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!

@SilverGlitterBaubles
It doesn’t have to be that at all. It cannot be via not for profit trusts. Also I’m not against profits. Companies pay tax on them. It’s better than useless health care.

I am amazed anyone is so dismissive of nurse practicioners. Of course they can monitor illness! If you have been monitored by a GP you are not that complex @AttentionAll just possibly not ready for a sensible change.

agree!
and dr surgery would surely become some kind of war zone with people livid that they paid and still get no treatment?
Maybe that's the underlying intention, to make people so angry and short fused they don't stop to consider the chain of command leading to the situation and just vent their anger at clinical staff?

@Soothsayer1 i just said the same thing to DH about A&E. People having to pay £66 and still sit there for 12 hours in pain without saying anything?

it wouldn't be fair on the clinical staff, seems to me that people would be so scared stressed and angry they would just shoot the messenger?
I'm sure that pitting patients against clinicians like that would suit the gvt as it'd deflect attention from the actual architects of the situation.

Sadly, the most regular GP attendees are children, disabled people and the long term sick... Our NHS needs a total overhaul. It was set up to treat the genuinely needy. Those who could afford it didn't need it, they paid to see doctors already! Same with state schools - free education wasn't set up for the well off, it was supposed to be for the poor. Our country doesn't tax enough to give free stuff to people who don't need it.

@Funkyblues101 Its not Bupa who come out to you if you have an RTA

It was set up to treat the genuinely needy.

It wasn’t. It was founded to be free at the point of delivery regardless of wealth and status to provide cradle to grave healthcare to British people and their loved ones during the most vulnerable times of their lives.

I would love to pay £20. I'm in Ireland, my doctor is €60 a visit, with no medical card cause we're over the means tested limit. There's been a few times in the past where I would have to delay seeing him cause the money just wasn't there. When my kids were younger I was also charged the same for them. Its changed now that kids under 7 or 12 (not sure which cause it doesn't effect me) are free.

People are trying to rewrite the history of the NHS in the same way they are trying to rewrite the history of social housing.

@JenniferBooth Totally agree. It was set up to treat everyone free at the point of access. Prescriptions were also totally free.

I laughably even saw on MN someone claiming the Conservatives established the NHS. As if. The Conservatives have always wanted the private sector to provide healthcare so it makes money for the rich, with charities helping the poor.

Yes, it's time to do this now.

@huuskymam Do you feel that you get a good service or at least a better one than we get in the UK for your payment of £60? From what I know there are similar issues in Ireland with waiting lists and GP appointments despite a semi private/ insurance based system.

FWIW if anyone here wants to pay for a GP appointment right now it's perfectly possible to do so.

Since there is a shortage of providers and it takes years to train them, I can't see how the introduction of copayments would improve the service, especially since many people would likely be exempted--likely classes being the elderly, children, and people in receipt of certain benefits (disability or income linked). If you exempted all of those, then the percentage of people who are charge liable would be under 20% at least if not lower (90% of prescriptions are free).

Depends on the chronic illness.
Our GP's send most of their diabetic queries and complex patients to one of our nurses who initiates insulin, titrates meds etc. They wouldn't have a clue.
There's a two year wait for a specialist appointment in secondary care for some of this stuff.

My bloke has Type 2. His care is completely provided by the diabetes specialist nurse. He says her expertise is fantastic, far better than the GPs’. It’s common sense really because it’s pretty much all she does.

What, pay for quite literally nothing in my particular area? Our GP practice is so useless the CQC GP standards has labelled it 'inadequate' and the NHS is now paying for Livvi doctors to take up the slack, to provide a tack-on service. Theses Livvi doctors cannot prescribe certain meds or standard mess for longer than 1 month, before you have to trt nd track down the elusive 'your' GP to help you. Many can't afford to pay for a good service let alone a shite one. I don't think people paying extra is going to help this at all. it is a more complex issue tgan that. But what do i know? I'm just a poor/poorly patient.

Yes I would. A nominal charge for first appointment I think is ok, and is the case in many European health care systems (incl. e.g. Norway which has a great health system). It should however be coupled with exemptions for low earners, children etc to avoid being a barrier to access treatment. Emergency treatment should remain free at point of contact.

@neurospicygal We went through the same thing with our surgery. I pay for my own omeprazole and mini pill OTC because i cant face the stress of dealing with them. In a way im paying for the convienience and no stress rather than the items themselves.

And the same applies to education - it was a universal right.

I do not want a nurse to monitor my chronic illness. Years ago Consultants at the hospital used to monitor me. Then it went to the GP. A nurse would know even less than my GP

A specialist nurse would probably know a lot more than your GP.

Employers already pay 13.8% employers NIC based on wages. That's a pretty big contribution wouldn't you say?

Depends on how "specialist" they are. I've had diabetes for 20 years. Used to be the GP who'd do the twice yearly reviews, who'd discuss the blood test results, "tweak" other medication such as blood pressure pills, give some pretty excellent dietary advice based on what I told him about what I ate, what exercise I did, etc. It was 15 minutes well spent!

Then around a decade ago, those reviews were taken over by the "diabetic" nurse who was OK, but couldn't "tweak" the prescriptions for other things, showed no real interest in my diet/exercise, and basically just increased the medication every couple of years when the HBA1C levels rose.

The last 2/3/4 years, it's been a different "diabetic nurse" each time, who've really not had a clue and showed no interest at all. Yes, they briefly check my feet (which I can do myself), but there's no conversation/advice at all. They spent the entire appointment filling in the questionnaire on the computer, asking whether I smoke, whether I drink, how much exercise, etc., but it's a paperwork exercise - they never follow up any of the questions with advice etc. My HBA1C has been rising every time, and is now at a level at which the previous nurse/GP would have increased the medication, but they don't even mention it, let alone do it. At my last appt, a few months ago, I asked what the HBA1C level was, and they gave me a figure, I queried whether my medication needs increasing/changing as it was over the level which previously triggered a change and she just glibly said "maybe we'll look at it next year"!

So, no, the "specialist" diabetic nurses I've dealt with recently don't really seem to have any particular expertise or knowledge and seem happy just to do the form filling and pass me onto someone else next year!

@lieselotte Probably. There are not enough. I would get a generic nurse who had attended a quick short course.

You’re very unlucky then @Badbadbunny. My bloke’s had the same excellent nurse for a decade. His treatment has changed several times in that time. He’s currently on Ozempic which has put him into remission.

Nurses cannot prescribe drugs so they have limits on what they can do. However I have heard they are good. Staff turnover is always an issue! But the general idea of GPS not monitoring everything is good. In fact the rich could pay for their own monitoring. As diabetes is such an epidemic, maybe a not for profit diabetes service would work!