We need to start charging for NHS services

[Fragmentedbrain]

£15 for the GP
£20 for A&E
NHS routes to paid-for fast track treatment
Options to pay for nicer rooms

We need to stop putting working people on disability benefits for want of a functioning health service it's barbaric

If heavy drinkers had to pay for their treatment due to behaviour while drunk from day one, it would give many of them pause for thought and dissuade them from becoming full blown alcoholics. The same with casual drug users before they become addicts.

It really would not. Addicts do not think of the consequences hence why they are addicts. And no one wakes up one day as an addict. It is creeping and insidious.

And if we are going down the slippery slope of charging people for treatment due to something they did, they you will have to charge people for treatment after breaking bones during football, or even DIY.

Addicts don't become addicts the first time they have a drink or take drugs. If they are financially penalized by their behaviour early on it would cause many of them (not all by any means) to rethink their path in life.

Really people who are struggling with drugs or alcohol are more likely to be care experienced, homeless, young people and are struggling from a disease the same as any other. These people are already highly unlikely to seek put medical care for fear of judgement and then you want to penalise them even more. What about suicide attempts, or self-harm, or being careless so you get in an accident?

Really people who are struggling with drugs or alcohol are more likely to be care experienced, homeless, young people and are struggling from a disease the same as any other. These people are already highly unlikely to seek put medical care for fear of judgement and then you want to penalise them even more. What about suicide attempts, or self-harm, or being careless so you get in an accident?

And again, why stop at them? Why not say to someone that has broken a bone playing football that they should be fined and put off playing anymore as they are a strain on the NHS. Same for DIYers.

People won't go to the GP for minor issues - they will then become major. Someone leaves an issue till they have an emergency and then have to get an ambulance, A&E and a long-term hospital admission which costs more than the initial issue. Also disabled people will be discriminated against, already many struggle with paying for medication (in the U.S - think about how many struggle with drug addiction and don't get help, think about how in a vile of insulin often costs around $10 but is sold minimum at $90.* *

Then there's the class discrimination. What about the 4.5 million in child poverty, those kids won't see doctors. What about BAME populations more likely to live in deprivation? Also women, particularly single mothers, postpartum? Their mental health will likely worsen, they won't be able to sacrifice food on the table for the doctors - so they will get sicker and it will cost more in the long-term. What about the elderly (yes some are well-off) but othera are very poor abd have nobody to look after them. There's so much research on why this would 1. Increase health inequality massively 2. Cost more in the long-run 3. Lead to more overall inequality and deprivation in communities in general e.g lack of advice on alcohol or nutrition in these communities. You can say only £20 (but would that even be enough, and then the price will just get higher). Right now GP's get on average £110 per appointment. So will it be that much. Also for loads of families £20 per appointment will be too much, they are barely eating or not paying bills.The only reason paying for face to face appointments will free up appointments is because those who cannot afford it but still need care and are sick won't be going. So yes you'll probably get an appointment quicker, because you can pay and some people (who may need an appointment just as much as you or even more) cannot.

What if (as many do worldwide) they have to ration medication such as insulin or HIV meds? The distribution of appointments should be solely down to need, i.e triage - which many GPs do. Who is that more likely to be? Those in deprived communities, we know they have poorer health outcomes, more SEN, more mental health crises.

What's already costing a fortune is the lack of acess to free care which we see in dentistry - Wes Streeting said a couple weeks ago that the number 1 reason for kids admissions now to Alder Hay Hospital is tooth infections and tooth issues because these kids aren't seeing dentists as their parents cannot afford it - and those very skilled doctors aren't spending that time on complex care.

Yes the middle-class is being squeezed but that's not because of the working-class, maybe focus on the millionaires and billionaires, and the owners of companies that don't pay staff well, or the water companies increasing bills when they pour more sewage into water. Also those with children, elderly, disabled, poor are also (like the middle class) being punished. They are working multiple jobs, but landlords keep increasing rents to ridiculous prices, so they are often getting evicted, or sharing 1 bed room with 2 kids and the parent. More and more schools now have to wash children's clothes and get them beds not because these parents don't love their children but because they cannot pay the electricity bills so don't do as many washes. People can fall on hard times, suddenly the rents too high, and then your homeless. Or you get pregnant (maybe your in an abusive relationship, or struggling with substance abuse) and then the child suffers because of who they were born to? Missed appointments are a problem and I think measures should be put in place to deter this - I know many services will cancel your referral if you don't attend.

Look at the amount of people in the U.S with thousands and hundreds of thousands of medical debt. Which impacts credit score and from there many other things. I just think once you start even if it's £30, what do companies (insurance) love to do - break things up. So over time it will be £30 to go to A&E, (just for sitting there), then extra maybe a couple hundred or a £1000 for a scan (MRIs are expensive so they'll be higher than an x-ray or ultrasound). People will refuse scans that they need because of the cost. Then they'll you more for overnight admission, and more and more.

I fundamentally disagree that people don't value a free service many people I know and myself included are so thankful for a free service otherwise we wouldn't have gotten treatment, maybe wouldn't have finished school if we couldn't get medication. Especially those who are of lower socio-economic status, because they know they can't afford it and value care.

They have to pay a fee for their treatment, yes. Not a fine, a charge for a service they are receiving. The same as if someone prangs their car. They either have to pay a garage for repairs or claim through their insurance and pay their excess. And in most cases, it will make them drive more carefully and cautiously.

Accidents happen.

Why can people not get their heads around the fact that there are MORE than two options - it's not either UK or US? 🙄

Do you really think that people who live in countries which have a charge to see a GP (here you also pay for ambulance call outs, unless they are termed an accident) are dying in droves? Funnily enough, several of the GPs I've seen over the years here have been from the UK.

But a car is not a human right. Healthcare and easy accessible access to healthcare is a human right. So you can't compare, nobody choses to become an addict, it's not fun, they're trapped and likely have gone through a lot, SA, homelessness, abuse, they're care experienced, county line, parents with addiction. We already know they don't acess healthcare because of the shame and stigma around addiction and often because they can't afford it (where they have to pay). Shaming someone with addiction or forcing them to pay, will not stop the cycle. What will is free acess to substance abuse clinics, and therapists, and housing and support to get qualifications and employment, and getting out of often very unsafe and vulnerable situations where they're often being exploited.

Hair transplants are not done on the NHS anyways. As for weight loss surgery only the most extreme often get it on the NHS. The NHS again very rarely does 'cosmetic surgery', unless you consider reconstruction post cancer 'aesthetic but you don't get what people traditionally think of as plastic surgery on the NHS anyways.

You don't get free GP appointments if you are a low income earner, you just pay less. The people in my family with asthma also pay for GP visits.

Translation services are also for deaf people, is that also their problem? What about children who have no parents with them and only speak minimal English?

God, threads like this make me so angry.

In the last 2 years I've had 9 A&E attendances (2 by ambulance), 2 urgent treatment centre attendances, probably a dozen GP appointments and probably two dozen outpatient secondary care appointments, plus a shitload of scans and tests. I was fobbed off as worried well for most of that time but it turns out I've got a serious genetic condition. In between the fobbing off and the prohibitive expense of what the OP proposes, I would just have had to stop seeking medical help long before I got a diagnosis, and would probably have become so ill without help that I would be incapacitated and on benefits for the rest of my life. So it's not a very joined up approach really, is it.

And as for the idea that "chucking money" at the NHS is somehow misguided, well, no, that's exactly what it needs. Everyone is so positive about the various European systems and even the US system, but the fact is that people pay more, both at the point of use and via taxation/insurance, than we do here, by a long chalk. The UK spends a smaller percentage of GDP per capita on their healthcare system than any other developed country in the world except Cuba, which is modelled on the NHS (and both are fantastically frugal).

The pp who pointed out the false economies happening in dentistry is spot on. You can properly fund the health service or you can disproportionately fund the fall out from not properly funding the health service. I fucking hate people with money who act like ill people are some kind of immoral drain on resources. A healthy population is a social and economic good that benefits the nation as a whole. The idea that we would "financially penalise" sick people to get them to reflect on their "behaviour" is just revolting.

So who will do all those low-paid but essential jobs which we all benefit from? Delivery drivers, cleaners, bin workers and women, healthcare assistants, shop workers, postal workers, hospital porters. Or are you supportive of pay increases in such roles which if they suddenly disappeared we'd all notice and suffer from the loss of such work.

we do have this option already though - I have always and always will pay for health insurance including the kids for better care and I use the NHS only when there is no other option.
I pay less than a few tv/ gaming subjections and others monthly wine bills
I am not rich by any means but it is on the top of my priorities.
Between my kids there has been private orthopaedics, private ENT, amongst other things over the years.

What about funding it through a tax on everyone's earnings? Everyone in work could pay in each week or month over the years and then they would be entitled to healthcare free at the point of need. We could call it national insurance or something.

The only people eligible to pay @Fragmentedbrain's proposed fees would be the people already paying in, or on decent pensions (ie already paid and still paying). Unless OP is suggesting that everyone has to pay (or just die if they are poor). So why not just raise NI or save money elsewhere in the budget, like um dropping out of NATO? And then there is the question of NHS waste could we look at that first?

'If I can't see your ribs from subsisting on a diet of mouldy bread and stagnant water you're not poor.'

I already contribute. It’s called tax.

You say this but I once got a text telling me off for missing an appointment I never made and was never told of!

GPs should be given 40 hour contracts, but working different shifts. Doctors cannot get GP jobs, so this would alleviate this problem. No practice should be allowed for every GP to be part time. The last Labour government gave GPs huge pay rises and cut their hours. In the good old days you had GPs on call 24/7. This took the pressure off A&E and other emergency services.

I had a medical card in Ireland and ir was well known that GPs did not treat their medical card patients as well as their fee-paying ones

How would that work? You can't get insurance for pre-existing conditions

No, because frankly it would piss me off that people on benefits would still get to see them for free.

They should see them for free.
I should see them for free.

Me working my arse off shouldnt un-entitle me to "enjoy" the things that my taxes pay for.