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!

So diabetics, asthmatics, anyone with a long term disability should just shut up and die, right?

My mate in the USA couldn't afford to pay for blue inhalers for her sons asthma - she had no health insurance. Instead the child was only treated when he had attacks requiring hospitalisation which was free at her local emergency centre. Fully preventable with inexpensive medicine and check ups. And far cheaper throughout his lifetime.

Please explain how weekly GP trips would be better than chronic conditions being managed by specialist teams?

Diabetics and asthmatics should not have their conditions managed via weekly GP appointments, no. They should be open to specialist teams who put together long term health management plans not their local GP. every week.

I do agree with this. Plenty of people with hundreds of thousands of pounds in the bank accounts still qualify for free prescriptions while I, on just above minimum wage, pay full price. I can afford to pay and am happy to, but I don’t think that it’s fair if people with financial situations much more fortunate than my own get their prescriptions for free. Again I believe it should be means tested, so those who genuinely can’t afford GP appointments and prescription charges should rightly be excluded from any costs while those who can pay but don’t have to due to exemptions should pay.

@dollymixtured So when I tried to kill myself at 19 years old - a very serious attempt - I had weekly GP appointments for two months. GPs spend a lot of time on mental health issues.

When DH was discharged from hospital, he needed weekly blood tests at the GP for a month to monitor his condition. He still has blood tests once a month.

So he needed free prescriptions and an asthma nurse by the sounds of it. Not weekly GP appointments

Weekly appointments would mean the conditions are not well managed. But these conditions are diagnosed and managed by GP surgeries.

GPs are not mental health experts. A more appropriate plan would be ongoing mental health support. Weekly appointments for a month following hospital is completely different to weekly appts on an ongoing basis. His blood tests I presume can be administered by a nurse or other HCP and would not require a GP appointment unless the results raised a concern.

@dollymixtured You want chronic health conditions managed by specialist teams? That would be way more expensive than GPs. I mean common conditions like asthma are managed by specialist nurses in GP surgeries. But there are lots of chronic conditions and even serious ones are often managed by GPs not specialists.

That's the point I am making, weekly GP appointments mean that things aren't being managed well, that is something we should be looking to change not seeking to preserve.

Another way to take even more money off those who actually work for a living!

@dollymixtured So you are only talking about the actual GP, not all the others staff in a GP surgery? So if I book an appointment with a nurse for antibiotics that is free, but with a GP it is £20?
Mental health support is totally lacking. Six sessions CRB does not really cut it.

If it requires a weekly appointment with a GP then I would argue it's not being managed at all.

I think you have me confused with someone else I haven't proposed anything. Totally agree that MH services are not fit for purpose, but I don't think the answer to that is having GPs pick up the slack.

dollymixtured - GPs are experts at managing chronic conditions. These patients don't necessarily need to be seen in secondary care. It is cheaper (and probably easier for the patient) to be seen in primary care anyway. It may take a while to stabilise conditions or to monitor treatment efficacy, in which case a GP may need to see a patient with a chronic condition regularly for a period. I'm not sure how you can argue that something isn't being managed well if it needs regular appointments - how else can the management be escalated and improved?! Lots of treatments take time, trial and error. No GP is seeing someone with high blood pressure weekly for 6 months! But someone with a mental health crisis may need regular follow-up (medications take a while to work) or someone with newly diagnosed T2DM or someone who is cycling through a few medications to find something they can tolerate for their blood pressure etc etc

I'd pay £20 but I'd want an end to sitting around for 45 minutes when they are running late, to be able to make an appointment without being on hold for an hour and an appointment slot within ten days.

@dollymixtured I agree chronic conditions should be well managed. But my point was that there can be good reasons for weekly appointments. Someone else I know with bipolar was managed during a crisis with twice daily visits from the crisis team and GP appointments every 2-3 days. It was short term but kept that person out of hospital which would have been far more costly.

Similarly when my dad came out of hospital after kidney issues I contacted the GP every single day for a week for advice. There were issues with medication which was changed about 5 times that week. It would have cost me £140 under this plan. The alternative was to keep him in hospital for another week.

I know GPs see a lot of colds and minor things, but they do see more serious things that need intensive short term monitoring. The alternative is consultants and longer stays in hospital instead.

I’m obviously talking about the people who do qualify for free prescriptions (which is actually loads of people) who then get prescriptions for things like aspirin & paracetamol etc.

Absolutely but a PP posted that they had had 4 appts in the last month, suggesting that this would be unaffordable and therefore unreasonable if appts were charged. I am merely pointing out that weekly GP appts should not be the long term default position for anyone. Of course in the short term much more regular visits may be necessary but in the long term weekly GP visits are not IMO a good model. Because a small number of people appear to take a disproportionately large amount of GP time in some cases and this contributes to the lack of access for everyone else.

You wouldn't pay for children if the U.K. adopted similar systems used worldwide

@Twiglets1 GPs are not allowed to give prescriptions for ordinary aspirin and paracetamol.
People read things and get confused. So aclovar for cold sore cream is bought over the counter. But I get some on prescription at times - it is a lower strength than over the counter but is for a recurring cold sore I get right by my eye. You can not buy it over the counter. But if you looked at a list of medicine given out on free prescriptions and saw cold sore cream no doubt you would be up in arms.

Because most rich countries do still balk at letting children die because their parents do not have money. Adults? Who cares.

Some people paying a small amount for a GP appt should not be equated with 'letting people die' it is gross hyperbole and sounds absurd.

Seems to me that in countries where health care is free or for a small initial fee, the equivalent tax/social insurance/government investment per capita is MUCH higher than in UK.

That fact has not been acknowledged or fixed by Government, and is largely ignored by service users who want service levels to vastly improve without it costing them a penny more.

People on this thread are so dramatic.
I have asthma myself, I take an inhaler at least once a day every day. I pay for my own prescriptions & I would still be happy to pay for GP appointments. I don’t see my doctor very often, only the nurse for an asthma review (would be happy to pay to see the nurse too).