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?

Many elderly people of chronic age related problems that could be dealt with in different centres, GP led with nurse practitioners, social workers, a hub for assessment, advice and community nursing services.

The priority should be children and people of working age.

I fear though, should this scheme be introduced with payment for having used your allocation (could be 40 visits, could be 4 per annum)
that the elderly will be exempt.

Many elderly people have* chronic age related problems

I reckon the Internet will hold the info needed so you "learn what to say" in order to get past the nurse prescriber to see someone with medical training

There is a petition against this by 38 Degrees:

secure.38degrees.org.uk/dont-cap-GP-visits

More and more specialist services are being cut. My hospital had a 5 day rheumatology clinic, now it is 3 days. I'm told to go to my GP who often doesn't know how to deal with my condition. That's not a criticism, it's just the facts. So, I'll just curl up into a little ball and suffer, shall I?

I wonder if people who advocate cutting frontline services have any idea of how stressful it is to manage a long-term or chronic condition. Sometimes my GP is my lifeline. I can't wait for my virus to progress to the point where I require hospitalisation, I need antibiotics now. Managing my condition effectively allows me to study and work, therefore putting back into the economy and paying taxes. I know that I am not alone in this.

In England, 90% of prescriptions are dispensed free i.e. the recipient is entitled to free prescriptions. I think if appointment charges were introduced it would probably be the same - the vast majority of appointments would be taken by people entitled to "free appointments". It's fairly logical really - as the people with most health need are the elderly, the very young, and the disadvantaged. It would be a hell of a bureaucracy providing minimal actual income to the NHS.

crashdoll, absolutely. There is a sense somehow that "we" have to limit what "they, the scroungers" take. But "we" are everybody - everybody is using these services to stay as functional as we can

Argy is probably right: there would be very little actual financial gain unless you cut the whole concept of no charges for the elderly and disabled. It is not about saving money but about political posturing.

I wouldn't be surprised if we had to pay to see our GP, before long.

Have been chatting to dh (a GP) about this thread.

He thinks that roughly a third of the patients who make appointments to see him are not unwell, people who attend because their kids have head lice, or for a split nail, or dry skin, or for people wanting forms filling. This third exclude people who have coughs and colds etc (so people who are unwell but he can do little to help other than assessment and reassurance).

The elderly do attend significantly more than any other group, but (he got quite animated about this) they attend appropriately and indeed he would like a lot of them to attend more for monitoring and for disease prevention.

Disease prevalence in the uk (apart from type II diabetes and dementia) is steadily declining but demand for GP appointments on average rises 5% every year.
Dh says this is down to two things, firstly young and middle aged people requesting to see their GP more (he says the current system relies on young people not seeing their dr to counterbalance the number of appointments for the elderly), and secondly GP's 'chasing' patients for want of a better word to attend 'please come in for your flu vaccination, please attend for an asthma meds review, please come in for a warfarin/BP check up. In the ten years he has been in general practice he says this aspect (monitoring/imms etc for disease prevention has increased significantly).

His thoughts on limiting no of appointments are mostly and but "something has to change as the system cannot continue to function with a 5% increase in demand every year".

Thank you curryeater I have signed. I wondered of there was a petition but I am busy working (in between reading all the comments here)

Surely GPs shouldn't be chasing people to attend for monitoring. Much of this monitoring for chronic conditions in the elderly could be undertaken by nurse practitioners and the chasing..........well isn't that what admin staff are for?

He's not the one doing the chasing , it was a turn of phrase, the surgery invites patients to make appointments, some of whom will be seen by nurse practitioners, and some of whom, those with complex comorbidities and polypharmacy will be seen by the GP.

Maybe the elderly shouldn't have free prescriptions,given they have as almost as much wealth as the working ages now.

I wish people would see their pharmacists more often for minor ailments. Our Boots ones are fantastic and only point me in the direction of the doctor if it can't be treated OTC. Instead of trundling off to the doctor for every cough and sneeze, people should pop into their local pharmacy (obviously there will be exceptions). They give good advice!

The NHS is a hugely efficient service in many ways, our percentage of GDP spent on healthcare is half of that in the US. And yet despite that level of spending they have huge swathes of the population not covered at all by healthcare and a great many more with inadequate cover. Most of this money spent goes straight into the pockets of private healthcare providers and it is inefficient spending for the return the population get.

While I don't believe in charging I do see every day (in my job) people abusing the NHS. Last week our outpatient clinic had 25% of patents not turning up. More than 25/80 patients DNA'd their appointments and didn't phone or email us to cancel (we have many user friendly options to cancel appts). They wlll all need to be squeezed into subsequent clinics over the next month (these are cancer patients by the way so you would think their appointments are important and we cannot discharge them for a DNA in the same way gastroenterology do for example). This will have a massive knock on effect and overfill the coming clinics. So then all the same patients will be complaining about waiting times!!

I'm 53 and I don't remember the NHS getting better between 1997 and 2009 - in fact that was when PCTs (a huge diluting laayer of bureacracy), NHS direct and the concept of GPs no longer providing out of hours care were introduced. It was also when it became impossible to book an appoinent in advance (the 24 hour pledge) and when 28 day prescribing (which meant endless needless admin and pharmacy collections) came into being.

The NHS is broke afaiac - its staff are rude and incompetent and it does not respond to the needs of working people.

We are high earners and pay for it and sybsidise it in spades. We have no voice but at least we can afford polite and private care x

I meant to specify income based JSA and ESA. I think those on contribution based do have to pay for their prescriptions. I was a bit out with the 2/3 of prescriptions being free. It's about 88% although that's an old number and it may have increased since then. It's definitely not just limited to those who don't pay into the system though.

Here's that petition again, just for the sake of it: secure.38degrees.org.uk/page/s/dont-cap-GP-visits#petition

As the 38 degrees email says: "Jeremy Hunt will be watching the public's reaction carefully. He is an ambitious politician with an eye on his own popularity. If he sees a huge petition growing fast, he'll realise this is damaging his ratings. So if enough of us sign, we could play a key role in getting this idea dropped."

NazgulSnood, I'm not at all surprised GPs are seeing rising demands for paperwork, with the nonsense of schools demanding doctor's notes for absences.

DWP/ATOS are more culprits. They've increased the frequency of reassessing people for Incapacity Benefit/ESA but reduced the number of reports sought by ATOS by letter, thus dumping responsibility on the patient who then makes an appointment with GP: "GPs 'flooded' with letter requests due to UK benefit reforms"

"stoical security payments" wrote Porto some time ago.

:o

I really think we need to introduce these to replace the endless fucking whingeing security payments we have at the moment.

If we could all be a bit less resentful of paying tax we could continue to afford the (wonderful) NHS.

Of course, our taxes won't go down with our entitlement.

Oh no, we'll still be paying, just more money will be diverted into "profit making" companies, as Parsing pointed out earlier.

Don't move to Jersey. We pay £41 per visit to the GP. We also pay for blood test, xrays, letters, referrals etc etc.

Oh and we also pay for contraception.

But do you know what? Because we have to pay to see the GP, minor ailments people go to the pharmacy. There is no major wait to see a GP. If you phone in the morning you are seen within 2 hours.

And there are no time wasters.

Jersey I know that paying will weed out the time wasters but it will weed out genuinely ill people too. I've been to the GP 3 times in the past few weeks due to infections from my immunosuppressant meds. I cannot afford to pay £41 a pop. What would have happened was that I would probably have struggled on and ended up in hospital, thus costing the NHS much more. What happens to people like me?

"its staff are rude and incompetent"

They are? Not the ones I know,and I have seen it from both sides rather more than I would like to over the last few years.And loads with DD when she was little...

With regard to the whole question of missed appointments both at the GPs and at hospital clinics,considering the regular threads on which people bewail the time they have to sit and wait to see their GP what would happen if everyone came? Hospital clinics I know personally are overbooked and seem to only run as smoothly as they do because not everyone who is booked attends.
I am open to being corrected by NHS staff - if you do all spend hours sitting around doing nothing and waiting for patients who "no show" then fair enough...