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!

Isn’t that just private healthcare?

Most GP surgeries have protocols in place for people who don't turn up for appointments- up to and including striking off.
The real issues are a lack of GPs, and paying a nominal fee for the current service is not going to help anything except that some people will have to choose between paying a bill and their health. And not all of them will be easy to identify.

There are people often working mortgage holders due to the nature of Uc who get no benefits but are on a ridiculously low income but don’t qualify for any support with anything (not a benefits bash at all btw, I was involved in an audit and the results showed this) this group pay for prescriptions eye tests dentists don’t get help with childcare costs bar TFCC And so on. Having a chronic condition in those circs would be a death sentence

In terms of referrals to CAMHS, unfortunately it is - we were deemed to be able to cope, we could, just about, but we could not make him better. For the want of a cheap drug, my son's life chances were severely impaired - he would not have been able to sit GCSE's, he could not sit, could not do homework etc etc - his life chances have been transformed. It has been remarkable to witness and heartbreaking that he could have been denied this opportunity.

Yes. A lot of people are barely keeping afloat and don't qualify for any help at all. More than a lot of people realise.

Yes it’s a good idea. I’m in Australia and that’s pretty much what happens.

No because it literally never works that way. Low income is always defined by benefit entitlement, unless you are saying people are asked to bring in three months worth of payslips for all earners in the family?

We pay for GP visits where I live. There is a card which low income/beneficiaries can get which lowers the fees. When you vist the GP you tell them you have this card and it goes on your records.

Is that really the case that the median number of GP visits per year is 7 or is that a figure that comes about because a small number of people are going weekly and the vast majority are maybe going 1-2 times a year. Genuinely curious as if the median number of GP visits is 7 then we have a very sick population which is even more of a worry or we have people overusing a service because it is ‘free’

www.manchester.ac.uk/discover/news/four-in-ten-consultations-at-gp-clinics-were-with-frequent-attenders/

to answer my own question it appears both are true. But it’s no wonder that appointments are so hard to come by if 40% of them are being taken up by 10% of people. Maybe it’s time for more dedicated elderly health teams who deliver care using a different model.

God no wonder its so hard to get an appointment. If "frequent attenders" are mostly the elderly (and I don't know they are) it's definitely another reason to stop free prescriptions and every other cost based on just being over 60.

How does it work in other countries (US excluded). Perhaps our friends in ROI could give their views. I believe (happy to be corrected) it’s around 50 Euro to see a GP.

in fact I’m interested in all other European countries and how their healthcare works and what they pay.

No I wouldn’t want to pay any extra to see a GP. Not unless there was a reduction in my tax/NI to cover this.

Also, a lot of people who work and aren’t entitled to any help won’t be able to afford this.

The problem is really that it will wind up like prescriptions--hardly anyone paying, if you start having so many exceptions.

Ireland is odd as GP visita are not covered unless you have a health care card, which about 50% of people do. If you don't the GP can charge what they want, anywhere from 50-100€. In France the allowed amount for a general doctor is about 25€. The assurance maladie pays 70% and you owe the rest unless you have the CMU or complementary insurance. There's a rather long list of conditions that results in the Assurance maladie paying 100% for many things. I believe doctors can charge more than the allowable charge and then you pay the difference, or some complementary insurance will pay the gap. Australia it depends if your GP bulk bills (accepts the Medicare fee as payment in full) or not.

The data on copays goes back to a 1970s RAND study, but the amounts in question were really quite small. Something like $5.

Canada doctors visits and the hospital are free, but you pay for your pharmacy costs ans some other outpatient services (many people have insurance through work for this). In Israel there's a low fee, something like 50 shekel (a little over £10) for your first family doctor visit each quarter, but you don't pay after that.

So Labour think GPs should be brought back under NHS control! Self referral to hospitals bypassing GP too! Chaos one imagines.

Chaos and madness

They have the floor in many ways and come up with terrible ideas like this

The average number (mean not median) is around 7, and that includes taking into account those who never come. A decade ago it was around 2. Now do you see why we cannot cope with demand when funding has fallen year on year in real terms?

We pay less tax than other G7 countries towards health care, and it shows. A reasonable conversation would be around higher rate tax payers paying £30 or £50 for the first small, fixed number of GP appointments per year. Those with chronic conditions or temporary ill health would not be disadvantaged by their need for extra appointments. I would be happy to pay.

At this stage the income from the plan might not be great. If eg we gave 5M higher rate tax payers, perhaps it would yield £500M - £1B pa. However…..

If this payment became a norm, it could be extended downwards on a sliding scale. Other countries manage it. Just because we currently link exemptions to records of benefits does not mean we must continue to do so.

This would bring billions pa

I wonder if GPS are relieved when appointments don’t attend as then they can do the other stuff they need to do. They are over worked.

@poetryandwine
I agree. We are always wanting something for as little as possible. Plenty of people could, and should, pay. Or pay into a funding system to get what they need. We use Eye Plan for example.

I can see Keir Starmer thinks we need to stop having GPS as gatekeepers to health appointments like physio. This could make sense but who judges need?

Totally agree. I live in France and a visit to the Dr's costs 23 euros, but if you are on benefits etc you are subsidised by the State. I can go to whichever Dr I like and can go the same day, or if I want to go at a specific time, I mqke an appointment. It means people actually think before they go and take up the Dr's time. The health service over here is fantastic. A friend recently had to have a hip replacement. From seeing the Dr, to having pre-surgery tests and being home, a total of six weeks. For me blood tests on the same day I saw the Dr, tests back to me and the Dr withing two hours. Prescription given that day and 3.70 euros for three months medication.

@TizerorFizz your question is excellent. My experience in 2 American HMOs, which offered excellent care, is that requiring GP referrals works well when medical care is properly resourced.

I think KS has a number of sensible policies, but this is not necessarily one of them.

Lots of parents take their children to the GP for pretty minor reasons. Plenty of older people I know never go to the GP even when they should.

"MPs and clinicians have also highlighted the impact of the growing NHS backlog on general practice. With a record 6m people on the NHS waiting list, a figure that was rising before COVID-19 but has risen faster in the pandemic, GPs are facing huge increases in demand for appointments from patients awaiting hospital treatment.
GPs have also reported a rise in rejected referrals and in workload dumped on primary care as hospitals struggle to cope."

www.gponline.com/general-practice-delivered-unprecedented-367m-appointments-2021/article/1738580

Massively relieved. Although as so many patients turn up late, even by a few minutes, the bonus time is simply used to try and catch up to finish your clinic on time so you might get some lunch. (Practice nurse).