To think if the Scandinavians charge to see a GP maybe we should too?

[Pickleup]

We’ve just spent twelve days in a Scandinavian country, during which time my DC and I fell ill and we had to get medical help.

We went to the local state-run health centre, took a ticket from a machine (like a deli counter) and waited our turn for an emergency appointment (Ie one where you haven’t booked). They run these emergency sessions 7 days a week!

We saw lovely GPs in an impeccably clean surgery. One of them said I needed a blood test and I was expecting to have to come back another day but she took us over the hall and did it herself with a thumb prick - then they tested the blood in their own lab there and then and told me I was good to go. The whole thing took maybe seven minutes.

On your way out you pay at a machine - it was just under £10 to see the doctor, and £5 for the blood test. Children under 16 are totally free.
No charge for doctors certificates.

We had to make a follow up appointment on our way out and there was reasonable availability - we chose something three days later.

Compare to the our GP surgery...at home in the UK, there is currently a ten day wait for ANY appointment with a GP. If you want a specific GP it is 14 days. There are no emergency appointments at all now. Blood tests - you are talking a week wait for results, minimum.

Isn’t it time we started levying a small charge for the vast majority of adults who could pay?

I know quite a few people who constantly seem to be at the GP for both them and their children. They are healthy people but book an appointment for the most minor of issues; I remember one booking an emergency appointment because after lunch out her bottom lip was tingling after she ate fresh pineapple
More needs to be done to make these people stop booking 2 appointments per week, I read somewhere that a high percentage of appointments are unnecessary.

Scandinavian countries are very different from the UK in that the minimum wages are much higher, childcare is much more reasonable and people's standard of living is generally much better. I don't think the same system would work in the UK. Speaking as someone whose child was born with a congenital heart defect and saw a doctor at least once a week for the first few months of his life...I would be bankrupt by now!

I live in Norway. It isn’t free after the first few appointments. It is free when you have spent over a certain amount, which is currently about 230 pounds. So it is quite a lot of money that you have to spend before it becomes free.

One of the greatest things I think about the Norwegian system is that prescriptions are electronic and online, so you can pick up your medicine anywhere in the country. Very handy if you are bad at forward-planning, like me!

I had no idea that you pay in Norway and Sweden for appointments.

So glad that doesn't happen in Denmark. With our tax rate it shouldn't happen after all

It's a difficult one, I think it should be free I've had to go to my GP's surgery four times in the last month and had a community outpatient appointment. I couldn't have afforded to pay £10 for each consultation. I've also had a blood test in that time and 13 different prescriptions so at £8.80 for each prescription £5 for a blood test and £50 for consultations it would have cost me £168. I don't have that kind of money.

Why should it be possible in a country of 5.5 million but not in a country of 60 million?

If anything it should be harder to organise and more expensive in a smaller country like Norway where many people are extremely geographically isolated, and there are fewer economies of scale.

I think some people are just so wedded to the status quo they reject any change. Even if it could mean better outcomes. It’s not just a question of “get more GPs” either - in Italy they have bonkers numbers of GPs per person but their health outcomes and consumer health index aren’t that good.

Sorry sonjadog I am just going on what the GP told me while she was taking blood ....I was asking lots of questions to distract me from the blood!!

For the umpteenth time... people on low incomes or with long term health conditions would not have to pay.

I understand why people are very protective of the NHS, but it is massively abused because it's entirely free. If people had to pay, even a small amount, they wouldn't be clogging up GP surgeries with tingling lips and minor sniffles. They'd go when they genuinely needed to.

Also agree there should be fines for no shows. People will argue about admin but it's manageable, particularly when you offset the initial effort against the benefit of unclogging the clinics.

60e to see a doctor on ireland. So if and 2 of your children are sick at the same time 180e.

Survival of the fittest in my house

Here in Ireland we pay 50 per gp visit. Children under 6 are free. It cuts out the time wasters tbh.

Another positive thing about the system in Norway is that you can get same day GP appointments. I wouldn’t swear that was the case all over the country, but it has been the case in the places I have lived.

Then it wouldn’t be the NHS any longer

I personally think we need to look at France and Germany and have an insurance type system. When the NHS started healthcare was very different and has progressed beyond anyone could have ever expected.

But no party will put forward such reforms as a nation we are loyally and often blindly attached. The idea was wonderful the reality is with the taxes we pay and how healthcare has progressed it’s no longer manageable and the NHS culture is outdated and money wasted is criminal

I think if GP’s and outpatient clinics set up text reminders for appointments, and could issue fines for no-shows, in the same way dentists and opticians do then that would be a start. And actually I think I would be willing to pay a small fee if it made it easier to access the GP. In my area there just aren’t enough to go around at the moment, so something needs to be done. They are also hugely inefficient.

No.
What about the homeless, people with addiction problems, ongoing mental health issues?? Thing is if these people arent getting to see GPs their problems can get so severe they end up at A&E when it could've been dealt with much more cheaply and easily earlier on. A&E is already under massive strain.
You could say 'oh well it could be free for people on benefits and that includes that list's but its complicated to prove you are on benefits and if someone is in the grips of addiction or a mental health crisis or living on the streets it can be very hard for them to sort thier shit out to get all their papers in order.

YABU.

If there was a charge then it would prevent lots of poorer people from accessing healthcare. In countries where there is a fee to see the GP typically mothers will not go to the GP themselves, even with conditions that turn out to be life threatening, because they want to save up to pay for their kids' GP appointments instead.

Firstly, there are over 66 million people in the UK, so that slight slip of millions in your post Pickleup covers the entire population of Norway!

Secondly, Norway spends roughly 9% of GDP on health, which is about average for OECD countries. But in a country of 5.2m people, this translates to more than $6,000 per capita – almost double the spend-per-person in the UK.

The Norweigans have a fully centralised health care system and they have closed many local services, so you do have people travelling very long distances for specialist care. In the UK, we have been pursuing a policy of decentralising services for a long time now.

There is nothing to stop us from trying to pursue a Norweigan system of healthcare, but it certainly won't be achieved by charging for GP services!

As I've said before, we need to make up our minds whether or not we want to be a full welfare state and if we do, then that has to be funded somehow.

YABU.

You really cant seem to grasp that for a lot of people £10 per appointment would be a lot. On going medical issues for some people would be a major issue. This isn't simply about "not liking change". You are living in your own privileged, ignorant bubble to assume because it would work for YOU that it would work for the whole country.

I'm a Brit living in Norway and, while I love the NHS, I vastly prefer the Norwegian system. It's only 5 days a week though, unless you went to legevakt the out of hours doctor which costs a little more. Kids are free up to 16, regular adults pay up to a point and then apply to get reimbursed for chronic illness. Families on low income can apply for reduced cost/free treatment.

The only thing that's shitty about healthcare here is dentistry, which costs the absolute earth! (Kids are free)

What about the homeless, people with addiction problems, ongoing mental health issues??

The logic on this thread seems to be that if we can find a single person in the country who couldn't pay the charge, then nobody should.

How about we set up the system so it works for the majority, and treats the exceptions as exceptions? So if nine out of ten people can pay, nine out of ten do, and we do something else for the rest.

9 out of ten seems a little ambitious. 25% of households in this country don't have £100 spare. Then, once we exclude children and those with chronic health conditions then it will be less again.

How about a voluntary payment system. GP's allocate half their appointments to people willing to pay, and half to those who aren't. Obviously the queue for the free appointments will be longer, incentivising those who can pay but don't want to to hop over to the other queue..

The paid appointments could be at the times of day that most suit working people, so they'd not only get quicker appointments, but more convenient ones.

PettyContractor, we already have that system. Anyone can pay to see a private GP. There is usually no queue!

How many people would it take to administer the paperwork that would determine whether people paid or not? Hundreds, thousands? So all the money made would go right out of the door on staff, and then some.

EmeraldShamrock I am a secretary in a GP practice - we send 2 x reminder texts and then often ring patients the morning of their appt day to check that they are attending. People still DNA. And it is very very rare for it to be an elderly patient - despite them often having masses of GP/hospital appts to remember they are diligent about cancelling appts they can’t attend.

Another way to kill off those pesky poor people (besides a no deal Brexit obvs)

No, terrible idea, dh and I pay over £1000 per month in national insurance to cover us and people who for whatever reason can't afford to contribute, doing this means everyone regardless of income gets equal accessibility to health care, it's one of the few remaining fair things in this country which makes us decent human beings, though I can't see it lasting for much longer with swathes of the nhs being sold off.