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!

Every missed appointment should be charged for

And the charge has to be sufficient to cover the administrative costs

I can just imagine the bureaucracy this would involve. Not to mention the appeals process.

I live in Guernsey where we pay for GP appointments. £60 per appointment and £40 for missed appointments.

Lots of people have healthcare through work and people in benefits get it paid for by the States.

It's generally easy to get appointments with your GP of choice mainly because people don't see the GP for silly things which they could have OTC medication for.

It has it's benefits and it's negatives. It is how it is. .

The more beurocracy the higher the charge for a missed appointment

No right to appeal if not phoned in

@inky1991

It's not disgusting, it's how nearly all other countries work.
This is not true.

I'm pretty sure we're the only country in the world who has unlimited free access to GP appointments.
This is also not true. In northern and central Europe, GP access is free and unlimited. [Free as in "free at the point of access" since patients have already paid once through their taxes]

We see a private GP already when necessary. I wouldn’t necessarily pay to see an NHS GP unless they give the same flexibility eg out of office hours appointments for dh and dc. Perhaps the NHS could look at maintaining the free service during Mon-Fri office hours but taking private patients in the evenings. That might be fairer across the board.

"Perhaps the NHS could look at maintaining the free service during Mon-Fri office hours but taking private patients in the evenings. That might be fairer across the board."

What? The NHS GPs are already overwhelmed and many do work at weekends (as well as being on call for services such as attending police stations).

The fundamental problem is that the UK has too few GPs - far fewer per capita than most European countries and most other industrialised countries - so expanding the hours further doesn't solve the problem, any more than paying £20, £40 or £70 will do anything other than cause appointments to be rationed by price and will further disadvantage the poor and the chronically ill.

Paying for missed appointments will free up nhs time

www.england.nhs.uk/2019/01/missed-gp-appointments-costing-nhs-millions/

So making better use of the resources we have

Would you charge everyone? Most of my non attenders today were the elderly. And I know them. They're not all frail and forgetful. They're active and they travel. Many will be very able to pay. As with prescriptions.
But no doubt there would be an outcry at the idea so the same groups would be excluded again and the same poor sods in the middle penalised.

Anyone who misses should pay

No because only those who could afford to pay would get seen.

Agree. But wouldn't happen.

Well I live in Ireland and pay €60 for a GP visit, I'm happy to pay for it. I'm happy to pay it, my GP is amazing and having a good GP is very very important to me. I can always get an appointment on the same day if it's urgent and the next day if it's something small. Health insurance provided through work refunds half the cost and then I can claim back 20% on my taxes so the actual cost to me is €24.

Those on low income, over 70 or under 6 get GP visit cards so they can visit the GP for free. From April, anyone earning under the median household income (46k after tax) will get a GP Visit card - this won't affect my household but I think it's great. It means around half the country gets free GP visits. An awful lot of higher earners in Ireland will have health insurance provided by their employers.

Free GP for all sounds great but my sister in London has to wait a week for a GP appointment. This would be an absolute nightmare for me.

@midgetastic

The report you link to is from 2019, referring to 2018 statistics. It would be interesting to know what the current figures are.

"Anyone who misses should pay"
Pay what? How much? What is the sanction if they don't pay - or cannot pay? What is the process for cancelling if the patient cannot get through on the phone to cancel and doesn't have email (and the GP practise cannot afford to have someone just monitoring this)? How much would it cost to administer and would it bring in more than it costs?

I think almost everyone agrees that patients should not be missing appointments, but without understanding the reasons why there is no point issuing a general policy of fining people. Do people not show up for genuine reasons - e.g. no transport, no childcare, can't get time off work/threats of dismissal, deteriorated to the point that they cannot physically get to the surgery etc - or is it really just because they can't be arsed? If the threat of a fine further deters those who really need to be receiving healthcare and support from seeking it, what has been gained?

Just to balance this out I’m in London and get same day appointments, and even private GP is longer - 24 to 72 hours

No issue with paying for GP appointments, we pay for dentist and eye appointments.

This alone would make sure people turned up, almost all EU countries charge and not for just GPs either, almost all medical appointments.

Exemptions for pregnancy, low paid, those with long term conditions & children.

@shivawn "An awful lot of higher earners in Ireland will have health insurance provided by their employers."

Is this commercial insurance, where the profits go to the shareholders, or through Mutual Insurance Funds which are for the benefit of the patients (e.g. as in Germany and many other EU countries)?

The NHS budget in England alone is £152 billion. Private providers would love to get their hands on this - if they can turn a profit of even 10% they'll be very happy. Convincing millions of people to pay £20, £30, £50 for a GP appointment as well is a capitalist's wet dream - and the reason why they lobby MPs and are happy to see the NHS run down so that they can reap the benefits.

As for the poor sods who can't afford to pay, or who live in areas where there are few GPs - well, bad luck. Look at what has happened to NHS dentistry and pray that Hunt, Barclay and Sunak, who only value "money and profits" rather than "patients and people," are prevented from letting general healthcare provision from going the same way.

@GPTec1 "almost all EU countries charge and not for just GPs either"

This is not true. For example:

Spain - visits and general check-ups are free.
Denmark - free
Germany - free
Austria - free
Netherlands - free (some patients might be charged but claim back from mandatory health insurance)

The rest can be looked up. There are many different forms of financing primary care. Many are free at the point of contact, paid for through taxation or mandatory health insurance administered by Mutual insurers, so in effect another form of tax. Those that require payment usually have an upper limit - e.g Sweden has a maximum charge of about £75 a year for unlimited GP visits.

I would now. But that’s only because I’m lucky enough to be able to afford to. In fact I get private gp via work it wouldn’t cost me anything.
but… it’s not that long ago that I was so skint (and not on benefits, just mortgage, bills and food) that £20 for an appointment might as well have been £20 million. I didn’t have it. Food was going on my credit card and I was living on toast. We both work but if one of us loses a job we’ll be back there pretty quick.
I think people who qualify for no benefits but live pound to pound would end up excluded from basic health care. I know in my skint days I would only have gone if I had to, I wouldnt have gone for a weird bump, or a flutter in my chest, or any other odd symptom but those are things that get us in the end.
just tax people more. I don’t mean everyone, but people who really can afford it (and I include myself in that). And make private health care tax deductible. Yes I get that means less tax revenue to encourage a private health alternative but the savings on tax to get one more person out of nhs surely frees up a bed?

it’s not telephone appointments - this afternoon alone there were 4 phlebotomy appointments, 2 smear tests and 3 routine GP appointments missed at the surgery I work at. I wasn’t in this morning but I know this afternoon wasn’t in any way unusual. Honestly, it’s soul destroying when you’re having to ask people to call back the next day for an urgent appointment because you’ve got no capacity, whilst someone else hasn’t got the decency to free their appointment up by cancelling it.

People love to moan that they can’t get a GP’s appointment, in the same breath as wasting NHS resources by missing appointments - every missed appointment has a knock on effect.

Should people pay for NHS appointments? No. At least half our patients would struggle to do so. There are private GP’s for people who can afford it.

@JackyinaTracky "Yes I get that means less tax revenue to encourage a private health alternative but the savings on tax to get one more person out of nhs surely frees up a bed?"

No it doesn't. There is a finite number of doctors in the UK, and overall a very serious shortage of doctors (and beds, equipment, intensive care wards etc). The UK has one of the lowest ratios of doctors to patients in the developed world - only half as many doctors per capita as in some other European countries.

Every doctor who leaves the NHS and only takes private patients makes the situation worse for those patients (and doctors) left in the NHS system. The Conservatives already did this with dentistry - for many millions of people it is now impossible to find a NHS dentist. If they are allowed to do this with GPs then the whole system will collapse, leaving the poor, the disadvantaged and those living in areas with very low numbers of GPs with nowhere to go. And as you point out, less tax revenue also means less money for essential services such as the NHS, compounding the problem.

@Ski4130 If so many people are missing appointments, why not "over-book" knowing that a percentage won't attend?

This is what hotels, airlines and any other organisation does when there is a finite capacity and a constant and predictable level of "no-shows" in order to make full use of the facilities and resources available.

I've asked the question earlier in the thread. In your experience, what are the reasons why people do not attend? Do they have genuine issues with childcare, transport, getting time off work, mobility etc or is it really as simple as they can't be arsed?

@Havanananana You are course right, i shouldn't believe what i have read elsewhere... Sorry.

@MarshaBradyo That's great and I'm glad that you don't struggle for appointments. Most of my family still lives in the UK and they have a very hard time. I hear from others that there's long waiting times for appointments at their GP's too. It's very stressful for those who can't easily get appointments when they're worried for their health.

@Havanananana As for the poor sods who can't afford to pay, or who live in areas where there are few GPs - well, bad luck.
What I was actually saying is that those on low income (lower than average) shouldn't have to pay, same goes for those with serious health conditions.

It’s pointless comparing other EU countries with us. None had the NHS. They do have contributory insurance schemes and more money in the system. We need to generate that extra. So we pay or have insurance. It’s not privatization. It’s an extra income steam.