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!

It’s already there! There would be care for NHS patients. Why not remove richer people from the clogged system?

Also, as in education, the better off would pay twice. NI should be paid by all taxed individuals. Not just those in employment. NI does not solely pay for the NHS. We have a complex system of taxation and expenditure. We need to spend what we have wisely as so many people are not working at all snd this number is increasing. Too many not in the workforce at all but still using services.

NI is a nonsense in my opinion. I don't understand why they don't just get rid and add it onto income tax.

Absolutely this. Plus of course with this lot, even if £20 doesn’t sound too scary right now, it wouldn’t be long before that £20 became £30, £40 or more.

Services have been starved of funding for years; one major issue is that we’ve made it really expensive for nurses to qualify by removing training bursaries for what is already a poorly paid job with awful working conditions and made it harder for qualified medical professionals from Europe to live and work here so we’re all paying agencies ridiculous rates for temporary staff to cover the huge labour shortages. Charging to use the service wouldn’t help that but it would dissuade everyone on a low income to seek medical help. And don’t get me started on the administrative costs of running a pay for access scheme like that…

No doubt they're scared of the potential loss of votes from those who'd be hit, i.e. pensioners and those living off investment income, such as landlords, etc.

But, you're right, NIC is an absolute nonsense and is just like other indirect taxes being raised to increase tax revenue whilst trying the maintain the illusion of us being a "low tax" country due to not rising the income tax rates.

It's an absolute travesty that it's just a tax on workers and that a worker earning say £30k pays more "tax" than a pensioner or landlord with an income of £30k.

If anything workers should pay less, nor more, as they're actually contributing to the economy and work needs to be incentivised not punished.

I don't see why i should pay yet my wealthy parents be exempt! It already annoys me they (on 3x my income) get free prescriptions, winter fuel allowance etc whereas my student DD's have to pay! (I'm not on regular medication thankfully)

No government has reversed the OAP benefit stream. I’m an OAP. I have rental and unearned income. I, and DH, should pay NI. Or at least at a reduced rate. We are very healthy right now but we should all pay. Votes are, in effect, bought by all governments by over generosity to the elderly. They (we!) need to understand we didn’t save via NI. It’s a tax. We are not entitled to anything when others worse off than us are paying. Having said that: higher rate tax payers pay more than all standard rate tax payers added together. So we need higher rate tax payers and it should not matter where they get their money from as long as it’s legal!

Because that's not how the system works. There is a finite supply of doctors, and the UK does not have enough; it has fewer doctors per capita than other European countries. The private sector exists in part by siphoning off resources (primarily doctors) from the NHS sector. For example many consultants work 2-3 days NHS and the rest private. If the private sector did not exist they would have to work 5 days NHS in order to maintain a full time job. (Of course, things are a bit more complicated than this: the NHS is able to pay less because the top consultants can make money privately, lack of private work would discourage some doctors, etc.)

Private care is lower volume: the doctors typically see fewer patients per day. So when doctors switch to working privately, the total number of patients seen will drop. If we incentivise further private healthcare, the number of patients seen may drop, not rise, unless (big if) offering private opportunities encourages GPs who have left medicine to return to work.

Changing the payer does not mean more care is available to provide. This is also partly why investment in the NHS takes years to show fruit: you can fix physical plant relatively simply, but increasing the number of people who actually do the work takes a long time. It takes over a decade to train a doctor, and the number that can be trained at any time is limited by existing hospital training capacity.

Well said

This.

Whenever people suggest private healthcare they don’t employ logic. More often than not it’s just cover for them to justify wanting better healthcare for themselves and their family. Screw everyone else.

Why and how would this improve the service?

I can't help but feel its main function is to:

A) Dissuade people from presenting to primary care. This will not save the NHS as a whole money, it will lead to more hospital admissions which is the most expensive intervention

B) Start eroding the NHS being free at the point of use

Please, if you're happy to pay for convenience you can already pay £40 for an online consultation or £90 face to face. Don't push for widespread change that is going to make swathes of people poorer and sicker.

Quite, especially with the retirement age inching up.

I'm going to be a nurse until 68 now, apparently. Wish me luck.

Only if you are very young. But you still have a much better pension than many others paid for partially by the state. And early retirement that many take. And lots of opportunities for part time working. And a top salary of £90,000 to aim for. Lots to look forward to!

You can tell the people who aren’t reading the OP as she’s already said low income people would be exempt from the £20 🙄

If we did it on the same basis as free prescription eligibility then the vast majority of appointments would be free anyway, because those categories of people (including children and the elderly) are the most likely to need an appointment/prescription

I believe 90% of prescriptions in England are free.

Don't underestimate the administrative cost of means testing either.

I think it’s is a slippery slope. Like when tuition fees were first introduced it was £3k/ year now it’s over £9k/year.

Righto @TizerorFizz so you want those you see as 'better off' as they have an income from working (from your perspective as a retiree) as clogging the system should they use the nhs or state education?

So many of this view but the caveat always seems to be 'better off than MEEEE, of course'. And anyone who questions the fairness of this of course gets the emotive 'YOU WANT PEOPLE TO DIE DONT YOU!!'

@TizerorFizz There are lots of people off long term sick. Run down the NHS and this is what happens.

@knitnerd90

Private care is lower volume: the doctors typically see fewer patients per day. So when doctors switch to working privately, the total number of patients seen will drop.

That assumes efficiency is equal between private and NHS, which in my experience isn't the case at all. The NHS seems to waste a lot of time and appointments due to foul ups and other inefficiency. I.e. it can take 2,3 or 4 visits to a GP (of course, a different one each time) to get a proper diagnosis/treatment of a condition, yet a private GP appointment time is longer so they can be more thorough and more likely to get the right diagnosis/treatment in the first consultation, or if not, then the second, as you'd probably see the same GP so there'd be continuation of care etc.

Likewise with other services such as MRI scans. OH who has bone cancer needed 4 attempts to get an MRI scan as the referral instruction was wrong for the first 3 (or the radiographer just read it wrong or did it wrong). Anyway, he was called back 3 further times before the oncologist got the scan she wanted. The next time, OH went private as he really struggled with the tube and found a private firm who did the sit up/open scanner - they did the right scan first time.

If the private sector is more efficient, either by better admin/management or more time per appointment, then healthcare professionals are more likely to get it right first time, and thus treat more patients than the NHS, due to not having the same volume of "wasted" appointments due to inefficiency.

I'm on the 2015 scheme and I'm 33.

Very kind of the state to fund my pension which now has an NPA of 68 for a physically demanding and risky job. My colleagues doing a less demanding equilivent private job receive a generous pension plus 10k in their annual salary, but nevermind that.

90k is for a chief executive. How many per Trust do you reckon there are of those?

The private sector is more efficient as they see largely well patients with one medical issue. They do not see elderly patients with multiple medical issues that are more complex and take longer to treat. Because private medical treatment for these type of patients is out of reach except for the very wealthiest.

And yet there will still be moaning and whining when there are no family members (read women)
to provide unpaid care so elderly relatives can be discharged from hospital. Because those family members will be working until 68

Where the private sector do NHS work, such as cataract operations or hearing aids, they are still more efficient.

I get my hearing tests and hearing aids from Specsavers now. In and out in one appointment with follow ups/adjustments as and when you request it.

That's SO different from when I used the NHS audiology dept- there was an initial consultation, then a few weeks later, the hearing test, then a few weeks later another appointment to be "fitted" with the hearing aids, and then another appointment a few weeks later for them to be "adjusted" to the right settings. So the NHS took 4 appointment over a couple of months to do what Specsavers do in a single visit.

It's also a lot easier to get batteries, replacement tubes/domes, etc from Specsavers and to get setting adjustments done!

@Badbadbunny They get the easy cases. My DP needs a double appointment example for simple tests such as a scan as he is disabled and so everything takes longer. A cataract operation would mean him being sent to the NHS as it would take twice as long as an able bodied patient. The private sector want the easy cases.

Yes, but the NHS still do the "easy" things in a convoluted, difficult and inefficient manner. If private providers can do the easy stuff quicker and more efficient, why can't the NHS do it the same way? But, you're missing the point really, my point was in answer to someone who said fewer people would get treated in total if there was more private, but I pointed out that greater efficiency in the private sector could mean more people being treated.