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/

How's paying for dentists working out for us?

Because many of them don’t need free prescriptions. Those with chronic illnesses that need multiple meds per year can get prescription prepayment certificates

And if they started charging to access medical care (I assume it would be GPs, A&E and ambulances otherwise you'd just push people to whatever service was free) I assume you'd have exempt categories? If those exemptions followed free prescriptions say, that would mean 95% of Visits would be free. After all, who uses medical services the most? It's the elderly, the disabled and children, all would presumably be exempt, so the
people charged to use the health service, the working population, would be the only people who actually pay for it anyway through there taxes.
This doesn't seem very fair to me plus adds a massive layer of beauracracy.

How would that stop waste though? I don't think that many people are chucking away their medication which they need. I do think GP's have had a lot of advice on not prescribing things which you can easily get over the counter like cough meds. Doctors are the ones choosing to prescribe, and they should always be able to justify the reason. If there's genuinely a lot of waste, then there needs to be better guidelines on prescriptions. I definitely think prescription exemptions should remain - especially as those who are disabled often have more medication and in lots of countries, disabled people will ration medication making them much sicker and more costly long-term. Or children whose parents cannot afford it get sicker. Plus pre-payment doesn't reduce the cost by that much.

Paying for A&E is fine, so long as the charge isn't ridiculous (I paid about 27 euros last time - nurse, ekg, quick blood test, doctor, x ray, treatment) and it isn't an upfront cost (so bill comes later rather than having to pay at the time). Knowing you have to pay something stops people going to A&E for things they shouldn't but it doesn't put them off going when they really need to when they it's a limited cost and they don't have to pay it straight away, can even set up a payment plan and pay it off a fiver a month if you need to. Less people clogging up A&E for unnecessary things will mean shorter waiting times so less people suffer.

If I did I would expect a much better service. No scrabbling for appointments, yearly check ups and full works bloods etc and not having to always be the one chasing and pushing to get something taken seriously.

Even if you don't have to pay at the time, it will still push people away. Look at the amount of people in the U.S with thousands and hundreds of thousands of medical debt. Which impacts credit score and from there many other things. Charging for primary and secondary care ends up costing more long-term because people don't get minor issues dealt with or managed- they turn major across months, years and cost way more. Also those with mental health crises (often low socio-economic background, vulnerable) will likely, evem more than now, not get the resources to keep thesmelves safe. Not many people go to A&E for fun, and if they do they'll have a long wait with triage. I just think once you start even if it's £30, what do companies (insurance) love to do - break things up. So over time it will be £30 to go to A&E, (just for sitting there), then extra maybe a couple hundred or a £1000 for a scan (MRIs are expensive so they'll be higher than an x-ray or ultrasound). People will refuse scans that they need because of the cost. Then they'll you more for overnight admission, and more and more.

Less people will go to A&E yes, but in the long-run it will cost way more when people get sicker. Not just in the NHS, but to the economy (off sick for longer) or even unable to work due to mental or physical health. So yes less people will go, because only those who can afford it will go, and the vulnerable and marginalised people (who also need treatment) won't go, because they can't afford it, or are disabled and will go less, or children(when child poverty is the higest in decades) the elderly.

Pre-payment equates to about 11 prescriptions a year.

“12-month PPC costs £114.50 and will save you money if you need more than 11 prescribed items in a year” NHS website.

One thing I think could be introduction to both reduce costs and make things easier for patients is more AI. I had a mark on my nail that could have been cancer. I did an e-consult with a picture. GP referred me to fast track cancer pathway. Had hospital appointment with a consultant, they looked closely at it, took a picture on their phone to expand and have a better look. Said it was nothing to worry about and would grow out.
I'm sure I could have just fed the picture into some NHS AI reader that could have said refer/don't refer. No need for GP or consultant appointment.

I would and I'm a disabled person with multiple chronic illnesses who's on benefits and who has to have regular face to face appointments.
My 80yo dad was in Italy last year when he was suddenly taken ill. He was rushed to a&e, seen straight away, had multiple tests, medication and spent the night in hospital. He paid 30 Euros, which he was astounded by because he thought it was going to be much more. The doctor looking after him told him that everyone pays "a little" so that the service works well. He also paid a small amount for his prescription for the same reason.
He spends the winter in Australia with my sister and is super impressed by their health service, as well. My sister has some chronic conditions and gets tests etc. when she had a cancer scare last year, her biopsy results were back in less than a week. She has access to so many different kinds of treatments and healthcare professionals because, for one of our conditions, pills are a last resort over there. Here, all they do is prescribe is antidepressants and painkillers. She needs health insurance, yes, but there are provisions for low income folk and their system seems to work much better than ours.

No one is talking about a us style private system, but the NHS introducing co pays for the public system. They are worlds apart, and you can't go bankrupt if the government sets limits on costs like they do in my country. Here you can't pay more than 600 odd a year on any medical costs - that's everything combined, including prescriptions, and there's never extra charges for scans and suchlike, they're all included in the doctor/A&E/clinic fee.
The issue with fees here aren't the normal ones, they're the costs for specialists which are higher, like 50 something euros. If they were the same as the GP fee then it wouldn't be a problem.

Also, what is the purpose of charging? Is it to stop people going to the doctor? Because if its not for that reason, well, we still have the same number of doctors, nurses, etc so the same number of appointments.

It would also likely make people value it more. Many people don’t value free stuff, they just expect it. They don’t cancel appointments they can’t make, because what does it matter…

I may be shot down in flames but I believe everyone should pay something a prescription?

I mean say a pound per prescription as it would hopefully make some think. If they're free many continue to get them even when they need to and I've seen cupboards stacked full of unused free medicines.

Same for lifelong conditions. Multi millionares will get free medication for life, would it be wrong to ask for a£1 a month to contribute?

This is a drop in the ocean I know bit would help somewhat and make people realise the costs, even though heavily subsided.

@Kendodd

"Also, what is the purpose of charging? Is it to stop people going to the doctor? Because if its not for that reason, well, we still have the same number of doctors, nurses, etc so the same number of appointments."

when a product or a service is either free or under priced then demand will outstrip supply as people will always value stuff less if it's free.

You can see examples of this in carrier bags where when they were free people took loads, but when there was a 10p charge demand fell 90%. Or napkins at McDonalds where people grab a handful when they only need one or two.

In the former communist countries, products such as cars or clothing were deliberately under priced. As a result demand was managed by queuing.

The NHS is exactly the same, because there is no cost to the service, demand is managed by queuing. Even if you increased the spend on the NHS, demand would increase.

The original idea of the NHS was to provide healthcare to those that don't have enough money to pay for it. This has now been replaced by a health service that only provides healthcare for those that have sufficient time to queue for it.

The solution is basically the same as carrier bags - a small fee to discourage frivolous demand but small enough to continue to allow access for the less well off.

Yes. I’ve always felt we should pay to see the GP, like we do a dentist.
The NHS is not a bottomless pit, we need to start paying a bit more into it now.

I’m having to pay to see one gif a second opinion after being robbed off by women’s Gynecology - it’s already happening.

I would pay but only if there was a demonstrable difference in the service. So much of Reeves’ taxes seem to be money grabs without any change to how things are run.

If paying meant we could see a GP within a couple of days and had a proper consultation instead of being hurried out the door after 3.5 minutes, then yep.

Well, no. I couldn’t afford to. I’m a 1950’s pensioner and previously had a private pension that was quite small as I didn’t know, was never informed, about the change in pension age. Without going into the politics of the change I’m left living on a meagre pension facing increasing costs from all sides. I don’t think I could afford to pay to see a doctor and I certainly can’t afford a dentist.

They wouldn't be being "punished"

However at nearly £20 for two items when there are so very very more people who pay nothing, it sometimes feels as though the payers are being "punished".

We wouldn't be though. These massive tax increases everyone except "working people" are paying is to keep services standing still, not to improve them.

I pay between £75 and £100 per private GP appointment - same day. Now, if you asked me to pay for NHS services, with NHS wait times, not a chance.

So you want those who are poor, disabled, single mothers, live in extreme deprivation to pay because you have to pay. Yes the middle-class is being squeezed but that's not because of the working-class, maybe focus on the millionaires and billionaires, and the owners of companies that don't pay staff well, or the water companies increasing bills when they pour more sewage into water. Also those with children, elderly, disabled, poor are also (like the middle class) being punished. They are working multiple jobs, but landlords keep increasing rents to ridiculous prices, so they are often getting evicted, or sharing 1 bed room with 2 kids and the parent. More and more schools now have to wash children's clothes and get them beds not because these parents don't love their children but because they cannot pay the electricity bills so don't do as many washes. People can fall on hard times, suddenly the rents too high, and then your homeless. Suddenly you become disabled (which btw most people do across life) and you can't work anymore. Or even if you can work, employers discriminate against you. Or you get pregnant (maybe your in an abusive relationship, or struggling with substance abuse) and then the child suffers because of who they were born to?

Your displacing your anger onto those vulnerable groups simply because your annoyed that you have to pay. I do agree the middle class are under more pressure than ever before (and something needs to be done on that, especially for people who rely on income not assests) but the solution is not to attack those living in dire situations who genuinely need and deserve their medication but cannot afford it. They may not pay for it and then get sicker and cost more long term because the medication managed said issue. Yes people pay for dentists, but do you know how many people haven't gone to a dentist in years because they cannot afford it. Wes Streeting said a couple weeks ago that the number 1 reason for kids admissions now to Alder Hay Hospital is tooth infections and tooth issues because these kids aren't seeing dentists as their parents cannot afford it. That's costing the NHS a fortune because these kids end up in hospital, and then very qualified doctors spend their time on that rather than complex cases. I fundamentally disagree that people don't value a free service many people I know and myself included are so thankful for a free service otherwise we wouldn't have gotten treatment, maybe wouldn't have finished school if we couldn't get medication. Especially those who are of lower socio-economic status, because they know they can't afford it and value care. The reasons for low satisfaction in NHS i think are pretty obvious (medical misogyny, waitlists, lack of staff etc). Yes missed appointments are a problem and I think measures should be put in place to deter this - I know many services will cancel your referral if you don't attend. As long as if we do that, letters get sent out on time to give the person notice because the amount of time my letter for a scan has come the week after the date is incredible.

Paying would be a big bonus as far as I am concerned.

The medications returned to pharmacies when somebody dies, goes into care or gets more support is astonishing. There is no penalty for those who waste thousand of pounds of NHS money in prescription medication as there is always an excuse, just as there is when people misuse ambulances or A&E - they are old or they are poor or they are ill, etc. I suspect even a small payment would focus their minds somewhat
I would favour the "everyone pays a little" rather than some being exempt and others paying. There is currently fewer than 1 in 10 prescriptions paid for and the charge is now significantly higher than the price of many of the medications issued to those who pay.

I don't disagree. I'm just saying the current system is shit.

Imo the main problems in this country come down to a massively unhealthy population, and accommodation prices vastly outstripping pay.