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.

This. But a Govt has to have the courage to do it AND the money is not to go to a private/for profit company or investment group as has happened with veterinary services. But the huffing/outrage there will be will keep MN going for years

I will never support a policy like this.

DH and I have never claimed income related benefits because he earns too much, however we have disabled children who I care for which means that I am unable to work. As a result of my lost career and the massive costs of accomodating disabilities (equipment, therapy that the council won't pay for etc), we have frequently struggled financially.

There are definitely times when I've been to the GP, where a £5 charge would have made me think "oh forget it, it's probably nothing anyway". Because it's hard enough to find the time to go, let alone the money to pay. One of these times in particular, it would have had potentially very disastrous consequences for my family.

As for charging for no shows, I also don't agree with that. It would disproportionately affect disabled people, single parents and carers (and therefore women).

Instead of quick fixes and a punitive response, we need to look at why people are missing appointments and then address the root cause.

This has been discussed for years, remember it being a talking point when I was on MAT leave about 12 years ago on The Wright Stuff.

It’s a bad idea because some people don’t have £5 or £10 going spare so would put off going to see the GP until they got paid meaning they may get worse. Also to some people, this money means fuck all so they wouldn’t care about losing it.

In Australia it costs $50 to visit a GP. There are still some GP’s that bulk bill anyone that shows up but there are some that only bulk bill people with a special govt health card (only the poor get those). Some GP‘s don’t charge for consults with children.

I can choose which GP I see. I can travel to other suburbs if I want to see a GP there. I can often get a same day appointment by booking online. I don’t have to justify my symptoms to a receptionist (like I hear happens in the UK). Occasionally I have shown up to my GP’s office when there has been something urgent.

I think that the NHS is completely broken. I had a friend years who lived in London would need to make multiple appointments if she had more than one thing wrong with her. In my country you can book online and request a longer appointment.

I’m concerned Australia becoming like the UK or the US in terms of healthcare.

In my opinion Doctor’s are absolutely entitled to earn well and to charge for their services. My concern is that Australia become like the US where insurance companies practice medicine - or the UK where GP’s won’t order blood tests because the NHS can’t afford to pay for it.

I prefer going to private hospitals for treatment. I’ve received excellent care in private and public hospitals - but I’ve also received terrible care from a public hospital wherein they scheduled me for emergency surgery on my pancreas when there was nothing wrong with my pancreas. Thankfully I was cognisant enough to challenge the surgeon as to why surgery on my pancreas (without a genuine reason) was not necessary. Turns out he had the wrong organ.

Why do you think that so many people can afford to homeschool? Many people need the kids at school so that they can work and keep a roof over their heads.

I don't know about Australia, but you are right about Europe. However, the medical care, especially where I come from, is superior compared to that in the UK.

Yes, people need to pay. The NHS was nice while it lasted, but it's not sustainable anymore.

What about the treatments? For example, my husband needed at least five GP appointments for an ear problem before they realised it was an infection and referred him to a consultant. All this misdiagnosis, going back and forth, and having to pay for it will lead negligence cases.
We need to ask GPs if they want this.😅

This would be similar to Medicare in Australia. You pay a certain amount and then claim the majority back, therefore being out of pocket by a nominal fee. It means you get to see a doctor much quicker and those on low income wouldn't have to pay.

I do feel that the eligibility criteria needs to be widened if using the low income model though. Low income means extremely low income and there will be people above this who still wouldn't be able to afford a nominal £5/£10 fee.

So we could have a prepayment card like we do for prescriptions.
If you need multiple appointments you pay £10 a month.
I'd also make those currently on free prescriptions pay for the prescription one.
Time to start cutting out the freebies to all sectors of society and hopefully the culture of entitlement will start to wane.

Exactly this i don't think I've ever been correctly diagnosed first time.

Why was it sustainable before, and what has changed?

I sort of get where you’re coming from, but as others have said it would put the people who need it the most off from going. There’s also the secondary issue that people who wouldn’t be willing to spend £5 would end up costing more money long term. For example, I have to go annually for a check up to continue receiving my contraceptive. Sure I’d pay for that (even though it’s the GP themselves that require this visit) but many wouldn’t. This would lead to more people getting pregnant without the correct access to birth control. This in turn would cost the NHS more money dealing with pregnancies. I can think of other examples too - people wouldn’t want to pay to stop smoking, they’re more likely to need expensive treatment etc etc. So whilst it’s not a bad idea in principle, I just don’t think it would work in practicality

If you think the NHS should continue to do almost everything and be entirely free at point of use to everyone, I do think you need to explain where you’re going to get the money to fund it. This is not 1948, when the average person popped their clogs in their 60s after a short illness. We have a hugely ageing population, millions of people living for decades with multiple chronic conditions, a massive Covid-induced backlog, many more medical interventions available to us and new ones coming online all the time, not enough working-age taxpayers, and the costs of medical equipment and drugs are going up and up.

My dad, who’s in his late 80s, has probably cost the NHS around £20k in the last year through appointments and prescriptions alone (no actual procedures) - and he’s not an appointment-chaser, he only goes to the doctor when he’s summoned. Meanwhile, when I was having gallstone attacks last year the GP kept fobbing me off with blood tests (basically a displacement activity to delay referring me to a specialist) and eventually told me I’d be put on a two-year waiting list for surgery, while experiencing unbelievable levels of pain that would soon have stopped me working (and thus paying tax…) I paid to have the surgery done privately, using up all my savings in the process. Yes, I’m privileged to have been able to do it. But yes, I’m deeply fucking pissed off that I had to, after decades of paying in and taking barely anything out.

The political problem we’re facing is that working age taxpayers — the people who use the NHS least, broadly speaking, but who pay for all of it — are getting absolutely terrible service from it. Can’t get appointments outside working hours, can’t see a specialist for two years, wait in chairs at A&E for 12 hours, getting a GP appointment is like playing the National Lottery … their support for the principle of a free NHS is going to fall away, which is when political parties will start to sit up and pay attention.

If you don’t want a payment-based NHS, you have to engage seriously with the problems that we have. Something is going to have to change. If it’s not co-payment, then what? A bit of gentle exhortation to stop wasting doctors’ time isn’t going to cut it (not least because time wasters, annoying as they are, aren’t the reason we’re in crisis).

We are an aging and, overall, sicker population now. We just can't afford to give everyone free, timely, appropriate treatment anymore and people are dying because of it.

We used to have a €10 quarterly fee for any practice we went to in Germany in that quarter (a lot of what would be GP work in the UK is covered by specialist Drs and many go straight to the specialist practice. Children go to a paediatrician.)

Apparently, it cost more to administer than it actually raised.

Actually no. We’ve rapidly moved to a situation where a few of us are paying for everything. I think there needs to be a more honest conversation about this. Many have private healthcare anyway do get their GP appointments that way without burdening the NHS.

I think it would be a disaster as it would put the people who have to pay (ie working people) off going, resulting in more time off sick. I’ve definitely had to put off getting my antidepressants until pay day and do without for up to a week, which is not good. When o was younger, I had to come off them altogether as I couldn’t afford the prescription fee.

I definitely agree with a fine for missed appointments for everyone as you have the choice to go or ring up and cancel, actually you can even do it in a few clicks on the app now.

Why are they free for those on benefits who are on more money that many working people?

I think we should pay too and appointments shouldn't be a rushed 10 minutes. Even 15 minutes would be an improvement. If you dont want to pay you can get the 10 minute appointments.

When I'm in France, I get a same day appointment with my doctor. I'm happy to pay for that. The system works well. GP and specialist care (including emergency care and diagnostics) is excellent and prompt.

I don't have to fill out an online form or jump through any other of the hoops that I have to in the UK.

On the face of it I wouldnt mind paying. Id happily pay more for a convenient appointment that lasted 15 mins.

but I actually think by the time you've exempted under 18s, certain benefits and pensioners, and people with chronic illnesses who need regular reviews you've probably hit 80% of a gps workload.

I dont know whether things have changed but when I did home care 20 odd years ago there were many clients who had repeat prescriptions for stuff like aspirin and calcium tablets etc. These prescriptions never seemed to be reviewed and I used to be astonished, when opening a cupboard, huge stockpiles of these medications that weren't being used. The amount of money wasted must have been phenomenal . Im not sure if it still happens (my guess is it does) the NHS must be losing millions purely on repeat scripts that just keep coming month by month and nobody seems to monitor it

So what happens if you cannot afford the upfront fee before claiming the rest back, as in you try to pay and the computer says no? Do they just not get treated?

Probably because we don't do preventative work and the food is worse now. Think of in the old days when you had actual school nurses and food made with real ingredients, rather than random chemicals so it lasts well and is cheaper to make.