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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

We need to start charging for NHS services

750 replies

Fragmentedbrain · 28/07/2025 11:03

£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

OP posts:
Amberlynnswashcloth · 29/07/2025 06:13

People who pay upfront will have higher expectations from the service. Who would be happy paying hundreds of pounds on top of taxes to still have to wait 7 months for an initial appointment in a filthy hospital with grumpy staff, shabby facilities and no parking? I think they get away with a lot simply because its free at the point of use our expectations are kept low.

Trad3rB3n · 29/07/2025 06:46

No way should anybody be fast tracked in the NHS on account of how rich they are. Need should trump everything.

And how does your little scheme work for those that need and should go to the GP/A&E and are already reluctant? How is it fair that those with chronic conditions should be worse off?

NHS is improving massively where I am. You are triaged before appointments and hospital wait times are improving massively. I’ve been quite impressed actually.

XXLfiles · 29/07/2025 07:59

Morningsleepin · 29/07/2025 05:13

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

Unless it's a state mandated insurance like in some other countries. It can be such that everyone must have it, cost only x and no one can be excluded. It's called social health insurance model.
It actually even covers basic dentistry where I am from.
Edit to add. And yearly gynae checks. Without need to beg gp to be send to them

Pessismistic · 29/07/2025 07:59

Kirbert2 · 28/07/2025 22:46

No one chooses to be so disabled that they are unable to work for a start.

I believe it should stay as it is but if it doesn't then things need to be in place for those who would otherwise be unable to afford it or those who need to use it more because they are either disabled or have medical issues which means they would be penalised for needing to use it more.

The only reason I'm on UC is because I lost my job due to my son having cancer and complications from cancer caused by the NHS delaying surgery he desperately needed which then caused a long hospital stay and my son to be disabled. They made the mistake, why should I then have to pay for that?

My options at the time were to lose my job or leave my child with cancer terrified and alone in hospital to cope with his new disability on top of his cancer diagnosis.

Sorry your going through this but not everyone on uc is looking after there ill kids some just have kids then decide to get uc to top up there wage or there partner works and they don’t because child care is too expensive.

Nasrine · 29/07/2025 08:18

@Fragmentedbrain

For people on the far right like you this is an excellent plan, because it would cull vast numbers of the heaviest users of the NHS, people like my son who have chronic illness, and people over 65.

FWIW, there seem to be a lot of posts on these boards at the moment pushing the line that the UK is on the verge of collapse. Lots of anti-immigrant sentiment. Calls for the reinstitution of the death penalty and a harsher criminal justice system. Insistence that the NHS is disintegrating and that we need to dismantle our welfare state and introduce a different system of healthcare. Lots of calls from people on high incomes for large cuts in taxes because even people on 100K have a terrible quality of life in the UK. Apparently.

Hmmm.

I smell a rat.

BIossomtoes · 29/07/2025 08:33

OonaStubbs · 29/07/2025 00:29

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.

I’d be embarrassed to reveal such ignorance about addiction.

Kibble19 · 29/07/2025 08:36

TheLivelyViper · 29/07/2025 01:26

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.

I know. What I meant was that the NHS should never be expected to pick up the pieces when someone inevitably gets an infection or similar from dodgy surgery they’ve had done cheaply abroad.

usernamealreadytaken · 29/07/2025 08:39

SteakBakesAndHotTakes · 28/07/2025 19:36

So the net contributors would then have to pay double to subsidise those paying nothing

Not if it was a refundable deposit scheme. Unless there was a watertight excuse for missing the appointment, then even those who have some kind of exemption should have to pay. Those who make it to their appointment don't cost anything.

WaryCrow · 29/07/2025 08:47

Haven’t rtft yet but can I correct what appears to be an error early on?

Yes in Europe - at least Netherlands , Germany, Belgium - they pay for appointments, 17.50 euros it was. It is an upfront payment only. It gets refunded. They have an insurance system.

Upthread people seem to be suggesting a payment which would not be refunded. In other words, prvatisation. And no, that is not acceptable, we can see from America how much that costs.

We all know, or should, that the modus operandi of the American-living neoliberals has been precisely what has been happening: the politicians run services into the ground demanding more productivity for less and less cost and pay the workers less and less until the system croaks, and then they privatise it. Leaving staff with no voice even to complain about their lack of rights. We saw it ourselves in Britain in the Victorian age when working people lived in squalor rarely seen in human history before.

FWIW I thought the need to pay upfront and claim back in European systems was grossly inefficient compared to our NI system and free at point of delivery, but I would rather that than Britain sink further into becoming America. As someone intelligent upthread said too, we need to be careful right now about removing incentives to work as it is not worth trying to actually qualify in many professions, including health, given the low wages and cost of training. Yes, people especially women are poorer than in Europe. We have gross inequality here, and much more sexism. The super rich and idle landlords are laughing at us all while they claim simultaneously that this country is rich because they’ve made it a success, and too poor to afford services that poorer countries manage.

usernamealreadytaken · 29/07/2025 08:49

Ginisatonic · 28/07/2025 16:32

There is a bit of a difference in scale between a restaurant collecting a deposit and a deposit being collected for every NHS appointment.

And what will happen when there is no money in the account? No money no appointment?

Most GP surgeries are individual or small grouped businesses, some considerably smaller than restaurants. No reason why they couldn't administer their own system, using the same system but run individually. Similarly each hospital or trust group.

And just for your information, Opentable (just one of the restaurant booking sites) processes well over 1.5bn bookings globally per year. Gps in the UK processes fewer than 400m. The software is available, it's political will that isn't.

usernamealreadytaken · 29/07/2025 08:49

BIossomtoes · 28/07/2025 16:35

A restaurant is on a completely different scale to the biggest employer in Europe that sees 1 million patients every 24 hours. It’s sheer idiocy to compare the two.

Most GP surgeries are individual or small grouped businesses, some considerably smaller than restaurants. No reason why they couldn't administer their own system, using the same system but run individually. Similarly each hospital or trust group.

And just for your information, Opentable (just one of the restaurant booking sites) processes well over 1.5bn bookings globally per year. Gps in the UK processes fewer than 400m. The software is available, it's political will that isn't.

EasternStandard · 29/07/2025 08:52

Nasrine · 29/07/2025 08:18

@Fragmentedbrain

For people on the far right like you this is an excellent plan, because it would cull vast numbers of the heaviest users of the NHS, people like my son who have chronic illness, and people over 65.

FWIW, there seem to be a lot of posts on these boards at the moment pushing the line that the UK is on the verge of collapse. Lots of anti-immigrant sentiment. Calls for the reinstitution of the death penalty and a harsher criminal justice system. Insistence that the NHS is disintegrating and that we need to dismantle our welfare state and introduce a different system of healthcare. Lots of calls from people on high incomes for large cuts in taxes because even people on 100K have a terrible quality of life in the UK. Apparently.

Hmmm.

I smell a rat.

Edited

Mn just isn’t as strongly Labour and you’re seeing other views. Probably because support for Labour has fallen since the GE, and more posters will vote for others.

BIossomtoes · 29/07/2025 08:53

Was there any need to post the same thing twice? Opentable is a commercial operation funded by the outlets that are members, there’s no comparison.

Kirbert2 · 29/07/2025 08:54

Pessismistic · 29/07/2025 07:59

Sorry your going through this but not everyone on uc is looking after there ill kids some just have kids then decide to get uc to top up there wage or there partner works and they don’t because child care is too expensive.

So people like me caring for their disabled child who constantly has appointments and needs to use the NHS should be punished and struggle even more financially because you don’t agree with why some people are on UC?

Nasrine · 29/07/2025 09:01

EasternStandard · 29/07/2025 08:52

Mn just isn’t as strongly Labour and you’re seeing other views. Probably because support for Labour has fallen since the GE, and more posters will vote for others.

I'm seeing more posts expressing far right views.

Which figures, given that the far right are currently on the ascendent in the UK.

Kibble19 · 29/07/2025 09:02

It’s a bit of a catch 22 (having read this thread) because the heaviest NHS users are likely to be elderly and/or not working. Many people have indicated that those groups should be exempt from payment, so would it actually change anything for the better?

All it would do is squeeze the middle more, and this is a workforce who largely are sick of feeling like they’re subsidising everyone else.

I don’t agree with this view that anyone on any benefit should be exempt. There would come a point where working became (more) pointless for many.

People also need to start taking a lot more responsibility for themselves. How many people jump off high things then show up at A&E for an X-ray because, amazingly, they’ve hurt themselves? Eating shit food then wanting the GP to prescribe meds for stomach problems? Complaining of aches and pains when they’re 4st overweight.

The absolute reliance on others to sort out their life is nauseating. If you’re an adult, you need to take some responsibility.

EasternStandard · 29/07/2025 09:04

Nasrine · 29/07/2025 09:01

I'm seeing more posts expressing far right views.

Which figures, given that the far right are currently on the ascendent in the UK.

There are more parties to vote for than Labour, it’s just that mn hasn’t really had a good cross section for a few years due to Labour type posting. I don’t think it’s bots or ‘smelling a rat’ etc just that fewer people now support Labour.

Nasrine · 29/07/2025 09:13

BTW - in terms of the state of the NHS - this assessment by the Kings Fund in 2018 found the following:

Key findings

• Overall, our analysis shows that the NHS performs neither as well as its supporters sometimes claim nor as badly as its critics often allege. Compared with health systems in similar countries, it has some significant strengths but also some notable weaknesses.

• Its main weakness is health care outcomes. The UK appears to perform less well than similar countries on the overall rate at which people die when successful medical care could have saved their lives.

• Although the gap has closed over the last decade for stroke and several forms of cancer, the mortality rate in the UK among people treated for some of the biggest causes of death, including cancer, heart attacks and stroke, is higher than average among comparable countries. The UK also has high rates of child mortality around birth.

• Among its strengths, the NHS does better than health systems in comparable countries at protecting people from heavy financial costs when they are ill. People in the UK are also less likely than in other countries to be put off from seeking medical help due to costs.

• Waiting times for treatment in the UK appear to be roughly in line with those of similar countries and patient experience generally compares well.

• While data is limited, the NHS seems to be relatively efficient, with low administrative costs and high use of cheaper generic medicines.

• The NHS appears to perform well in managing certain long-term illnesses, including diabetes.

• Health care spending in the UK is slightly lower than the average in comparable countries, both in terms of the proportion of national income spent on health care and in terms of spending per person.

• The UK has markedly fewer doctors and nurses than similar countries, relative to the size of its population, and fewer CT scanners and MRI machines.

So what the OP is suggesting on this thread is to damage the one aspect of NHS provision which is its primary strength - in the accessibility of healthcare, and subsequently in the way it manages long term conditions like diabetes where accessibility is crucial.

Note that we've traditionally spent less on healthcare than other comparable countries, despite the UK population being fatter and less healthy than most European populations. (BTW, recent estimates of NHS spending in the UK have been distorted by the inclusion of pandemic spending in the totals).

Would also add, this report is from 2018, following 8 years of underspending during austerity, where the growth of healthcare spend didn't keep pace with the growing cost of treatment or of an ageing population.

Teanbiscuits33 · 29/07/2025 09:17

DeedlessIndeed · 28/07/2025 11:31

Unpopular, but I think abuse of the NHS should be charged.

Missed appointments should have a fine. Misuse of A&E should have a fine.

Yes to pay for nicer rooms, nicer food etc. It could subsidise the other areas.

I am on the fence about having to pay for GP appointments. In principle maybe, but chronic conditions that require repeat visits should only pay once. Shouldn't be penalised for having a condition.

I agree with this in principle, but there’s one major issue with it that I can see, and that is that people who are genuinely ill will end up too scared to go to A&E for fear of over reacting and there being nothing wrong. They might be accused of time wasting and get charged, so I do feel that it will stop some poorer people from accessing the help they need.

1apenny2apenny · 29/07/2025 09:17

The problem is that those that are paying for everything seem to now be being asked to pay for more. Currently if you are on benefits you get a wealth of other discounts/help. Cheaper broadband, prescriptions, bus passes, heating allowance, school uniform help etc (depending upon how old and which benefits you get). There was talk recently if reducing water bills for those in low incomes/benefits. Due to wage stagnation we are seeing the gap between those working hard and those choosing to not work or work parttime and get benefits close, close so much that when you add in these extras people are better off not working. The money/benefits given is tax free, no work required, nothing put in. This money comes from those working and people have had enough, I don’t feel you can ask people, normal taxpayers (especially those higher rate tax payers) to pay more.

So I think whilst some charges are good eg a missed appointment charge that is paid by everyone frankly charging people more is not on. We already pay NI for it, well those working do. Not paying twice!

TherelsALightThatNeverGoesOut · 29/07/2025 09:37

Pessismistic · 28/07/2025 22:37

Do you agree if everyone who gets benefits should be exempt are you happy to pay for others.

Of course. I don't want to live in the sort of country that is happy to watch those on low incomes/disability benefits or UC/pensioners suffer and/or die because they can't afford healthcare. That would be simply barbaric.

BIossomtoes · 29/07/2025 09:55

TherelsALightThatNeverGoesOut · 29/07/2025 09:37

Of course. I don't want to live in the sort of country that is happy to watch those on low incomes/disability benefits or UC/pensioners suffer and/or die because they can't afford healthcare. That would be simply barbaric.

It’s quite terrifying how many people seem to want a return to the 1930s.

rewin · 29/07/2025 10:15

Given that health care needs to be rationed (as it's turned out it does), it still seems to me the best way of rationing is on the basis of need.

The worst way? Price/ability to pay.

In the end, this is a matter of morality. And, yes, to be sure, there will be some cheaters/queue jumpers ... but we need to try and minimise the incidence of this, not encourage it by formalising a pricing model of care.

Yes, I could afford to jump the queue and pay a private doctor to treat one of my ailments rather than be triaged on the basis of need and waiting my turn. I'd think I was doing wrong, though, if I did ... Just as I would be doing wrong if I jumped the queue in a supermarket, say, or a railway ticket office. (Less serious examples, to be sure; but the same principle: queue-jumping is wrong.)

Meanwhile, I'd like to pay more tax so as to try to diminish the length of the health-care queues. I know this is an unpopular view nowadays, but nevertheless I think it correct (in terms of what is right or ethical). It's less selfish, you see: we ought not to be selfish.

sashh · 29/07/2025 10:22

Screamingabdabz · 28/07/2025 11:32

I would go even further and say the whole NHS needs to be privatised. It’s no longer sustainable in its current state.

I think that is the stupidest statement I have ever read.

I have worked in the NHS and in a private medicine.

Private hospitals are run, like businesses, everything is charged for, that means every test, tablet, X-ray etc has to be entered in to some sort of pricing system, that takes time. You also need to employ people to collect the payments.

You also want to encourage people to come back and to spend more.

The best healthcare should be run the opposite way to a business. You want people to not come back because they have had appropriate treatment.

It is in the interests of the NHS to do more preventable medicine. I'm at the age where I get mammograms and FIT tests, I could not afford to pay for them.

Ponoka7 · 29/07/2025 10:26

DeedlessIndeed · 28/07/2025 11:31

Unpopular, but I think abuse of the NHS should be charged.

Missed appointments should have a fine. Misuse of A&E should have a fine.

Yes to pay for nicer rooms, nicer food etc. It could subsidise the other areas.

I am on the fence about having to pay for GP appointments. In principle maybe, but chronic conditions that require repeat visits should only pay once. Shouldn't be penalised for having a condition.

How do you prove intential misuse of A&E? My DP was fobbed off twice, he had bowel cancer and had to be dying for a CT scan yo be done. He wouldn't have needed a fine waiting for him, to have to fight.
There's too many people on low wages, self employed who are falling through the cracks as it is.
It'll also go down well with the migrant protesters, first death of someone too poor to go to A&E and it'll cost us more in policing.