it was the same. That does seem quite petty, I guess they're very little private GP's in Wales then?

Yes I agree, I have needed forms done before and they've cost so much. Lots now charge for forms which need a medical doctor to sign which I think is unfair. I once just got the letter they had to write for me from the NHS app and downloaded it then printed it.

But people don’t always know what a minor ailment is, sometimes they aren’t.

Agree with this.
My "chronic indigestion" and a "bit of backache" (so I thought), turned out to be a STEMI. I never even saw A&E as I was taken straight from the ambulance to the cath lab to get a stent put in. Not all "minor ailments" are minor.