Should GPs charge for letters?

[Lanchester]

GPs are semi-independent contractors to the NHS.
They were trained at huge cost to the taxpayer.
Most of the older GPs made precisely Zero financial contribution to their own training.
They do not have to provide out of hours cover.
They earn SO much that many of them can afford to cut their hours to part time - and STILL have a handsome standard of living.
That part time working is a major cause of the 'shortage of doctors at the NHS coal face', and of the 'hard pressed' feelings of (presumably other?) NHS staff.
(Ironically therefore, it could be that if the GPs salaries were halved, there would be more GPs working hours available to the NHS?).
The GPs final salary NHS pension arrangements are fairly legendary ....even within the NHS.
Do the GPs refund the NHS for the use of resources used to provide a letter??????
E.g. if a Typist is a full time member of surgery staff funded entirely by the NHS, then would it not be a FRAUDULENT activity for the GP to use the typist's time for 'private earning' purposes for the GP???????
If the GP wants to charge for a non-essential letter (e.g. for a holiday company) then that may be a fair charge if the GP tells the patient in advance that the letter will incur a charge.
For any ESSENTIAL letters (e.g. medical letter for a court) the GP should regard that as an important part of the 'doctor-patient relationship' which the GP is already well paid for via the state funded NHS by the patient's taxes. The GP should NOT charge for essential medical letters.
Also, most patients earn a small fraction of what a GP earns, and many unwell patients may have an impaired earning capability and so may be on only £70 per week benefits.
Therefore, the GP should not assume that all patients are able to pay £25 for a letter.
If that letter takes the GP about 10 minutes,
then he/she is paying themself at the rate of about £300,000 per annum for that letter...... on top of their already excellent salary.

Sounds like such a letter would take at least half an hour to compose and dictate, plus typing time etc.

Why is your the patient's time worth more than the GP's kids' time in terms of what said GP has to do that day? Hmm?? It's not as if he/she can do it while seeing patients is it?

So do you suggest he/she cuts an NHS clinic short, (ie you're admin is more important than currently sick people - nice) the GP runs over so all the patients are cross/late/inconvenienced; the cleaner can't get in the room in the evening and misses putting their kids to bed tonight?

The world isn't all about you. If it's not paid for by the NHS it needs to be paid for by you. We're not talking about a referral letter here, after all.

OP, your rambling penultimate post makes not a jot of difference.

You are unreasonable.

Everyone has told you that you are unreasonable.

OP, if GPs earn such phenomenal salaries, surely their tax compensates for the public money that was spent on their training, so it all works out fairly?!

I'm not a GP and I still think you're wrong. HTH

OP, you are Jeremy Hunt AICMFP

Other posters have pointed out where you are mistaken in your beliefs about GP funding. I'm just wondering why you resurrected a zombie thread to get your point across initially. Did you search for threads about GPs charging for letters? What is your underlying agenda?

I don't particularly like the OP's tone BUT when dd was badly injured our NHS GP had to sign an insurance form because of a holiday insurance claim. A perfectly completed form was delivered with sticky tabs on the bits that had been drafted for her and where she had to sign. It must have taken all if two minutes and dd was treated privately so was not a drain on NHS resources.

I was asked for a cheque for £30 psyable to the doctor personally not the practice and told to come back the following morning to see if it was ready. The receptionist then got arsy when I said could the practice please phone me when it was ready. Actually for the equivalent of £15 per minute I expect a phone call when my DD is in a wheelchair.

But Ripening if the GP hadn't competed the form then it would have had to be checked against the notes wouldn't it? So not a two minute job really.
Unhelpful receptionist though for sure.

NHS employees do not get final salary pensions. Nor do we get "weeks off for and our training paid for". We get a maximum 5 study days a year, which has to include all professional development (so attending courses, portfolio maintenance, preparation for delivering teaching etc). Courses are mostly over weekends, funding is never guaranteed and travel/accommodation is not refunded.

How many letters like yours do you think GP's are asked to write over the course of a month? How much face to face patient time is lost because of having to write them (done properly, each one will probably take at least 20-30 minutes). Why shouldn't the NHS (and it is the NHS, not the GP's!) be compensated for that time that is taken away from its other users on admin not essential to the treatment the NHS is providing?

fastdaytears is right, a completed form would still need cross checking. If we are signing a form for insurance or holiday cancellation and it is later found out that it was completed incorrectly then we are responsible and there could be financial penalties for the practice. Granted some forms are quicker than others but very rarely is it a 'two minute job'.

As others have mentioned some older criminal defence solicitors went through a law degree at tax payer expense, they then work in the criminal courts legal system which is funded by tax payers, should they work for free?

If a GP is doing work out of their allocated hours and most of them are- the GPs I do know, write letters and insurance forms at home or in the office late at night when they have finished seeing patients and calling patients and writing referral letters, and doing practice admin.... Why shouldn't they be paid for something that cuts into their own time, or do they owe their souls to the taxpayer as well?

You are so wrong I can't actually work out where to start. Medical students pay exactly the same towards their degrees as anyone else so anyone with a degree has been trained at the public expense.
They are paid about 90 pounds per patient per year to look after you. You would struggle to insure your pet hamster for less than that.
Most GPs 'part time' is more hours than your full time.
Any time spent writing needless statement of fact letters takes them away from patient care.
If you want these letters done on the NHS then the tax payer will have to fund it (and they shouldn't as most of these letters are not required if a little common sense is applied by the companies requesting them)
A full time GP pays 10000 per year out of their own pocket on medical indemnity fees.
I could go on but I am bored now and you have made too many uneducated statements to correct now stop making a tit of youself and have a lie down.

Still wondering why you posted on the zombie thread first...

Is that you Jeremy?

How is a medical letter for court "essential" to the health of the patient?

Well, to be fair, it can be. Suppose, for instance, someone is being prosecuted for their child's non-attendance at school, and she can prove via a letter from her GP that there was a medical reason for it. It could well be that having that letter makes the difference between her being found guilty or innocent, which in turn is likely to have a fairly major effect on her mental health; indeed, in some cases it could make the difference between going free and being in custody. For the child, it can make the difference between going without education and having the right to home tuition, which in turn is likely to have major beneficial effects on his mental health and wellbeing.

fastsaytears the GP didn't complete the form; I handed it over completed with a letter from the hospital. The bits I completed were all marked with stickies. The cheque was payable to Dr Jane Smith not to "grunty practice". It really was a two minute job and there was no respect for my time from the surgery staff. For £15 a minute I don't expect to do the running to see ifvsomething's been done.

I wouldn't have been in the least grumpy over £30 if the receptionist had said "we'll let you know when it's ready"

the GP didn't complete the form; I handed it over completed

I get that, I just mean that the GP had to read the bits you filled in and check that it is what they would have written. They can't sign it otherwise can they?

But basically we agree because the receptionist was a bit of a cow and unnecessarily so. Pretty sure their phones make outgoing calls and it's not hard to work out that a parents whose child is injured and in a wheelchair might be having some logistical problems.

But then the receptionists at the practice I go to make me cry almost every time so I might be biased.

I could go on and on but even the simplest of insurance forms will have questions such as 'was there a history of any similar condition in the two years before the insurance was purchased'. You might think ticking no is really simple but I have to scroll through two years of records and that might include both paper and computer records. Again might be quicker for some patients but still not a 'two minute job'!!!

Are you Jeremy Hunt OP?

Didn't the idea of a "typist" go out in the 90s?

I don't know where to start with your OP tbh.

Just one minor point: do you expect letters from your lawyer to be provided for free? And immediately?

No. Thought not.

My GP kindly provided a completely unnecessary letter for my DD last week, which the school had requested. He phoned me and explained it wasn't part of the NHS remit and there would therefore be a £20 charge, and I entirely agreed with him.

Best £20 I have spent. He wrote a very comprehensive letter. I am eternally grateful to him.

Can any GPs on the thread tell me what sort of gestures of gratitude are really appreciated? Chocs (unhealthy)? thank you card? wine (inappropriate)?

And, if GPs are earning £300K pa (which they're not) why the hell are they driving T reg Honda Accords?

Ok ... the consensus seems to be that I as the OP am being unreasonable in tone at least ...
and possibly that's true ....

but I notice that no-one has specifically pointed out much that is actually incorrect in what I have posted.
...If the facts were wrong I expect they would have been specifically challenged.
Maybe then the narrative is based on correct facts :)

By the way - can I emphasise that in the original post I said that it is probably ok to charge for non-essential medical letters - e.g. to holiday company.

I think the problem is that many NHS Staff do work very hard for not particularly great pay, but ...HELLO PEOPLE... guess what? the very same thing is true of the vast majority of the population !

1% per year NHS seniority payrises were not a Zero % payrise by the way.
1% 0%
Contrast with : Private sector 0% payrises = 0% payrises

I personally know that some long serving 'Staff Grade' doctors working in hospitals were historically underpaid but did much of the important work in the hospital, whilst being barred from becoming consultants themselves.
Also, some midwives were historically overworked and underpaid, whilst having very responsible jobs.
I hope both the above situations have improved.

However some other NHS Staff - such as some senior GPs and Consultants - do nowadays experience a very comfortable lifestyle as compared to the majority of their patients who are paying for them to have that lifestyle.

It seems to be that the more people get paid the more they think about money and status vis-a-vis their colleagues,
and the less they think about patients as people needing their care and diligence.

Three cheers for Jeremy Hunt and 7 day NHS working !
(and I am not usually pro-Tory policies)

Every GP partner I know has had a cut in their take home money of between 10 and 20% in the last few years and it is continuing to fall. Many now earn less than their salaried GPs. Yes, there are a few who run many practices and earn 6 figure salaries, but they are doing that from being businessmen/women and only seeing patients every now and then. Those GPs who are at the coal face for the majority of their time aren't caning it in. Don't believe the Daily Mail on doctor's salaries.