To think that *some* people paying for healthcare *some* of the time would be no bad thing.

[manicinsomniac]

I am a big fan of the NHS and think it would be terrible if we lost it.

However, I think we could help prevent that happening by it being not quite so free as we are accustomed to, iyswim.

I had to go to my GP today for help with my totally avoidable and self inflicted health condition. I was given an appointment just 3 hours after phoning and the doctor was calm, non judgmental and extremely helpful. I am independent adult with a good, full time job.

I can't see why I, and people like me, shouldn't pay a token amount towards GP appointments, just like we do for the dentist. Even just £10-£15 a visit could make a huge difference on a national scale, surely.

Obviously if you are a) poor b) have an illness or disability that requires frequent appointments c) are a child or d) need expensive treatment/care then the NHS is vital and must remain free.

But I don't see the need for this 'free at the point of use' thing for all people in all situations. If you can pay for standard, infrequent appointments then I think it would be fine to be made to.

AIBU?

No fucking way would I be happy paying a charge for missed appointments. If I book time off for an appointment which is then so late that I have to return to work / collect kids from school etc. Then it is their fault the appointment is missed - once I was attending a different clinic and had to wait 5 hours for my appointment for which I turned up on time.

The reason the NHS puts so much blame on patients for missed appointments is entirely political - it is the form of wastage they can fix most easily and cheaply and with the best results. Fixing a poor management infrastructure and poor staffing is much more difficult and costly.

But the elderly are some of the people most in need - some of the people the NHS should be helping most! They are not a drain on services, they are (partly) who our health system is designed for!

The bottom line is, the NHS is struggling trying to provide care for everyone which ends up being substandard. This happens for various reasons we need to address, but until a way is found of making the NHS more efficient, maybe we need to say that the NHS can no longer also afford to care for the super wealthy (the top 0.02% or something??) in addition to everyone else?

Actually, looking at stats, maybe more like the top 1% or just under.

So they should be exempted the tax then, yes?

Well in that case embroideryqueen the wealthy can no longer afford to fund it either. Or require a say in how it's run. I for one would put every nurse manager back on the wards to do what they were trained to do. Care.

Meanwhile we'll have about £100k or so back a year please.

Lampygirl, What do you suggest the GP should do when a patient comes in with a condition that needs 25 minutes to sort out yet they have only 10 minutes to do it in? Perhaps they should kick out the crying patient who has just been told they have cancer, so you can make your appointment?
Its a doctors surgery, not a bank, or a hairdressers. People go to see the GP with actual real life problems. Your lack of empathy to others is appalling.

It hasnt worked with NHS dentists, many people cannot actually afford the prescription charge if they suddenly need 3 items at £8 each, so no. This kind of thing looks 'good' on paper but never works in real life.
It s like when ward sisters were replaced with ward managers in hospitals. It didnt save money at all. Now the old system has been dismantled its difficult to put it back.

Another reason for missed appointments is letters asking you to attend which arrive after the appointment date

Can anyone explain to me, how missing an appointment (which id never do btw) actually costs the nhs money? I get that it wastes money, (waste of receptionists time is all I can think of though) but can't understand how it costs.
Gps are often, through no fault of their own, behind time wise. ( patients with multiple problems, emergencies etc). Surely if someone misses an appointment, they either catch back up ten minutes or can get a phone appointment/done admin out of the way.

Although I will support pensioners getting free prescriptions I really don't agree with the exemption age being 60, when women's pension age is rising, it should be free when you actually get your pension not before, BUT the NHS do not agree.

From 2003 until March 2015 I had a medical exemption card and like another poster has already said I did not see why I should get free prescriptions for anything but my Thyroxine which the medex card was for. So in Feb 2015 when I had a chest infection and was prescribed Antibiotics, Steroids and an Inhaler, I didn't claim on my medex card, didn't tick the box just signed the back and I paid for my prescription.

In March 2015 I became 60 and was age exempt, I claimed for my Thyroxine using my age exemption as I would have got that free anyway. and until Jan this year didn't need any other medication, that's when I got another chest infection same medication, again I didn't tick the box that said I was over 60 just signed the back. To my total surprise I was told that I didn't need to sign the back and as my age and DOB are computer generated on the front of the prescription my medication was free as I was automatically exempt, I did offer to pay but was told no its free, and that's correct I checked the NHS business advisory service website. I was happy to pay, I could afford to pay but was not allowed to

As a dentist, if you have idle time where someone doesn't turn up, you're still paying about £80-100 for your overheads so actually shelling out cash. Then you're struggling to make your targets risking the NHS taking cash away from you. Incredibly frustrating

Mrs Morton - sorry I wasn't talking about dentists - I understand for you because you have your uda's to achieve.
But gps work on capitation don't they, unless I'm wrong? And their overheads are there regardless of whether you turn up or miss the appt.

MrsMorton & BeaufortBell no, the super wealthy should not get tax exemptions. They should simply be required to pay more than others in order to use NHS services on an opt-in basis, ie. If they choose to use NHS rather than private then they can but must pay extra. (Which in any case would still be less private services AFAIK, plus A&E services must always remain free.)

I'm totally fine with the 'paying twice' idea for the super wealthy - IMHO there is nothing wrong with the wealthy subsidising the poor / vulnerable (to some extent).

I'm sure the super wealthy would be totally fine with that as well. Cant see what could go wrong

What about scrapping the prescription charge (as so few prescriptions are paid for anyway) but having a donation box instead? The actual cost of your prescription printed on the form you hand over, then you choose how much to pay towards it.

So the prescription charge is £8, but if I were picking up a prescription for medication which actually costs the nhs £8 I'd likely donate £10, because I can afford to and wouldn't expect change from a donation box. If my prescription actually cost £50 I'd probably donate more than £10. I don't think I'm particularly virtuous, I expect there's loads of people who would do the same. I imagine that many parents would donate £1 or so for kids medication, especially expensive stuff. Even for people who can't afford it, they'd be less likely to waste prescription medication if they knew how much it actually cost.

I've literally never met anyone who paid less than the recommended donation for poppies in November. Most pay the exact amount, a fair number pay more.

"however, if I call and say DC has to be seen now they know I will have tried to sort it out first and that I see them as they should be seen as the last resort."

This situation is entirely lacking for most of us - a set up where we're known as an individual or a family, and the treatment can take our circumstances into account.

When I was 5, a GP came out to the house because I had measles and was delirious. He advised my mother what to do about my fever, and told her I would be fine. And reassured her about my newborn brother, who was breastfeeding (and she was immune). I know he knew my family when he gave her that advice.

When I was 37, I had my first baby, at home, a midwife (two, ultimately) attended me and I was taken to hospital afterwards for repairs to a third degree tear. The baby was born at 12.20, I was operated on around 7am and I was told I would have to stay in "at least overnight".

But -

The mw who had attended dd's birth came to see us and got us discharged, I am sure partly because she knew from experience that dp was going to be good to us all, my mum was around, and home was a good place for us to be (and she had seen our modest but clean and friendly house). Also, she knew me well enough by then to know that I wasn't going to rest or sleep at all in hospital and recuperation was going to start when I got home. And that there were people who would send me back - or take me back - if something went wrong.

So. When people whine and moan about these time wasters using up the NHS with their fatness, their inability to know what a simple blister or athlete's foot is - I think - well our culture is a bit sick.

These people aren't looked after. Instead of calling their mum, or looking something up (with the interior resilience that comes from successful problem solving), or just getting on with it - they are - you tell me? - just going to see HCPS?

So - who is failing here? Not HCPs, but society, which is teaching under capitalism that everything is a SERVICE.

Remember - the ultimate aim of capitalism is the commodification of all relationships.

I feel a huge responsibility to society, and HCPs, and the lovely old dears in my neighbourhood who were amazing to me with my newborns in the pram, because they have looked after me. If people don't feel that - and don't feel their adulthood - their responsibility - how they should serve back - whose fault is that?

It's not theirs, as individuals. They've been failed by a society, by an ethos, that has failed - not failed, chosen to to - teach collective responsibility

I'm fascinated by this idea that seems to have taken hold that the NHS is "crumbling" and "can't hold on"

My understanding is that, comparatively, judged globally, it is very cheap and efficient for what it does, and does it well.

Where does this emotive insistence that "it just can't last" come from?

Please, ask yourselves. What figures, information, that this is a bad way to run things, do you have?

If any. Is this just vague empty "PHPHPHWHH WE CAN'T GO ON LIKE THIS" nonsense that has no data?

I am really interested in this

You're right howbad. My sister and I are both at the same gp surgery, as is our mum. I've been referred to a geneticist to check if breast cancer in our family is inherited. If my sister and mum went in they'd have to go through the same process and take up 2 further gp appointments. In addition to that, each of us would separately have to fill in the same family history form, which would need to be reviewed, and then have separate appointments with the geneticist. So three times the work, even though we have all agreed we would happily share the medical information. That definitely is wasteful.

Free prescriptions are there for certain medical conditions, because they are conditions that can cause a lot of different health problems. Your thyroid may have not caused you any other issues, but many people have other health issues as a result.

CPtart My DM retired at the age of 79 two months ago after working in factories for 50 years. There are more cases than you think.

MrsMorton

Some of us understand moral responsibility and would keep working in order to pay back society because we aren't selfish and money driven

HowBad The Daily Mail I should think!

It is very important that the better off continue to "buy into " and use the NHS as that keeps it going and ensures high tax payers (me) keep paying those taxes. So we need to feel included and not resented.

It is utterly unfair that we pay the same tax rates but Scots and I think Welsh even if they are billionaires do not pay a penny in prescription charges. Scots don't even pay student fees. We should be a united one nation with the same rules for all. Or if the welsh want free prescriptions they pay 5% more income tax.

Scots pay more tax per head