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?

Civilised society falls apart when you start to say who is more and who less worthy

Tan I have issues with the public sector not providing education for her too.

I support higher taxation and a higher level of services in general

Cats meow. I've seen your posts before. Just out of interest - how often do you or your family use the nhs, and how much have you put in the pot?

are me personally, a lot. I have some long term conditions.

Between us we've probably put a lot in, one person in my house pays 40% tax and rarely uses it.

It would be an awful idea. Remember Baby P? Do you think his parents would have taken him to a doctor or hospital if they had to pay a tenner?

I think far far better to charge people who call an ambulance when they have a little cough. Or who turn up to A&E because they tripped and fell and now have a bruise on their shin. Or the ones who come to A&E because they cant be bothered to wait for a non urgent appointment at their GP for a non urgent problem. Or the ones who damage their liver with their excess alcohol consumption and require transplants, or the ones who regularly take paracetamol overdoses and then call the ambulance immediately. Or the ones who waste everyones time because they think a nurse or doctor looked at them funny and then complain about it. Or the adult children of elderly people who leave their parents in hospital because they cant be bothered with having an adult with a broken arm at home.
My list goes on. But healthcare free at point of care MUST continue.

So is your dh one of those who you think should pay more tax?

It's not my DH, but personally I'd change the levels from increasing at 43,000 and 150,000 to going up to 45% at 80,000 and 50/55% at 150,000.

I'd have no problem with us paying more tax, I'd have no problem paying that tax when I earn enough.

My daughter attends the local community dental centre as she has special needs. The NHS dental service already charges people - it's 18.80 for a basic exam with scale and polish. That goes up to 51.30 for fillings and root canal treatment. As an adult you have to show proof of free entitlement in order to not pay the fee e.g. you get DLA or jobseeker's allowance. I don't see why this shouldn't be applied more generally in the NHS, particularly with GP visits. Surgery and the like should always be free though, in my opinion.

I think the NHS is something that the British can be proud of, and i would certainly pay a small fee if it helped make it sustainable in the future. Another option would be for people to sign up voluntarily as a paying contributor.

I totally agree with the OP. I have lived in several countries and not one of them - including several northern european countries - had a totally free healthcare system. Health care costs money and a lot of it considering the advances that have been made and the aging of the population. It is daft to think that all of a nation's healthcare should be provided for free and by income tax. Obviously these countries have refined the model of payment over decades so that the lower paid can still access healthcare. The UK hasn't got clue. The UK system is close to breaking and the death of a family member from cancer showed how broken it is. Shee would probably still be alive if we had lived in germany, for example, where they have a healthcare based on insurance. I am not saying that their system is perfect, there are no doubt lots of dodgy areas, but it is very naive to think that a country of our size can manage the health of its citizens for free. People manage to pay for internet access on their phones, which never happened 10 years ago. They can afford some contribution to a functioning health care system. Some countries actually manage to do a very good job of combining private and state healthcare, such as Australia, which almost has a sliding scale of treatments from basic to luxury, meaning that the wealthy get a much more comfortable experience that is not really needed while subsidising the poor.

Receptionists are not triage CatsMeow. They're something different. If they're just receptionists they aren't triage. I was talking about triage systems which are being increasingly used to weed out non-urgent cases but people are very resistant.

They're actually supposed to deal with the problem of unqualified staff having to assess risk. But a lot of people won't accept anything less than a face to face appointment even though they normally just get told the same thing!

They introduced a nominal fee to see a GP or go to A&E in Ireland and it soon increased to €60 for all but the poorest families - so those earning average amounts pay for both adults and children. They introduced university fees here. They increased from £1000 to £3000 to £9000 within a short space of time, and soon it will be higher.

So paying £10 or £20 does seem reasonable but once the precedent was set it would soon be £50.

We are paying, though. I pay massive amounts of tax much much more than I ever get out of the state or ever will. I am a net giver. (the majority are net takers).

Hoever I would certainly support a much smaller state and much lower taxes (say 20% tax/NI, 20% CGT and no IHT nor stamp duty for starters).

My family use the NHS regularly (actually sitting in hospital typing this). Having a family member with a long term illness already puts us at a financial disadvantage, as one parents always needs to be available to be with our child. Having spent most of January in hospital with our ill child - it has been difficult for both of us to have full time jobs. I'd love a full time job and a healthy child but you have to deal with what you have.

Having used the NHS regularly I am aware of the flaws but we couldn't afford to keep our child alive under private insurance. We've checked and it was too costly, especially on one wage. Ironically, the worker in our family pays higher rate tax, but we couldn't afford an increase there either as the wage has to cover all of us.

It's hard because vulnerable people are vulnerable for a reason. Equally Higher rate tax payers see that disabled/poor people get support and assistance not available to them and when asked to pay more feel resentful. I understand that argument too.

Personally I would crack down on health tourism (it isn't a minor issue - I promise you that) and I'd fine for missed appointments - but as another poster pointed out they'd tried to cancel and couldn't get through, so her surgery would need a better system (email maybe), so that it would be fair to fine those who didn't show and didn't attempt to cancel. A £25 fine would hopefully stop people wasting slots at the GP.

Also maybe a fine for misuse of services? This would be difficult to categorise but people who show up to a&e when it's not an accident or emergency really frustrate me. I wouldn't want it to put people off but people do need to stop going to a&e 'just in case it's serious' when it's blatantly not serious.

Bill ah right. We have a weird thing where the receptionists try to direct your appointment and always fuck it up

Deo well then I assume you're a higher earner. Do you really think it's fair for you to be on 6 figures while some families are scraping on minimum wage? The least we can do is redistribute resources with services

Cats I think your proposed tax plan would net the pot with far less than current - there's loads of people in between 43k and 80k.
It really is simplistic and a slightly childish view to just say tax high earners more.

""Because most triage people are idiots......I refuse to speak to them now. I know my condition, I know what I need. I don't need some unqualified jobsworth telling me to call back later.""

I, like the person who posted that, have an underlying health condition, that I'm an expert in.

In October, I went to my local Walk-In Center, saw a Triage Nurse, who dismissed what I said and then I saw the Nurse.

Who also dismissed what I said, I was trying to explain that you can't always hear Pneumonia etc, this clinic has XRay facilities and I was trying to not go to A&E. She looked at me like I was mad and told me to go home and take Iron tablets.

So for three weeks, my Pneumonia had time to take a full grip, yes, I've complained.

I've seen some idiot Triage Nurses, when attending with relatives and when I worked in Home Care. The point of the Walk In Centers were to take pressure off A&E, but my local one has become a joke. Our Children's one, is very good, though.

I've tried to cancel a hospital appointment that I've got, but the person on the other end of the phone, wouldn't, without closing down my whole referral, this is for my health condition. I was trying to explain the situation, appointment not needed because I'm seriously ill, so I'm being seen three weekly by my Consultants, he was having none of it. I hope that I remember to sort it out when I go to my next appointment.

I used to have the same issue when I did Home Care. We'd have a person admired to hospital, so knew we wouldn't need the appointment, sometimes they'd cancel it, sometimes not. Even when they did, we'd get a 'missed appointment' letter.

The NHS should remain free, otherwise we pick up the cost later on, anyway.

I can remember when the Lottery was coming into being and we were never given a proper explanation why, the money wasn't going into services, as was first suggested.

are no it isn't childish. It requires a bit of admin and loopholes being closed, as well as a change in how services are delivered. At the moment it goes from 43 to 150. I'd also like to see higher after 200,000 because we're getting ridiculous there.

I think it's disgusting some people hog the wealth

Also, I've been missed diagnosed a few times.

My DH was misdiagnosed, his Cancer wasn't picked up until too late.

I make complaints etc but if I had to pay, I'd be suing.

Catsmeow, you do seem rather good at wanting to spend other people's salaries. they do have to work hard for them! For example - I earned a bonus last year by working an enormous amount of hours. I was frequently at my desk until 11pm, 5 nights a week; I worked many weekends; missed numerous nights out, had to cancel a weeknd away, and barely saw my OH... It was taxed at 62% in the end. take any more of it, and why would I bother? I could relax, work less, earn less. And the result would be, the taxman getting less out of me. Which is the opposite of what you are trying to achieve! If you make it too unrewarding, people won't do it.

Plug the gaps where money is leaking, ask whether we should be treating non uk residents for free/failing to collect the cash from those who are charged, get the government to smarten up on collecting from the super rich and the corporations, shame the amazons and the googles for not paying tax - vote with our feet. Those would be my suggestions. I bet most of the people crying, "get google to pay its taxes!" use it and the search results regularly.

Birds that's disgusting. This isn't about my condition but

They made my appointment with a student when I explained I was pregnant and bleeding and had been told I needed an urgent cervical exam. I explicitly asked them if he could do it. The poor bloke panicked and said "I'm not allowed to do that! Plus I'd need a chaperone!" And had to make me a new emergency appointment and get extra staff and it took 4 hours...

scared but they earned that money off the back of a society that gave them the chance to do it. No one does it on their own do they.

You still earned more than you would without though. The money you got was still on top of your normal salary. And personally I feel I have an obligation to provide for others...

I agree with your latter points except I do think everyone should be treated regardless of nationality

It would be better to work on improving the current system and educating its users, rather than introducing a pay system by the back door. Or the front door for that matter.

It really is simplistic and a slightly childish view to just say tax high earners more

It really isn't and I say that as a higher rate tax payer, as is DH.