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/

I wouldn't be able to, we live hand to mouth every month. There is literally nothing to spare, we'd have to go without food or electric or skip a bill.

The whole system is grossly mismanaged. We have a ‘NHS’ that treats all and sundry that have not paid into the NHS. If I go to France I need to ensure I can access health care via. EGIC card? Not sure as I have not been to France for some years. But I have to pay if I need treatment there. We are a NHS not a International Health Service. I’m not alone as a housewife, (I hate that term but..)you know whoever runs household finances knows this. We all have to responsibly manage our finances. The NHS are the equivalent of inviting all and sundry in for dinner, off the streets and they don’t even bring a bottle of wine.

Tax payer here - with a cystocele that’s rendering me unable to work - o have a job in a local authority. NHS wont treat bevause its not ‘bad’ enough . I’m left with no option but to pay so I can go back to work - currently trying to find a way to borrow £7500 plus….

Its disgusting.

Absolutely, yes. It need not be compulsory, but if those that wished to pay £10/20, it would make a world of difference

They were able to means test pensioners for the winter fuel allowance, the same is doable for GP appointments I guess

Some years ago I needed to go to A&E while on holiday in the UK. I explained I wasn't a resident and tried to show them my EHIC card but they didn't want to see it, just asked me to give the address of my parents that I was staying with. They didn't want the hassle of chasing payment so put me down as a resident. That's not good.

The rest of the world seems to have to pay a figure towards seeing the gp

Friend who works in a building with lots of staircases to run up and down needed a new hip. In her 50s, slim otherwise fit, after two years on the waiting list for a new hip she went private.

Months later she was contacted by NHS about coming in for a pre op assessment.

I always pay to see a doctor, I don’t waste time with the nhs because the doctors at my local surgery don’t like seeing patients.. or even speaking to them if they can help it.

I use my private gp for consultant referral. I think a system like in France which works well where everyone has to pay a small amount to access the health service is the ideal. But I doubt that would go down well here with this welfare state.

Yes I would

It's only about 60% of people who qualify for free prescriptions (still a lot). But 90% of prescriptions go to those who qualify for free prescriptions (mainly because older people tend to need a lot more medical care and all those over 60 qualify).

At the moment people who qualify for free prescriptions should already have some sort of government issued paperwork that supports their eligibility. Means testing the whole population would be pretty expensive and so add to administrative costs of the NHS (not what were after!). We could use the fuel allowance means testing to determine eligibility for those over 60 which, I believe, would cut out those 60-65 and about 25% of people over 60 - probably not as huge a number as needed to make much difference, especially since we'd need some sort of frequent flyer certificate like we have with prescriptions for those with chronic conditions if we didn't want a bunch of people keeling over because they couldn't afford care.

The trouble with all these approaches is that research suggests the unintended consequences of charging for medical access at the point of access leads to missed and later diagnosis, mismanaged chronic conditions and more severe presentations which cost the health service more to treat and manage. This is why we have free prescriptions for such a large group of people. If those who currently have to pay for prescriptions also had to pay to access GPs or other care, we would likely see a big spike and it's workers who would be hit - the people who produce the wealth that pays for everything - lowering productivity and damaging the economy.

A more difficult to implement, but likely more effective plan would be to increase tax on everyone, even those on benefits, and have people able to get that tax discounted if they follow healthier lifestyles, get their vaccinations and screening tests, take a first aid course, etc. so that the burden on the health service is lowered and those who don't follow those guidelines pay more without it impacting their ability to access medical care when they need it. Would be a massive row over what would constitute a healthier lifestyle, though, especially since the UK is such a diverse country.

I have many time to save taking time off work

I'm not looking forward to this? Gp already restrict patients from discussing more than one issue at a time. It is very hard sometimes, listing all the symptoms you have whilst making sure they are all related to each other. For example, not a lot of people know back pain can be a sign of a urine infection traveling up to the kidney. So they don't mention it, because they are scared of mentioning more than one thing. Will this money remove that cap?

Good point with a private GP you can have 15 minutes 30 minutes so have time to explore in more detail. It's so rushed now. The GP has to see you, check existing meds, issue prescription and write you up in a very small window of time.

That's the thing. It has to improve your workload if you can be seen before you become sicker. 100 years ago my husband's grandfather was a dental surgeon practicing in an industrial city. Some of the factories would have him visit the factory check on the health of the workers teeth. He advised on dental hygiene as well as treatment. Was a forward thinking factory owner who did that.

What happened to

Well Woman
Well Man
Asthma clinic

Those check ups have just vanished.

I don't know about your GP's surgery but mine do a yearly review for chronic conditions like asthma. Obviously if you have more issues you can book an appointment for that. I know post 40 you have a yearly health check as well. As for Well Man and Well Women, I think that stopped a while ago, as I haven't heard anything about that in a while. But I think screening tests for women and men check this out. Smear tests, mammograms, and prostate cancer checks for men.

Smear tests here are every five years now. Even if you've had previous dodgy results and have had laser treatment? Previously it was every eighteen months if you were high risk. My friend is going privately rather than wait five years because of her previous history.

Asthma clinic haven't been called in for five years now.

My husband has had two prostate surgeries had to really push for a PSA test even though consultant recommended it because of the family history of cancer

That's been happening for years on Scotland and Wales. As both boys and girls now get the HPV vaccine and the growth of cervical cancer is very slow. So 5 year now makes sense to spot the cancer. All the research now suggests there is no significant damage or danger to having 5 years - as more people get vaccinated, it will be less likely to get cervical cancer. If your last smear test found changes to cells then you will still be on 3 year pathway (what I saw on NHS website). And you will be checked sooner and more tests. Overwhelming majority will be fine on 5 year pathway. Also if you have history of cervical cancer as well in the family then you may be able to get 3 year as well or use home tests in the meantime. Also if you have history, you should try and get the vaccine. Any symptoms and tests will be done regardless. Having laser on the cervix doesn't always (it can sometimes though) mean your at higher risk. Depends on whether you have some cervical tissue on the outside when it's the inside tissue or a more severe issue with cysts etc.

Your GP shouldn't be not doing asthma clinics, do you have asthma? My GP doesn't have a set clinic, but will message to you to book an appointment to have a review. So they might be doing it unofficially. GP's are meant to review most chronic conditions yearly.

Sorry about your husband, is he at the age for the prostate cancer checks yet or not? As in the age range when they start inviting you. Prostate cancer tests can now be blood tests, so very bad if a GP isn't doing that. You could complain to PALS.

Re HPV vaccine my friend too old to have had it at school. Her grandmother died of cervical cancer. She's had three abnormal smear tests in ten years hence the laser last year. Her surgery is adamant she cannot have another test for five years. With two young children she is concerned that it's jumped from 18 months to five years so she will go private

Yes I have asthma. Used to have a check up every year pre COVID.

My husband his father prostate cancer. His brother two years ago. He had the turps OP ten years ago so wanted a check to see if the levels were okay.

Wales our health board in special measures for decade now. I had an x-ray a year ago all clear for arthritis in hip despite the fact I needed a stick. Now it's two sticks and chronic pain. Had a private x-ray two weeks ago because I was facing a wheelchair. Right hip bone on bone, left hip severely inflamed. They rechecked old x-ray it had been taken at the wrong angle.

So I need two new hips 🙈

I'm very sorry about the horrible care you've gotten. Honeslty I have my own horrible stories with mental health care and gynae and other issues as well. I genuinely think you should complain to PALS about the x-ray (doing it at the wrong angle is a wild excuse and poor practice). Have you got an NHS consultant for you hip issues (ortho or rheumatology I'm guessing). If so I'd ask for your private scans to be sent to them, hopefully they'll do the operation for you. I'm sure you're in lots of pain which could have been dealt with earlier.

I also have asthma and still get my yearly checks. I know your in Wales but I'm pretty sure the rules on yearly checks still apply. I'd try and raise this with the practice manager and threaten formal complaint to PALS otherwise (as they are failing here). Also I know many GPs have a patient group (yo give feedback etc), you may benefit from joining and having an ear to partners. Did your husband manage to get checked for PSA?

Re smear test (I'm not 100% but still pretty sure) that at least from whst I've read (albeit talking about England) she should be able to get it in 3 years seeing as family history and repeated abnormal results. Her surgery should be doing better (maybe there's a GP with an interest in women's health, who may help). I hope she receives the checks she needs (whether NHS or private). I agree we have lots to solve in the NHS but don't think cost will do much without changing conditions for staff, training and focusing on prevention as well. Also other services such as social care for adults need to improve so that the hospital doesn't also have that burden.

You can't book a smear test anyway. There's no mechanism to do so. If you go in the doctors and ask to, they just tell you to call them, but they don't answer the phone.

I haven't had a smear test since 2019, nor an asthma checkup. There is no preventative or chronic care available on the NHS where I live and there has not been since Covid. I don't think it's just here.

I've been in Casualty a few times with some acute condition - pleurisy, pneumonia etc - but no follow ups. I do my best, you know, I order my own tests off Randox and treat what I can. It's pretty haphazard. I think soon it will all be replaced by AI because at least AI will answer the phone, even if it tells you a load of rubbish.

The direction of our whole state system is that a small number of contributors pay huge amounts, so that everyone gets the same thing for free. But since it's such a small number of contributors paying for so many takers, the service ends up being pretty inadequate - despite it costing those few contributors so much each.

For many things, we can't avoid being gouged.

But if they try the same model for state services which you pay for at the point of use - like GP appointments - then those people deemed 'able to pay (for everyone)' will simply go fully private, since that's much cheaper than being over-charged in the state system in order to subsidise everyone else.

Yet another nail in the coffin of state services. How long do you think we'll accept paying huge amounts of tax for services which are only for other people.

Sorry @LondonPapa - my question isn't to you. I quoted your post in agreement, since it shows irrefutably why trying to get us 'Broad shoulders' to pay for NHS GP appointments - yet another layer of redistribution - simply won't work.

The only thing that could work would be to get the usual takers to pay part of their own cost, in order to reduce unthinking waste (people don't value or take care of what they get for free). But that won't be accepted politically.