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!

@Twiglets1 You need a review of your asthma. Using your inhaler every day is a sign of poorly controlled asthma.

This may have been said already - it's a long thread - but paying for a GP visit in the UK would the tip of a very unpleasant iceberg. The government would be delighted as it is already trying to push privatisation by underfunding the NHS and not actively looking to address the current issues. As someone who has spent a fair bit of time in the US, private health care really doesn't work for the vast majority who can not afford either the monthly fees or the co-pay amounts. The result is a large nation where the poorer in society have to suffer and do not have affordable / easy access to the best care.

Paying for a GP appointment will progress to paying for hospital appointment or ambulance services, anaesthesia, bandages, crutches, stitches etc etc. The tipping point will come where medical professionals set their own prices, hospitals form lucrative and tied partnerships with insurance companies and the cost at every stage increases sharply - large medical bills would be funded through increased healthcare insurance premiums and co-pays and the gap between those that can pay and those that cannot will widen.

As someone of 58, I can recall when the NHS was the envy of the world and with the right approach and investment, it could be again. For those who are considerably younger, it may be that you have never experienced it at its absolute best, but it can be done.

The £20 or £150 proposed for a GP appointment will quickly turn into £3K for an x-ray, £400 for a pair of crutches, £50K to remove an appendix etc. The process of having to check itemised invoices as they have to in the US, to remove fictitious medical items, will be the least of our worries.

I just looked up the income cut off for getting free prescriptions as a few people have suggested that they could use the same cut off for free appointments. If I’m reading it right you have to earn £15,276 or less. It’s such a low amount and you can see how many above that income simply couldn’t afford it(same reason they don’t access dental care).

Or it could be just like many systems across Europe. You have no evidence at all for your assertions.

Yes, there should be a sliding scale based on income.

Agree it is a very low amount. As a family we have often struggled but have never met the requirement for free prescriptions on a low income. If you have a full time job on minimum wage, you do not qualify. If you have children you have to be getting free school meals to get free prescriptions for adults.

Of course anyone with multiple prescriptions can get a prepay certificate so it's not a prohibitive amount in reality.

No I wouldn’t want a pay to see GP system. I wouldn’t go unless things were serious. Eg a lump that turned out to be cancer- I only went to appease my mum.

I’d rather pay more tax or NI as long as it went into training, recruitment and retention.

@dollymixtured How much do you earn?
I did once get antibiotics I could not pay for. I just ticked I was entitled although I was not. I needed them.

Would you charge everyone? Or would those on benefits, children, the elderly (by far the biggest user group and some very wealthy) be exempt? Leaving just the poor sods in the middle yet again.
Most of my non attenders are older people. I suspect many would be quite happy to charge 21 year old student John for a no show, but for 81 year old George there would be an outcry.
Unfair.

Nothing like a touch of light fraud to show your support for the NHS.

Absolutely not. I have no issue in seeing my GP/nurse.
i can call at 8am to make an appointment. If its terribly urgent they will see me. But i can get an appointment within 2-3 days.

and for my regular appointment every 6 weeks i book in advance at each appointment

Definitely, always thought this would be a good move.

The government in the UK only ever presents the status quo and privatisation (US style) as the two options. As others, including myself, have pointed out, there are plenty of European countries where there is some element of payment at point of delivery, non of whom have privatised healthcare systems like the US. Instead we have 80% of the costs of basic treatments/appointments fully covered (or up to 100% depending on status and additional insurance - usually covered by an employer) and easy access to necessary services. In the EU country I live in, I could also easily get an appointment with a specialist without a referral, and I end up paying maybe €10 towards the cost of an appointment.... Well worth it if you ask me!

I think it depends on where the threshold is. Someone on a low income or with low disposable income, but not on benefits, may struggle / someone unable to work due to recent illness that has caused secondary issues e.g. post covid may already be struggling financially. There's also the issue of not enough GPs anyway. If everyone that needed access could realistically get it, then maybe.

I'm under the care of a specialist asthma nurse thank you for your concern. It is very well managed as I have a full life and work part time. I take a preventer inhaler every day to avoid asthma flare ups and it works very well. Also have a reliever inhaler for the odd occasions I feel breathless but don't need that one very often.

"As someone of 58, I can recall when the NHS was the envy of the world and with the right approach and investment, it could be again."

This is something worth repeating. The NHS was once excellent, GPs were accessible, waiting lists far shorter than they are today and for their time, hospitals were at the cutting edge of medicine and technology.

Successive governments, but particularly Conservative governments, have failed to ensure that expenditure and investment have kept pace with the increased and changing demands on the NHS. Changes in technology, changes in the age and medical profile of the population, changes in the attitude of the public to healthcare - these major changes have hardly been addressed by the politicians, and where they have been addressed (e.g. by Lansley or Hunt) the politicians concerned have somehow managed to make spectacularly wrong decisions at the wrong time.

"there should be a sliding scale based on income"

There is - it is called taxation. Those who earn more pay more in tax and more in National Insurance. However in a universal healthcare system this does not give them priority over those who pay less tax or NI.

Yes to this. They are already aware that there is a huge link between bad teeth and heart disease. There are no dentists in our area taking new NHS patients at all, and I put off seeing the Hygienist pre Covid due to the cost, only to find we then couldn't see anyone at all for over 2 years.

It took 7 visits to my GP before they grudgingly referred me to a specialist and found out I did actually have cancer. Would they have to refund the £140 in your scenario?

The people most often at the GP are young children and elderly people, both of whom would be exempt, so what exactly is the point?

Out of interest when was this golden age you are referring to?

No. Thin end of the wedge. Tories are trying to dismantle the NHS bit by bit and privatise healthcare. Don’t give them a helping hand. It’s a terrible idea.

I understand you felt you had no choice at the time as you needed the antibiotics but they do spot checks apparently and if they find someone ticked the box but wasn't entitled to free prescriptions they can fine you up to 5 times the cost of the prescription - so not advisable for other people to do

www.nhsbsa.nhs.uk/nhs-penalty-charges-and-enquiry-letters

My idea: set up a service where every DNA gets a fine notice, with an opportunity to state a reason for the non-attendance, in mitigation.

You'd get Booker-prize winning fiction in response, but they'd be much more wary of DNA'ing next time, and word would get out. You'd only have to actively run this for a year or so.

The problem is ensuring patients actually receive the appointment time.

Mobile? No one under 40 answers a mobile unless they're 100% sure of who's on the other end. And tbh, many staff clerking arrivals (often older people themselves) get the number wrong. Too many/too few digits.

Text? As above.

Email? Possibly, but with a 'please respond in order to confirm your attendance'.

But we ran a system in Queensland 20 years ago for (hen's teeth) MRI appointments where pts had to confirm receipt of appointment. But the number we'd contact, 24 hrs prior, who actually weren't going to turn up at all, it transpires, was shocking.

Not in the current system which structurally can’t manage to provide care and where there’s been privatisation of primary care in some areas. I’m happy to consider a new system and then have insurance and pay on the models used in some places in Europe, but not pay for this system.

I feel the same about social care. I’ll pay more tax for it but I don’t want to pay into the largely privatised, run for profit not people system we have in place at the moment.

Out of interest when was this golden age you are referring to?

1997 to 2010. I remember it well.