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/

So if the NHS is a sacred cow. Then we're left with increased taxation on working people or dumping the triple lock pension.

We've twelve gps only one works four days a week. The others women morning surgeries because of child care half a week. One partner does a lot of work at a hospital at night on call doctor, another does duty shifts at police headquarters caring for prisoners at night . One has a private clinic cosmetic tweaking service. There's many calls on our doctors.

Well those GP's working at prisons or hospitals are doing their jobs and helping. In terms of the GP's that can only do morning clinic perhaps we should look at the horrendous childcare system in this country. Not enough support, many women (around 47% I think) have to go part-time in the first few years after having children even if they don't want to out of necessity. Think motherhood tax - only 1 in 10 women can afford to retire at retirement age because of motherhood tax. They have children, less promotions (unlike men because they're seen as unreliable), earnings start to deteriorate as do pension contributions. I think it's something like tens if billions if women were able to fully contribute the economy and not have constraints like childcare. Same goes for GP's.

What we need is to increase training posts, many people after F2 are applying for GP training (pass the exams, and are qualified) but there are kot enough posts for the number of applicants. This is the same across all specialities - so many stay as F3 or locum instead of training or leave to other countries with better conditions and enough training opportunities. Doctors even after they leave uni, during training have to pay for the training which they must do, and for their exams (often a minimum of a thousand and upwards). So I think if we improve conditions and make it easier for doctors to get on training pathway (along with other things) we can begin to improve. Also the 10 year plan if enacted would be amazing, more digital tech, more community care so less costs in the long-run and prevention.

yes you can but you still pay for glasses.

GP's are not employed by the NHS, they are contractors who operate as businesses paid according to the GP Contract. Provided that they adhere to those terms, they can operate their surgeries and services as they wish. In some places in the UK, businesses are buying up practices and amalgamating them, rather like vets have been doing. You'd describe it as privatisation if GP surgeries had ever been public!

I know they are technically private, partners run them and they just have a contract with NHS England. But the training is done by the NHS. When you become a doctor you do F1 and F2. Then during F2 you apply for training is whatever speciality you choose (often do an exam called MRSA) and have interviews, show your portfolio from F1. The training is again a contract with the NHS, the GP surgeries have to allow them to come in for rotations and also mentor them etc. GP training is 3 years 18 months doing 3 hospital rotation and 18 months doing GP rotations. After that you do exams and then are a fully qualified GP. Also my points on conditions are mainly about hospitals, though being a GP I'd very stressful especially because you only have 10 minutes. I think that should be extended to 15/20. Often then you can properly go through an issue, then islnstead of the patient having 2/3 appointments in a couple of weeks they only have 1. So long-term benefit.

Surgeries could decide to have longer appointments. I am not sure what your point about training is? Its still doesn't make GP's NHS employees.

NHS should stay as it is now.

Paying for NHS services seems reasonable if everyone contributes, but it feels unfair that the very poor, illegal immigrants, criminals, and others might not pay anything while still receiving immediate medical care. Meanwhile, people end up paying for private healthcare on top of funding public healthcare for those who aren't contributing, and the worst part is waiting months to receive medical care.

It could turn into a situation similar to what happens with parents who pay for private schools—facing hate and resentment from parents who use state schools, even though private school parents are contributing to state schools as part of their civic responsibilities, despite not using them.

The training that GP's do. So after the first two years of bring a doctor F1 and F2. Then if you want to do GP you do 3 years of training - during that time you are an employee of the NHS not the GP surgery. Part of the GP's contract is to allow those GP trainees in and mentor them on placements etc. I was saying to @justasking111 point there are many people who are applying to GP training (qualified, pass MRSA) and cannot get jobs to train as GP's because years ago the government extended medical school places (postiive) but didn't increase training posts for GP and other specialties. So now more people are applying and after F2 many just get unemployed even though they want to do GP. Or they do locum in hospital - when they could be seeing patients in primary care. Also even once they qualify many GP's are unemployed (because again GP surgeries like you said being private makes it more difficult as there are limited roles. Many GPs are doing Uber. Also with the demand it would be currently hard to extend appointment time.

My friend bought into a partnership in a GP practice. Finally finished paying them off a decade ago. Was £250k back then. She worked full-time and paid most of it out of her salary.

God only knows how much it would cost to buy into a practice now.

And when they complete their training and move to being GP's, they cease to be NHS employees. currently there are 4000 GP training places on offer each year.

Whilst I think that NHS doctors appointments should be free to encourage early diagnosis, some people take the Mickey by booking and not turning up or booking for really trivial things.I don't see why the NHS couldn't hold your credit card details in the same way as some platforms do to book hairdressing appointments. You could book an appointment with a fee only taken if you don't turn up.

I do now as I live in the US, and my family in Ireland does too. The acceptability depends on how much you have to pay.

I can see it becoming an enormous political hot potato in the UK.

It's almost as if no other country in the world has a healthcare system that could inform you or suggest to you how the NHS could be tweaked to ease the financial strain.

I'm not going to claim that, for example, the hybrid public/ private system in Ireland is brilliant, but it's there, and it's easy to investigate how it works. A little research might help set your mind at ease.

I didn't say that - I have many ideas as do many economists and public health experts have ideas on how to make the NHS more efficient. I was replying to other ideas, just charging for primary care appointments is not a good idea. However, I do think there needs to be little reliance on the private sector - especially for vulnerable and marginalised populations who always suffer as a result. I actually don't think all hybrid models are bad but many do statically show that those in rural areas (more likely to be lower socio-economic, elderly struggle. You said you live in the U.S - think about how many struggle with drug addiction and don't get help, thinl aboht how in a vile of insulin often costs around $10 but is sold minimum at $90 - many disabled people in the U.S have to ration meds and look at the stats on health outcones and inequality in the stats, they are stark. Imapacts life expectancy, employment, schooling etc. Plus the so-called 'big beautiful bill' has just cut 17 million Americans access to healthcare. The impacts that CDC and other health agencies have talked about will be immense. People will just be going to ERs and it will cost much more. Even in Australia those in rural communities and those trying to access mental health care are not receiving the level of treatment they should.

The key problem, over and over, is that the population is so damn unhealthy. And yes of course I'm talking about preventable stuff that has been caused by poor diet and lack of exercise. I see people my age (50) and far younger who can hardly walk 100m without gasping and panting.

What is the government's plan to address this? What are they doing about the proliferation of fast food outlets, and the overwhelming choice of shit food in supermarkets? People are eating junk food all the damn time.

You can pay privately now, so yes I would and will but will expect a premium service.

@TheLivelyViper So charging for GP appointments is fine in other countries but it's horrible and callous in the UK?

Ok then.

I know British people have a reputation for exceptionalism, but that's really a new one.

Why are you having a go at me when we've had pages and pages of this debate? Very odd response.

£20 to see an NHS GP is significantly cheaper than over £100 to see a non-NHS one.

I'm not sure you really get one, I think private GPs and nurses are under pressure as well and tend to rush you a bit. I had one private nurses' appointment a few months ago but it was a bit rushed. I actually had more time with an NHS nurse who triaged me after a GP referral (done via e-consult with no face to face time at all).

No I think it's callous everywhere. What I did say is that sometimes hybrid models of public and private can work - but I still think there should be little reliance on the private sector. I think charging for GP or primary care appointments anywhere is bad. That's why I stated some problems of health inequalities in countries with more private than public healthcare. £20 is less than private yes. But for many people that would be too much. Also £20 wouldn't cover all the costs, as I said GP surgeries currently get around £110 per appointment so it wouldn't even generate enough money and thus would likely have to be higher. Reinforcing so much health inequality. I do agree though that tweaks can be made to improve efficiency and care - I back the planned changes in the 10 year plan.

Also your suggestion was not only charging for primary care but also A&E (haven't seen many others say this - other than ambulance charges which I also think is wrong). As well as having those who don't pay have to resign to also having to wait longer for emergency care of some sort.

Yes it would be very easy to ban drive-throughs as a first step.

And then as a second but much less easy step, invest in walking and cycling and get cars off pavements and cycle lanes so people can walk and cycle safely. I know that doesn't work for rural areas but get the urban population much healthier and you'd see improvements. Dutch people are much healthier than British people and there's a very good and obvious reason for that - they cycle everywhere instead of driving.

I was listening to a discussion about this on LBC last night. The problem with charging for doctor's appointments is that so many people would be exempt from the charge. I imagine that it would be people who are exempt from prescription charges,such as under 18s,pensioners,and people on certain benefits. Apparently the number of people who qualify for free prescriptions is about 90% in England,so only a very small number of people would actually be paying for the appointments.

I agree with this. And also prescription charges, even a minimal £1 per item or something to stop waste

The prescription charge is something they should look at to be fair, half the charge and make everyone pay it

I imagine the administration involved in such a setup would be way more than £1, so pointless

Why? Why punish people who are currently excempt? You know, children, elderly, pregnant women, unemployed, those suffering with chronic diseases…