to think that within a few years we will be paying to visit the GP,Conservatives consider limit on GP visits

[MiniTheMinx]

The Conservatives have considered limiting the number of times patients can visit their family doctor in a year, it has emerged.

"Labour health spokesman Jamie Reed told the Independent on Sunday: "This paper, hidden away on their website, reveals the Tories' true agenda for the NHS. After throwing the NHS open to ever more privatisation with a wasteful and damaging reorganisation, it seems the Tories want to go even further.
"It's shocking that they are considering limiting the number of times patients can see their GP - changing the fundamental principle in the NHS constitution that access to the NHS is based on clinical need.
"The Tories have already wasted £3bn on a top-down reorganisation of the NHS and overseen a crisis in A&E - now they are consulting their members on opening up the NHS to even more competition, and making it harder for patients to see GPs in the evenings and at weekends."

A Conservative Party spokesman said: "This was simply a topic to provoke discussion and isn't Conservative Party policy."

Yet.

We all know where we are headed with this don't we? or am I being an unreasonable old cynic?

I remember saying on a thread on the news board that a £20 fee to see the GP is not so far away.

Tories So Fucking Predictable.

I work in OOH though I am not a clinician. I agree with a poster upthread about better education about appropriate use of services.

I'm torn. obviously people shouldn't be denied access to their gp, but DP's family are a prime example of wasting time. at least one of them goes once a week, for attention seeking minimal injuries/coughs&colds/made up conditions. the local go entertains everyone of these ailments, to the point FIL had an ivestohatory heart procedure that found nothing. he hasn't mentioned a heart problem since. its infuriating.

fellow mum at baby group constantly takes her Ds too. she went to see if she could get prescription sun cream the other day as her baby is blonde.

at the same time my dad is very ill, but there than the odd appointment, he is referred to hospital clinics for his heart problems etc. I'd like to see a summary of reasons for GP visits and the demographics. the elderly/vulnerable who are truly ill need GP's. but there are plenty of time wasters!

I think a lot of people on this thread are denying or unaware of the scale of time wasting and appointment missing that goes on, and it's cost. Missed appointments are c 10% on average, estimates of time wasting vary more but are a similar scale, so 20% of the Doctors (and hospitals) time is wasted. That's bad enough in good times but when you are cash strapped it can't be ignored anymore.

There is a reason why just about every other health service in the world charges

I'd like to be able to opt out of the NHS though and spend the money on private health insurance.

What are you going to do if you have a serious car crash? No private hospitals have A and E departments.

But why should everyone suffer the affects of these bone idle people?
The Nhs is supposed to be there for us all, if we have to start paying it will lead to A&E being even more overstretched and will leave those with next to no money dying needlessly!

I agree sassh, that comment was made in a dream world. My brother died of osteosarcoma, his treatment would have ran into hundreds of thousands if not more. Without the nhs he wouldn't have had no quality of life atall

"But why should everyone suffer the affects of these bone idle people"

Because money is limited, so if 20% is wasted then everyone is already suffering. And given the health service is also 20% of UK tax spend, that is potentially a huge amount of money.

But privatising the nhs (as that is what it is) is only going to benefit those who can afford health insurance, it will not work.

pumpkin I don't want to see things go this way, but an alternative is systems like the German one. I only know about it through my German friend, but she says everyone there has health insurance (it's mandatory, like car insurance here) but people on the lowest income/ benefits are automatically put onto a basic state scheme. Or you can opt for a fancier private scheme.

I don't want that here, but imo it would be preferable to people not being able to access reasonable treatments.

The problem with what is happening is not just that the NHS is being privatised, but it's being done in an incredibly ill-thought-out and cackhanded way which will mean that the poorest suffer.

Mandatory health insurance could only work if it was illegal to charge more or refuse to cover people with pre-existing conditions and chronic illnesses.

At the moment BUPA etc will exempt pre-existing conditions from cover. If a long term condition such as diabetes is diagnosed, they don't want to know either.

It took us 8 years to get dd diagnosed with a perfectly well known condition, simply because no doctor thought to do the right tests. During these years, we belonged in the category of Wasters of Doctors' Appointments. Now she is in the category of Genuinely Disabled. Nothing has actually changed. She has the same condition she always had. It wasn't her fault that the doctors couldn't remember the small print in the medical book.

And regardless of which category you are put in, the schools require exactly the same number of doctors' notes if you are absent and don't want to be sent to prison for letting your child truant. So there will be plenty more court cases.

I also think the same as a previous poster: there will be lots more deaths from cancer because people will not seek the GP for their recurring back pains. In particular, they won't go back if they've been fobbed off once.

The problem is that the NHS as it was orginally conceived is no longer fit for purpose.

There are far more of us. There are far more treatments than was ever thought possible (increasing every year). The aged population is enormous.

Unlimited free treatment for all can no longer be funded...

Oh well, if a few more are put off seeing their GP for grumbling pains or changes in their bowel habits, there will shortly be fewer of us to treat.
Problem solved.

What I don't get is how the employment situation is going to work.
Atos are passing more and more chronically ill people as fit for work. These are people who will need doctors' certificates whenever they are unfit for work. So what do they do when the doctor refuses to see them because they have run out of their allotted hours? Will employers be forced to let people self-certify? Or can you sack someone for failing to provide medical evidence when they are no longer entitled to see a doctor? The more chronically ill people the government are trying to get into work the more this situation will arise.

Very good point Cory I guess some people will fall through the cracks, Atos assessed as fit, anything but fit to work, facing a choice of work until they drop and say nothing to employer or find they are entitled to nothing should they take time off for uncertified/undiagnosed illness.

The Tories will of course say this is just an idea they are batting about but it is more than that. This is about testing public opinion.

We don't need to be in favour of this for it to happen, we just need to stay quiet for them to give it the green light.

I think the French system works quite well (although they're talking about changing it which I'm not happy about).

There's basic social coverage for everyone. This is free (well, paid for by taxes) and covers all essential, health stuff (including antibiotics etc.)

Then there's the "top-up" health insurance, which covers most things not covered by the state. Often your contract is through your work (you usually can't opt out of this) and payment is taken at source.

When you go to the Dr you pay upfront (23 euros usually). This used to be fully reimbursed but recently they changed it for "solidarity" so you get 21 euros back.

Treatment is sometimes paid for upfront (and then reimbursed by social coverage and/or the top-up), sometimes you don't pay anything upfront and it's fully covered (e.g. for all my pregnancy stuff I never paid anything upfront).

They've also now introduced a "solidarity" tax for medicine - mostly it'll reimbursed except for 50 cents per product - this is to try and reduce the amount of medicines people claim for! (a nation of hypochondriacs)

For people without a lot of money (means tested):

Either the top-up health insurance is completely free, or you get a voucher contributing to it, so you get a 50, 60 or 70% discount etc.

I like the system because I never have to wait for an appointment. At most, I've had to wait one day to see a Dr. (specialists can usually be seen within a week or 2, with one exception who had a waiting list of 6 months but he's very good ).

There's also an SOS Dr system with a Dr making house calls. At most I've waited 3 hours for one. Yes I had to pay 50 euros for his visit but I got it all back.

The problem is that a lot of people waste doctors time with minor ailments that they really don't need to see a doctor about. If people were charged for appointments then they'd think more carefully about whether they really need to see a doctor.

But if this becomes the case then I'd want taxes reduced as the NHS is supposedly one of the reasons why we pay such high taxes.

Oh and I'm not entirely sure but I think if you have a long-term illness you are exempt from the upfront Dr/test fees.

There are different statuses of patients - like I said, once I was pregnant, all tests/appointments linked to that were free, I didn't advance any money.

Also, there are plenty of people who do not pay anything into the system yet get the same (in fact more) entitlements from the NHS like free prescriptions than tax payers. Perhaps charging people a small fee to see a GP would make people realise that the NHS is not actually "free", just funded by the taxes of those in work.

Plenty of people who are tax payers get free prescriptions as well. I think over 2/3 of people are eligible for free prescriptions. They can't all be unemployed surely.

"Plenty of people who are tax payers get free prescriptions as well. I think over 2/3 of people are eligible for free prescriptions. They can't all be unemployed surely."

How does that work?

Mind you, I can see where this "pay to see the doctor" might go, ie only those who are actually net tax contributors will have to pay as everyone else will be let off.

ophelia275 Tue 28-May-13 10:09:07
"The problem is that a lot of people waste doctors time with minor ailments that they really don't need to see a doctor about. If people were charged for appointments then they'd think more carefully about whether they really need to see a doctor."

The difficulty is that only the doctor can know if the ailment is minor or the first sign of something serious.

That irritating cough- is it just the hangover from a bad cold or is it lung cancer?

The funny change in your stools- is it an intolerance or the first signs of bowel cancer?

That spot of blood in your bra- exzema or breast cancer?

in my case it was exzema, in MILs cause breast cancer which then developed into cancer of the spine leaving her paralysed from the waist downwards

Or me with dd all those years when I had no idea why she was complaining about pains or if it was serious or perhaps even if she was telling the truth, but had to keep going back to the doctor because she simply wasn't functioning?

She is now coping with life on strong painkillers (having recently come out of the wheelchair) and I have been told that part of the problem is that she was not diagnosed and treated in time ("the damage will have been done" as one consultant put it). If I hadn't kept pestering she would never have got that diagnosis.

The people who will be kept off seeing the doctors won't be the real hypochondriacs (they will pay!) but people like MIL who are already worried about troubling the doctor.

I agree with all PP saying you shouldn't limit GP visits.

It also wouldn't work here in France because you need a Dr note whenever you have anytime off work with illness...even just for one day.

People over the age of 60
children under the age of 16 or 16-18 year olds in full time education
women who are pregnant or have had a baby in the last 12 months
people on IS, JSA or ESA
people claiming working persons disability element of Tax credits
people with diabetes, hypothyroidism, hypoparathyroidism, myasthenia gravis, addison's disease or are undergoing cancer treatment

All of these are exempt from prescription charges. I think there are a few other categories as well. The only people who are definitely not working from that group are children and those claiming ESA, IS and JSA. The rest are likely to be working and paying taxes.