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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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

221 replies

Pickleup · 28/02/2019 10:13

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?

OP posts:
QuirkyQuark · 28/02/2019 15:26

My Gp surgery is excellent. Same day appointment for an emergency and our bloods results are often back the same day and the Gp calls if there's a problem. Not every surgery is dire.

Graphista · 28/02/2019 16:54

We DO pay to see our GP's via taxation an average of £30 per visit.

We SHOULD be questioning why it's not being funded and run properly but that's nothing to do with how it's paid for.

"Ah, the niavety of someone lucky enough to only need to see a doctor when they 'fall ill'." Just what I was thinking! The people who'd be spending more as they have more appointments they need are those who can least afford it!

£10 might not be much to you op, to me it's my weekly electric top up, 1/4 ish of my weekly food bill. It's a lot of money when you're on a tight budget because you can't work due to ill health and needing appointments most weeks.

If this model were in when dd was still a child just a few years ago, she also has a disability so easily possible I'd have needed to miss a weeks food to cover medical appointments costs - or not have the appointments and dd and I go untreated, only to have things worse possibly leading to hospital admission.

"If our governments raised tax the NHS could be better and still free" even this isn't necessary!

This govt have CHOSEN to use our taxes to (not a full/exhaustive list) bribe the dup to stay in power, pay themselves exorbitant pay rises and expenses, cut taxes to the very rich, wasted on a punitive and ineffectual new benefits system that isn't working, pratting about with brexit...

That's the real wastage of our taxes!

"Obviously for it to work, there would be protections in place for people on low incomes and people with long term conditions."

"Obviously children and the poorest would be exempt from charges"

You'd trust THIS govt to do this effectively and fairly? I bloody wouldn't trust them to organise a piss up in a brewery

Plus there's the cost of administration especially if there's exemptions - which the govt are very reluctant to disclose fully.

Yes we need more and arguably better quality gp's in some cases.

@colehawlins I rarely tag people but I'm very interested to know more of what you know on this and what time period.

"Yes more GPs but also an end to fund-holding.

GPs are noticeably less keen to refer since they have been running their own budgets. The inevitable result has been undiagnosed patients are clogging up primary care taking up multiple appointments with the same set of symptoms until either they hit crisis point and end up in A&E or a referral is finally made. People are arriving in outpatients clinic sicker and with more complications, apparently."

I started a thread in October about medics being particularly dismissive of women. There are some truly shocking stories on it, including people as you say ending up in a&e, admitted as inpatients and even dying as a result of gp's fobbing them off with quite serious symptoms - mainly because they're avoiding referring them or their children to specialists. I have personal experience of this with my own endometriosis (14 yrs until DX, 3 babies lost, 3 surgeries needed in the end) and dds disability (several years of symptoms inc a hospital stay of 10 days that we later learned could have been avoided if dd had been DX and the issue would have been treated differently/more aggressively from start).

The issue of Gp's not making referrals when they should seriously needs addressing.

www.mumsnet.com/Talk/am_i_being_unreasonable/3402449-Aibu-to-ask-you-to-tell-me-your-experiences-of-being-dismissed-by-medics-as-a-sick-woman-I-promise-to-listen?watched=1&msgid=85248454#85248454

IF it were decided to charge for GP visits then I expect the quality of those appointments to be better than they currently are in certain ways!

"it’s worth noting that Norway has the joint best health outcomes of any country in Europe. And it ranks third in Europe in the overall consumer health index which looks at things like drugs and waiting times" there's far more factors that affect a persons and a nations health outcomes than just the healthcare system. Employment, wage rates, housing, childcare, social care etc all have a huge effect on this too.

"But in Norway their taxes are much higher than ours AND they still charge a nominal fee for health services" if it's so well run why do they NEED both higher taxes and fees paid to Drs?

"Perhaps they think this way that patients are encouraged to take a bit more responsibility for showing up to appointments and following medical advice, and doctors surgeries are encouraged to treat patients a bit better..." I really think 4 visits as a visitor who could afford to pay is nowhere near even being classed as evidence for their system being better!

SurgeHopper - almost all illness/injury/disability is "self inflicted" or otherwise avoidable. The only exceptions being genetic conditions the parents weren't aware of before conceiving! People aren't perfect it's the nature of being human. Yes there are excesses that need addressing but it's still not as simple as being that sufferers fault. You cited certain examples:

Alcohol - it's relatively recently that the damaging effects of alcohol have really started to be well understood, particularly in non alcoholics. Indeed even among medics it's not totally agreed what amounts are problematic and which conditions are caused/exacerbated by it. Previously alcohol was even PRESCRIBED for certain conditions and not even that long ago. Imo the availability and the advertising of it is very poorly regulated. The cultural aspects of our relationship with alcohol as a nation seriously needs addressing - there's subsidised bars in the Houses of Parliament, mps are voting on important issues while under the influence ffs!

Tobacco - very similar to alcohol. We're slightly further down the road in recognising the harm it does but we're still a long way from it not being a big problem. Availability & advertising is slightly better regulated than alcohol but not massively so. Again there's huge cultural issues around its use. Then even with the move to vaping - we don't yet have long term evidence/research that this is actually safer, what little research there is that supposedly proves its safe is usually funded by the manufacturers (not always obviously so but if you dig that's what you find out)

Poor diet - I personally think we're only just starting to acknowledge the harm of certain ingredients, and some I don't think have even been started to be researched properly, including those that supposedly make food "healthier" (sweeteners come to mind). Generally speaking there's no bad food within a good diet, the problem is people eating too much of the same types of foods and not enough of others. Plus of course preferred cooking methods - which aren't always just out of laziness, it's quicker and cheaper fuel wise to fry something than boil or oven cook. This is one of the reasons why poverty is a factor in poor diet. Also the initial costs of some foods are cheaper than others and cheaper more filling foods aren't necessarily the healthiest foods to be eating the most of. Numerous discussions on mn on this.

My disability is as a result of a car accident, I was stationery some fool hit me. So not sure how me the patient having a non entitled attitude would have changed that.

The endo they're not entirely sure why that happens but believe there's a genetic component but possibly environmental factors too - do you think patients are to blame for pollution? Including that from nuclear testing and illegal disposal of chemicals etc?

Dd has a genetic disability that her father and I had no idea we were carriers of until she was DX. Neither of us are sufferers but now I know more about it (and still learning) I'm fairly confident there's relatives on both sides that are undx sufferers, albeit milder cases. Although in one case not mild symptoms but with a misdx in place (exs side, I have mentioned it to him but he was pretty dismissive so I doubt he's mentioned it and I'm no longer in contact with them due to the divorce).

But then perhaps you'll say dd shouldn't become a mother? Well then you're getting into eugenics.

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

Personally I think we should be going back to post war national insurance ringfencing minus using "surplus" for other govt determined expenditure - because it's clear its NOT really a surplus and should be reinvested in the Nhs and welfare state.

The money is there for properly funding and running the Nhs it's being diverted for other govt agendas.

AgentJohnson · 28/02/2019 18:36

Careful what you wish for. DD was hit by a car and an ambulance was called, I was not far away and went with her in the ambulance. Fortunately, it was just cuts and bruises but my insurance company started harassing me for the details of the person driving the car. Apparently, in the Netherlands you have to pay for non life threatening ambulance journeys.

Every system has it plus points but many have a minus points that you only see if you’re in the middle of it.

Tinkobell · 28/02/2019 18:54

It's an interesting debate. Given most people's aim is to live a long and healthy life here's some facts to chew over:-

  • Cost of living in Sweden is higher than UK
  • Swedens life expectancy is a bit higher than the UK's and accessibility to frontline healthcare has to be a major factor.
  • Sweden taxes much higher than UK on the whole I think.
So this must mean that people spend on healthcare but accept having less money for other stuff?
Sakura7 · 28/02/2019 19:08

Swedes get a lot back for their taxes though, like childcare and free third level education.

Gronky · 28/02/2019 19:08

I've often thought that a good way to discourage missed appointments would be to require the absentee to show up at the surgery at some inconvenient hour and run a card through a time stamp in order to be able to make future appointments. No financial penalty but still acts as a deterrent for all.

PettyContractor · 28/02/2019 19:15

Anyone can pay to see a private GP. There is usually no queue!

I've just googled private GP rates, first one I've found is £90. The £10 charge being discussed here is closer to free than that. Even if the charge were £30 (which I think is what the NHS pays GPs) that's still a different ballgame to going private.

BollocksToBrexit · 28/02/2019 19:33

Cost of living in Sweden is higher than UK

I disagree with this. Some things are more expensive, some are cheaper but overall I've found it much cheaper to live in Sweden. Primarily because house prices are vastly lower so more money in your pocket once the mortgage is paid. We have a massive 4 bedroom house out in forest with a separate 1 bed guest house and extensive grounds, no neighbours within shouting distance. All within commuting distance of Gothenburg. It cost us £35k.

SaucyJack · 28/02/2019 19:47

No, I don’t think it would have a productive effect.

All the people I know who make unnecessary appointments because they need a bit of TLC or like to get a scrip from the GP instead of seeing a pharmacist are those who are at home all day anyway such a parents taking small children and pensioners- and these are exactly the sort of people who’d be exempt from GP charges.

It’d only mean working taxpayers paying twice, or adults in poverty foregoing necessary medical treatment because they can’t afford it. Which would also quite possibly lead to far more expensive (for the NHS) hospital admissions in a number of cases.

AnxiousKatie · 28/02/2019 19:52

Yes, OP, a small charge to see a GP and reduced tax would be sensible.
There are much better systems in other countries, but people who think NHS is the best have no experience of better healthcare systems or think that waiting 10 days to see GP is fine as it’s free at the point of contact. It is not free though, as we pay for it heavily through tax.
Of course, there should be some provision for people who cannot pay, children, elderly.

Alsohuman · 28/02/2019 20:03

Anyone who thinks a charge would mean reduced tax is deluded. The NHS is deeply embedded in our culture and free at the point of delivery is one of its founding principles. No politician who wanted to be elected would dare suggest it. Look at the reaction to the proposed dementia tax.

HermioneWeasley · 28/02/2019 20:08

I think only the U.K. and Denmark have fully socialised/free at point of use medicine. Every other country has an element of paying, even socialist European countries. Are our healthcare outcomes so much better? Are people dying from lack of access to GPs in Spain?

TheFirstRuleOfFightClub · 28/02/2019 20:10

My ex-h was so financially abusive, there would be no chance in hell I'd be able to access healthcare if I'd needed to pay £10 to see a gp. I already couldn't afford to pay for my prescriptions as it was, even although our "household" income was relatively healthy. How would you get round a situation like that?

You wouldn't, you'd have to just suffer in silence.

*Maybe a percentage of 'No Shows' should be accounted for within the booking system.

Or maybe people could take their appointment seriously ?*

What about people with memory conditions, brain injuries, mental health problems, hospital admissions, fluctuating mobility problems, severe anxiety etc? The things that aren't catered for because you know, one size still fits all despite it obviously not working and this current system draining money.

MumofTinies · 28/02/2019 20:11

I really hope they don't start charging. When I was less well off I put off going to see the dentist because I couldn't afford the appointment charge.

I wonder if it would cost the NHS more in the long term, if people put off fairly simple issues until they become a much bigger problem, it will be more expensive to treat.

EssentialHummus · 28/02/2019 20:30

I think what your OP describes is efficiency (in appointment access, availability, blood tests etc) that the NHS needs. Doing so would reduce A&E pressures imo and in general move people through the system faster than they are currently moving. But I don't see that direct charging is the way to achieve this. And I can imagine it costing more to administer than it raises, costing the NHS money.

TedAndLola · 28/02/2019 20:32

@PettyContractor I pay £25 to see a private GP on PushDoctor. A prescription is £8.

teyem · 28/02/2019 20:36

If you get a prescription from a private doctor am I right in thinking it isn't subsidised by the NHS and so costs more that the usual prescription charge?

Graphista · 28/02/2019 20:43

Pettycontractor you're missing the point. You'd already suggested a 2 tier system where some pay and those who can afford to pay, the person who responded to you rightly pointed out that there already is that system in place.

£10 is just as unaffordable and undoable as £90 if you have £0!

Plus why should the poor (and the people most likely to be seriously sick/disabled) be relegated to a third rate system? It's applying a moral judgment to the ability to pay.

It would also as many pointed out be a false economy as people most needing care would avoid until it became a crisis situation at which point they're likely admitted to hospital, probably through a&e - that's a damn site more expensive than if they'd been able to access a gp weeks/months earlier.

It's my major argument against gp's blocking access to specialists, it's a false economy, it doesn't gain for anyone really (except that particular GP & their surgery!)

I've asked repeatedly on medical discussions how much an early referral to gynae would have cost vs 14 YEARS of GP appointments most months (not just to report symptoms but to get treatment that really only masked the symptoms), multiple a&e visits when symptoms were particularly bad, including when I was unconscious so couldn't say to anyone "this is normal for me" (fainting was a symptom), treatment for an ovarian torsion (believed to have been caused/exacerbated by the condition) 2 mc inc a partial ectopic, surgery for that, then a more thorough lap as that surgeon had seen some of the endo then a 3rd surgery to remove more of the endo that could be removed surgically. I'm pretty certain avoiding all that by an earlier referral and treatment would have been a damn sight cheaper! And that's not even taking into consideration the amount of time off work!

Anxiouskatie I've experience of non uk healthcare systems. None are perfect...organised crime infiltration, unnecessary procedures, lack of support for certain illnesses or patients, lack of funding...much of this sound familiar?

PrismGuile · 28/02/2019 20:59

No thanks.

I have £100 to last me 2 weeks (v junior at work and shite pay this includes £35 travel). I have already seen the Gp about an infection in my leg, now it's back. I've also been about my eczema 3 times, a new contraception twice and a chicken pox vaccine which took 4 visits to sort. Within 2 months. That's £100 on top of my prescriptions...

Not everyone goes to the GP once in a blue moon... I don't want to have to think 'do I let my infection get worse, not get my eczema steroid or not eat this weekend'.

The threshold for not paying for prescriptions etc is much lower than you would think. I don't want anyone getting sicker because they couldn't afford to see the GP.

PrismGuile · 28/02/2019 21:00

And yes I can usually get an appt within 3 days through the app and an emergency one the same day

Doobydoobeedoo · 28/02/2019 21:07

"Obviously for it to work, there would be protections in place for people on low incomes and people with long term conditions."

We're supposed to have this kind of protection in place for prescriptions. Asthma is a long term condition, can be fatal in a matter of minutes if you have no inhaler available, and yet isn't given any consideration when it comes to whether or not a person pays.

anniehm · 28/02/2019 21:22

I would not mind paying, but we have excellent service already, have never failed to get a same day appointment and booking ahead it's 3-4 days

Frenchfancy · 28/02/2019 21:23

Whilst you do get the money back in France it can take time. Dd has a bad knee at the moment. We have spent 150€ in the past 2 weeks to cover Dr's, x-ray and mri. We will probably get it back in about 2 weeks.

For many people that is just too much money. One woman aged 45 died in our village because she was waiting to get her medical costs reimbursed before going to her GP. By the time that happened it was too late.

FrowningFlamingo · 28/02/2019 21:41

@EmeraldShamrock GPs do not usually get any allocated lunch break and I don't know any who don't work several hours over their contracted ones on a daily basis.
I'm not sure 'most employees' get an allocated lunch break either to be honest, it's not just GPs.
The majority of GPs are self-employed partners, not employees anyway.

SinisterBumFacedCat · 28/02/2019 22:22

With not charging for long term conditions you often require several appointments over a long period of time to diagnose it in the first place. Sometimes this can take many years and various referrals. Would all these appointments be back dated?

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