It wouldn’t be a bad idea if we paid for GP appointments?

[Babybear260]

I’m no economist or politician but it occurred to be that if everyone (or the majority of the populn excluding students, under 18,s , pensioners and very low income households) paid, I don’t know ~£5 every time they saw a GP, could that improve the NHS?

I know many, many people that spend twice that a week on lattes and cappuccinos (including myself) so I wonder whether if the majority of the population could stump £5 per appointment it would help?? Because most people aren’t seeing GP’s weekly so surely people wouldn’t mind contributing?

sure people have thought of this before and there must be a reason why it wouldn’t work because obviously if if did, it would be an option.

Where is your evidence it isn’t already?

Actually yes, but also this: https://www.thetimes.com/uk/healthcare/article/just-10-of-patients-account-for-40-of-appointments-with-gps-3jm7rrnr7?utm_source=chatgpt.com

The above was an article in the times about 10% of people taking 40% of appointments. These ‘frequent attenders’ had on average 60 appointments a year. If we assumed the 10% were mostly the over 60s and those on benefits, charging for the rest would still be a big win for the NHS.

HOWEVER the original study that prompted the news report did attempt to look into the nature of these frequent attenders. Here’s a quote:

‘Our analysis suggests that frequent attenders are identified across all parts of the UK and that deprivation, practice size or regional variation are NOT drivers for the number of frequent attenders by practice. There is evidence from Europe that frequent attenders (and particularly persistent frequent attenders) are more likely to be female and older, present more social and psychiatric problems, receive more prescriptions of psychotropic medication, have more medically unexplained physical symptoms, and more chronic medical conditions.3 17‘

Also this:

’A systematic review focused on children also found that frequent attendance in children was associated with presence of psychosocial and mental health problems, younger age, school absence, presence of chronic conditions, and high level of anxiety in their parents.18’

So, erm, it is highly likely the frequent attenders are the worried well (physically, that is).

YABU because it would be the usual already financially stretched suspects that end up paying whereas the chancers that are already at the GP every 5 minutes demanding paracetamol on free prescription would no doubt be exempt on some pretext.

Plus all monies would disappear into a black hole and nothing would improve.

This isn’t unusual in other countries and it helps to assign value to the appointments and makes it less likely people will miss the appointment.

All hell would break loose if it was seriously considered here though, I would imagine.

But what do you call inappropriate use of a&e when they send you away because they think there is nothing wrong with you but they turn out to be wrong this happens a lot. I don't know about other peoples local hospitals but you can't even go to our a&e without being triaged first so anything not a&e worthy gets sent to urgent care, ooh gp or even the pharmacy

This was in 2021 though how gp surgeries are run now is vastly different. Now you have to fill in an online form, you are then triaged and then the dr decides on whether you get an appointment and what sort of appointment

In my experience, the nurses at GP surgery routinly give follow up appts to people who are cognitively impaired and then wonder when they don't turn up. This is then recorded as a no show, previously there would have been home visits for this.

Where are you getting your information from to back this?

I see no point. In my family, I'd pay - but I last saw the GP 3 years ago.

DP, who sees the DR very frequently, due to his various disabilities, would pay nothing I'd imagine due to his higher rate PIP. The kids wouldn't pay as under 18. Of approx 150/200 appointments in the past few years, we'd pay... £5. I imagine many people with complex health needs would be the same.

The 60 appointments a year was for all staff. The phenomenon of frequent attenders is unlikely to magically go away due to changes in online booking. Also, anecdotal evidence, an experienced ambulance call handler friend of mine says that around 75% of ambulance callers are non-emergencies, the worried well, people with mental issues. Some people deliberately refuse to hang up, blocking the line for others. So, I reckon, if anything, the frequent attendance phenomenon has got worse. It’s easy if it’s all free. People abuse free stuff.

No problem paying but I would make it universal.
Sick of subsidising things for those who have more income than a fulltime minimum wage worker that pays there way

in Australia some of our doctors are free called bulk billing and some you pay and get a rebate. I think my last gp appointment was $120 and we got $85 back. Specialists always cost and they are rarely bulk billing.

my doctor bulk bills children and pensioners but charges everyone else.

I’d like to back up the posters you’re criticising. I’ve got elderly relatives that are constantly up the surgery or the hospital for things like a ‘pain in the knee’ and ‘had a funny turn after eating a boiled egg’. Some even manage to get MRIs, various scans, blood tests. It must cost the NHS a bomb. Each time they get a non-diagnosis of ‘You’re old’. It’s like ‘being a patient’ is their MO. They love the way the family rallies round each time there’s a scare. Tbh it gets tiresome.

Yes, seems a good idea, also I think parents should pay an annual service charge for the state school their kids attend, duplicated for each child. This would help people moderate the number of kids they can afford, too many take from the state and don’t contribute sufficiently.

I am in favour of paying something, as is seen in many other countries. I would go so far as paying this sum at the time the appointment is made. If you cancel 24 hours ahead it’s reimbursed, but if you miss an appointment - tough.

There’s little point or economy in trying to collect from no-shows after the fact.

Children should always be free, but given the volume of elderly at my surgery, I think they should pay too, and get a refund if they are on low income.

Hello Rachel.

Why should your husband and kids be exempt?
Everyone uses the service everyone pays no exceptions. Should be like that for everything

Absolutely. Id love to pay only £5 for the doctor. In Ireland we pay €60 for every appointment, maybe even €70 now. Very low income earners can get a GP visit card but im on the lower end of a normal income so I cant get one and the fee is quite prohibitive. I would like to see a lower fee but I do think a small fee is a good idea.

Absolutely! I'm asthmatic and unfortunately more likely to not only get everyone's just a cold but for those to affect my asthma and develop into a chest infection which in turns niggles the asthma.

Last Tues night I had a mild attack randomly out the blue. Saw GP on Wednesday as im supposed to. All good thought was a one off as nothing flagging. Had another that night so again seen again Thursday and started steroids. Friday night on phone to 111 as another one. Seen early Saturday and I did have a chest infection flagged so got antibiotics. Wednesday called GPs as didn't think they were fully working and was seen again. I was correct and got different antibiotics.

Now ive got a med review to see if current treatment/inhalers is working for me (normal after an attack) on Monday.

If i had to pay £5 per GP visit it would cost me £25 just to breathe post asthma attack/chest infection.

I have to do that then maybe people can wear a mask when they have germs and stopping being grotty and passing them on. Ahh didn't think so

Criticising? All I said was where did you get your information for this.

It would be disastrous.

I've spent this week acknowledging one of my department will be late/finishing early / shifting their lunch because they are on a 2 week cancer diagnostic route. It's looking like not cancer, but should they really be paying for appointment after appointment?
I'm also negotiating another person pulling forward some of next years leave because 2 weeks off plus a string of prescriptions has left them totally skint.

Have you seen birth rates? Schools are closing or merging due to lack of numbers because young people are not having dc. Previous generations were the ones who had them regardless whether they could afford them!

Won’t happen because people would just choose to homeschool.

I think it should be free BUT if there was a scheme where you had to pay it should be :

1. very low cost
2. similar to prescription where you can buy a yearly prepayment certificate that saves you money
3. GP surgeries all open 7 days a week

That is because they habe an insurance based healthcare systems not feee at the point of service which is the basis of the NHS

i personally think we need to move over to this type of system as the NHS is broken but we keep being told that it’s great having a free at the point of service healthcare system. It’s not greet it’s shockingly poor service we should expect better and deserve better

but it will mean we shall pay more and the problem is at the moment is so many people just can’t pay more and those who can feel all they are doing is paying more of their money to the government