To ask if you would pay for GP visits

[justanotherhappyflunkie]

Been talking with various friends who all agree they would rather pay a nominal sum to see a GP rather than the current system.

I have lived in a country that does this (free for children, disabled people, discounts for beneficiaries and long term sickness) and it was great. Same day appointments, good range of doctors, quick referrals.

The UK equivalent of this would be around £20 per visit.

AIBU to suggest it is the system that could help the NHS? prepares for a flaming!

I don’t use a particular service.

There is one private gp practice I prefer out of all of the ones in the area, but just google “private GP X town” and I’m sure you’ll find a lot come up. More and more are cropping up everywhere due to demand.

I don’t like the apps, I prefer to see someone face to face.

No private GP where I live.
But I can see my excellent NHS GP the same day.
Continuity of care is really important. If you see a private GP make sure it is a practice you can go to whenever you have an issue. And it has to be face-to-face.

Smear tests are free between ages of 25-60. Contraception free for ages 17-25. That is the sum total of it.

Oh thanks. It might sound stupid, but I didn't realise private services organise locally as well as the remote services.

Yes, I think a lot of people just see the apps being advertised and think that’s it.

But there are always private practices around. There are none in my town, but there is in the closet city and the next towns over.

The one I use is a 30 min drive from me, but the longest I’ve had to wait for an appointment is 24 hours, so I really don’t mind. Especially as the phone is picked up right away and no one asks what you want the appointment for or argues!

As I asked in a previous post when does that free kick in?
When you go for that first appointment or months or years down the line when you are finally diagnosed?
I was really lucky my chronic condition was diagnosed within 6mths many other people with it take years for diagnosis.
I'm not on benefits mainly because the amazing meds I'm on have kept my disease relatively controlled so I can live a fairly productive life - but in order to be on those drugs I have to have regular drs appointments as they are extremely dangerous meds. I already have to pay for a prepayment cert for my prescription which is fine but was tricky in that first year when I didn't know what was going on.
I'm not elderly - I was diagnosed at 19

Getting regular treatment has 'saved' lots of money as I have avoided expensive surgery by slowing disease progress. It's cheaper for the nhs to manage this through my GP than the hospital system however paying for GP appointments would mean many people would bypass the GP for stuff like this.

Paying nominal amounts for gp appointments doesn't solve the fundamental issue of not enough GPs in the system.

Perhaps the government should concentrate on retaining & recruitment rather than making the healthcare jobs so unappealing that staff leave in droves. www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice-data-analysis

amp.theguardian.com/society/2022/apr/11/gp-numbers-in-england-down-every-year-since-2015-pledge-to-raise-them

"To those saying NHS is underfunded. You are wrong."

Compared with many other countries, the NHS is grossly underfunded.

UK per capita spending on healthcare (2021) was $5,387
Germany $7,383 = 37% more
Austria $6,693 = 24% more
Sweden $6,262 = 16% more
France $6,115 = 13% more
Denmark $6,382 = 18% more

The Conservative's argument that taxes have to be kept low (the UK is already a low-tax country) otherwise the country will suffer from decline and poverty is nonsense. These are some of the countries with the highest standards of living and the highest quality of life - with wealth far more equally distributed than in the UK. One measure of quality of life is the reassurance that good, affordable healthcare is available as and when it is needed - surely something that the 5th/6th/7th wealthiest country on the planet should be able to offer its citizens.

The underfunding is not just a one-year snapshot - the NHS has been underfunded for the last 12 years or more, with the result that staff are leaving (or not joining in the first place), many facilities and buildings are not fit for 2023 and there is still much equipment in the NHS that should have been scrapped years ago but cannot be replaced as there are no funds available. If the government underfunds by, say, 10% a year, then at the end of 10 years, the NHS is missing a whole year's worth of budget.

I live in one of the countries above. I can see a GP at any time just by walking in. I can see a Consultant within 2-4 weeks. When I recently needed minor surgery, the time from seeing the GP to actually having the surgery was about a month. There are no backlogs (and were hardly any during the pandemic). Ambulances arrive within minutes. There are almost twice as many doctors per capita as in the UK, and more hospital beds, intensive care beds etc. per capita.

As for the inefficiency argument - much of the inefficiency in the NHS is due to outdated equipment and facilities, including IT, and a service that is so overwhelmed trying to keep the ship afloat that there is no time to actually look at how to improve. Instead of looking at new ways of working or improving, doctors, nurses and administrators are tied up explaining to patients that they cannot be seen for another 6 months, or that their vital operation has yet again been cancelled. Demoralising for the NHS staff - stressful, and sometimes fatal for the unfortunate patient.

@JennyForeigner sorry that was me. I name changed to earholes the other day and my old and new names keep randomly swapping when I quote people. It’s very annoying!

I'd pay. It obviously doesnt cover the entire cost of the appointment but would help go towards it and discourage people from missing appointments or time wasting. The caveats being that being free for low income, elderly etc people and follow up / regular appointments would have to be properly thought through and implemented with a buffer (eg it shouldn't just be people on universal credit but should include a decent buffer so for example people linked to tax bands.)

This is not equivalent to private GPs or health insurance as the whole cost needs to be paid.

Either way we are all going to have to pay more in some way and at some point and it makes sense that if you use a service more then you pay a bit more if you can comfortably afford it

If other countries successfully run such a system then I dont see why we can't

And the 24 hour wait was because I wanted to see a specific GP. I could have seen one of the others at the private practice that day.

I have a fear we are going towards an opt out package. I think basic emergency care will be paid for all by NI . This will be reduced for those who opt out to go private for additional treatment. Leaving a rather underfunded shaky health service which is neither use nor ornament for those who have no choice

No because it means the lower income working age people have to subsidise everyone else as normal (the rich go private already) just paying for a prescription is hard. Dsd earns minimum wage, how is she supposed to find over £30 to see a doctor and pay for her prescription monthly? (Mental health, repeats not allowed but not part of the free prescription scheme, no mental health drugs are). Meanwhile rich pensioners with their triple locked pension, winter fuel allowance and free bus pass don't have to pay.

I would support all those on household incomes over £100k paying (that includes us) as long as richer pensioners and the children in those households also pay

May be surprising to some people but not everyone has £20 to spend on a GP appointment. I know people who don’t qualify for free dentistry but can’t afford the fees to go so just have broken, fucked teeth that cause them endless pain. It would be the same if we started charging for a GP consultation, people would avoid going and this would subsequently cost the NHS more because they’d either end up in A&E or serious illnesses would get worse and they’d clog up the hospital that way.

I agree. DH and are over 60 (just 😂) but we earn £100k pa (pre tax). We can afford £9.80 or whatever it is.

Great Post, so we'll said. We could have a much better service but it's a political choice to underfund the service and to privatise it bit by bit.

People should look into the links between the Conservatives and US Health and disability insurance companies going right back to the early 90s. The current state of the NHS is a deliberate choice by them.

Not sure about charging people to see a GP. But totally on board with fining people for missed appointments. I live overseas, and if you miss a GP appointment you pay a fine equivalent to £50!

It’s down to voters too. I know people post they want to pay more on here if they do, but generally people feel taxed enough and probably don’t want to vote for higher taxes.

The other issue is low users usually pay more, I don’t mind and actually wanted the NI increase to go ahead, but I also want personal responsibility to feature more.

If I earn enough, I would pay; no question at all. Maybe it's because I'm from Ireland originally where most people have to pay at least €50 per gp appointment so I don't see it as a big deal.

If all children, disabled, elderly, people on benefits, war veterans etc get free appointments, it's unlikely to be much easier for other people to book appointments anyway. Most people who attend the GP surgery will come into those categories, so everyone else wouldn't notice much difference.

@Opa

What I would like the government to propose is how they can cut back on their own salaries and expenditure first and reroute some of those costs to the NHS

Have you actually done the Maths? Did you get your "noughts" wrong? You could zeroise MPs pay and expenses and it would be just a drop in the ocean when the NHS spends £150 BILLION per year. The wages and expenses of MPs is probably less than a billion, so not even 1 per cent of the NHS running costs. It'd be a political gesture at most and make absolutely no difference to the NHS for the vast majority of the 60 million UK population!

@gogohmm
If she hasn't got one already please encourage dsd to have a look at a prepayment prescription certificate if she has monthly prescriptions. It will probably save money.

www.nhsbsa.nhs.uk/help-nhs-prescription-costs/nhs-prescription-prepayment-certificates-ppcs

I didn't know about them until a fab pharmacist strongly encouraged (wouldn't let me leave until I filled out the paperwork) and it's saved me thousands over the years.

@Takingabreakagain It's not that easy any more to cancel appointments (any more than it is to book them). I had undiagnosed Covid and was feeling dreadful before a simple blood test. I could go online between 0600-0800 (the time my surgery says it reviews online requests) to cancel. I missed that slot and was not capable of going online. Or phone if I could get through which I did with DP for an hour and got through half an hour before the appointment. Meanwhile weeping into my cup of tea and necking paracetamol.

I cannot think nowadays there are too many people dodging appointments unneccessarily. Unless as a PP suggests they are suffering from memory problems and don't respond to phone/email reminders.

However my GP surgery does have a list (as does local hospital) of the cost to them of missed appointments and it is flabbergasting. Very hard to hunt down and make people pay for negligence if that's what it is - if there isn't a good way of proving negligence and not just too ill to come/no one to take me/can't afford parking/couldn't get childcare - and a better way to cancel appointments.

So richer people pay for a service that will give them easier access to appointments by putting lower income people off booking an appointment?

You would have quicker access because people can’t afford to go, hence there being more appointments.

No I do not agree with this at all. It will lead to people delaying going to the Dr and treatment potentially costing far more in the long run due to not being treated earlier.

This is perhaps true but the way it's spun in certain areas of the press I think puts people off. I think if most people felt the money would be well used they'd be happy to pay more tax.

I do think more personal care for one's own health and better preventive care would be helpful but I think that would also require massive government intervention and higher regulation of the food and drink industry, tobacco, vaping etc.

I've heard of people with health issues going to the gp to seek treatment for chronic low grade health issues and they get turned away and told help is only available once they become seriously ill. I understand why this is, that the seriously ill have to be prioritised and that we're not in a position to practice preventive or more holistic (by that I don't mean alternatve therapy just seeing the whole person) medicine. We are just storing up problems for the future though.

@Fushiadreams if only people would understand why they're asked questions. It really isn't difficult. Receptionists need to ascertain if a GP is the best person to deal with the problem.

When we've had new receptionists in post who aren't good at asking questions, I've seen patients who wanted to order their repeat medication, people who wanted to ask about parking at the hospital outpatients, people who wanted vaccinations (nurses do these), people who wanted to complain about the noise in the waiting room - seriously, many many patients don't understand which issues require a doctor, and which don't. Hence the receptionists asking. Otherwise the person who's passing blood in their poo can't get an appointment because it was snapped up by someone who wanted the phone number of the local X-ray department.