To think NHS gp's should work like NHS dentists

[Gaballout]

It's so hard to get an appointment. Why don't GPS run like the NHS dentist to stop time wasters and people not showing up.

So charge people a small amount for an appointment and if you're poor you don't pay (just like NHS dentists).

The NHS is under funded and tax rises they just won't bring in. This could bring in millions a year and there's no outcry about NHS dentist costs.

Do we really think there's millionaire 70 year old sitting in the NHS GP's surgery for hours every week, let alone missing appts which is the original justification for charging?

SleepingStandingUp I assume she means that in many countries you go directly to the relevant doctor if it's obvious which doctor you need - children direct to paediatrician, ob/ gyne issues direct to ob/ gyne, ENT issues straight to ENT practice.

GP still exists but isn't a gate keeper, though going through them can allow you to jump a queue in urgent cases, they are there to direct you if you really don't know what's wrong and for minor general issues, medicals, vaccinations etc.

Sorry but other countries with far far better health services have fees, but only in the UK it's impossible to charge for fees as it's too risky? 1/10

Oh for god sake, another thread from people who are financially comfortable and just can't understand how some people struggle. Do you have any idea how fucking grindingly depressing it is to have to watch everything you spend and always get the cheapest. How depressing it is when things other people take for granted are impossible or extremely difficult for you? How hard it is to make friends when you can't afford to do the social things they do and it is too humiliating to explain why you can't go?
it is not just people on benefits who struggle - working people struggle like this too. And now we have fear being ill too, eh? Or getting a chronic condition that means a lot of doctors appts?

The reason I don't agree with this is that I don't trust our government to decide who can afford to pay and who can't.

There’s barely any NHS dentists around and the ones that do exist have long waiting lists. People who can’t afford to go to the dentist just don’t go which isn’t the end of the world I guess unless there’s a huge infection. If someone put off going to the GP it could potentially kill them.

There are plenty of people who live pay cheque to pay cheque and every penny is accounted for, an extra £25 - £50 for a GP appointment or two would cripple them. Not poor enough to qualify for NHS GP but too poor to pay for treatment. It happens, my DM is like this with the dentist and hasn’t been for years as a result.

Re the admin:

So - you have your system in place to accept payments (including cash payment, which have to be banked - maybe no nearby bank these days, so someone has to take time away from the medical centre to do that);

Then - would there need to be a system to distinguish who should be paying and who is exempt - partially? / totally? / temporarily / permanently? (as their circumstances change). Who is going to collect and update that information?

And unless you are really going to turn people away, if theydon't pay at the counter and are later not found to be exempt w, to bill them - and then somehow enforce the payment of the £15? Or why would anyone pay?

Easy - really?

Gaballout lots of countries have state medical insurance and actual appointments free at the point of use. Are you sure fees per appointment are so widespread? Germany phased them out several years ago as there were all sorts of problems. I know people in Ireland who don't go to the GP themselves because of costs and only take children - who I think still have to pay.

Sorry but other countries with far far better health services have fees, but only in the UK it's impossible to charge for fees as it's too risky? 1/10

Yeah, in these countries poor people are put off seeing doctors.

And the NHS is one of the most cost efficient health services in the world.

arethere all the millionaire 70 year olds I know are either house rich / income poor or spend their time and money visiting their private consultant. If that is the bar there would be very few paying.

The people at the NHS doctors are generally time rich due to lack of income and / or health. If you are not going to charge them, which you couldn't as they have no money, then you will not dent the problem.

I'm an HCP and we aim to have a DNA (Did Not Attend) rate of under 2% (but it doesn't work like that) . Patients make their own appointments by phone / if they cannot use a phone for whatever reason or are unable to make the appointment , they recieve a letter.
They also recieve a reminder call or text .

Still there is a DNA rate.
I phone people who di not attend then they are sent a letter and a letter is emailed to their GP.

What reason would be acceptable to miss an appointment with a fine?
(Because 99% of patients say we should fine , until it's them)

If I call , they will usually protest it isn't today . Or they forgot . Then after I convince them it was today they will say "Oh, I;m not well today " (Even though they were in fine fettle when argueing wuth me )

So-
illness? Hospital admission? Illness/admission of a spouce or family member?
How do you prove it ?
Or is it just a case of pay the fine anyway.

And don't get me started on the late comers - especially the serial latecomers

One reason people can't get an appointment with the GP is because there's a massive shortage of GPs. I'm pretty lucky where I live I only have to wait about 10 days for an appointment for something that's not urgent. My PILs live in on of the places in the country that's best served by GPs and they wait 2 or 3 days.

People's taxes would cover what's needed for the NHS if everyone started paying their fair share. I'd love to see a political party close all the loopholes so that the rich in this country can't avoid paying their taxes but not one will because they're all in it together.

*I said it's not hard to administer the £15 not pay it!

Already said poor people that couldn't afford it wouldn't have to pay it...*

Access based on eligibility critieria is always expensive and bureaucratic to run.

Ursaminor well they manage to work out who pays and who doesn't in the pharmacy next door and there's a system to ensure it isn't abused. I screwed up Last year, thought we still got free ones but exception card had run out. I got a letter saying I needed to pay the prescription cost and a fine, and if I didn't they'd increase it

Hang on a minute @Gaballout - going by one of your other threads, you're not that enamoured with your dental service.

www.mumsnet.com/Talk/_chat/3483847-Ive-got-a-painful-oatcake-stuck-in-my-gum
"Dentist has a wait, didn't book something as it was several weeks away"

In what way is that any better than trying to get an appointment with a GP?

I’m a GP and I wouldn’t like to charge people for appointments. It would lead me to have to consider financial constraints when advising follow up appointments , which I would find very difficult ethically and clinically. Imagine seeing a patient with depression, for whom part of their depression related to financial worries (as it does with most people ). I could end up seeing them less often than they needed, because I’d be mindful of their money worries.
That said, I would be happy for patients to be charged a nominal fee - say £1 - for missed appointments . And I mean appointments they themselves have made.

I agree OP

SleepStandingUp
Yes, and there are teams of people behind the scenes policing that system! Do we really the NHS to have to fund more bureaucracy? (Speaking as an exmember of said bureaucracy).

And - post payment verification would only be a part of it, as I've already narrated.

Well ii don't agree with charging any way, I'm just saying there would be a way to link it together as long as the criteria for free were the same

I'm not poor but over 8 years I had 50+ blood tests and maybe 40 courses of antibiotics. I was in the GP at least once every 2 weeks. TBF it was their "bloods normal" attitude that completely missed my diagnosis for 8 years but still... I would have been skint!

And I'm immunocompromised. So still see the GP too often for antibiotics and rescue antibiotics to keep at home. I already pay for all my prescriptions (pre payment card) and private dentist as I couldn't find an NHS one

I'm like Ollivander, not poor but require lots of medical procedures. I'd have no money left.

I forgot the million and one appointments for "sciatica" - cauda equina. That was 4 trips to a&e and 4 MRI scans plus two neurosurgeons. Good job I worked for the NHS for a decade!

I work for the NHS and believe it should be free at the point of use. To charge would put off time wasters but it would also stop people who genuinely need care from accessing it. I know missed appointments are expensive and frustrating but I don’t think charging for them would work. I’m not sure how charging for missed appointments would be feasible, but wouldn’t be against that for persistent offenders.

However, I think there should be a little more awareness from the public of the true cost of the NHS, not to shame people in to not using it but just to show the value they are getting. Things like the true cost of the drugs we only pay a prescription charge for, an ante-natal scan, a blood test, an operation.

Already said poor people that couldn't afford it wouldn't have to pay it...

So who decides who is poor.
On paper I am doing ok, in real life I am not so bad, but add a couple of Dr visits on a bad month and I will be at the food bank too.