Charging £25 to see a doctor....

[cantheyseeme]

What does everyone think about this stuff in the news today? would you pay?

[alreadytaken]

Reviving this zombie thread because it is on the agenda again. www.pulsetoday.co.uk/news/finance-and-practice-life-news/gp-leaders-to-vote-on-charging-patients-for-appointments/20006624.article#.U25fH_ldUTo

Something to ask the candidates about when there are elections

[edam]

Well said, Colditz.

Dunno if this might be any use to your Mum and sister? There's a 'I am on a low income, can I get help with dental charges' box. Seems they make a comparison between your income and the charge for the dental work that needs to be done - so if a dentist says your Mum needs new dentures, with an NHS charge of £214, she may be able to apply for assistance if she can show her income is too low to afford them.

[YOUCANBEMYFRIENDIFYOUBUYMECAKE]

bloody hell. What is this all about.
As someone else said what about people with 'chronic' illnesses do we get a discount probably not!! We will be working for our GP and NHS appointments not paying off our mortgages grr

[somewheresomehow]

the trouble is with this idea is that all those on benefits, kids under 1 and the oap's would'nt pay and everyone else has to and every year like the prescription charge it would go up, thereby pricing low/middle income but not on benefits people/families out of health care and it would end up with people packing out a and e which itself is in crisis because hospitals are closing/merging thereby limiting available beds

[colditz]

£25 is half my weekly food budget. I have two asthmatic children. We're going to fucking starve if this is brought into practice.

Yes, we have, on the whole, accepted paying for eye tests and dental treatment, but the working poor aren't paying for it because they have STOPPED GOING TO THE DENTIST AND OPTICIAN! My mother and sister haven't been to the dentist since my sister left school and mum lost the tax credits. Neither are eligible for an nhs card. My sister desperately needs glasses, and has stopped driving because of this, and I suppose if I forced the issue, she would go but she's put off by the price. My mother needs new dentures, hers dont fit her.

If there had been a £25 charge for the doctor, the pain in my sisters leg would have been ignored, or treated with old prescription drugs left over in the med drawer, and the blood clot that was sitting there would not have been noticed, she would not have been treated with heparin, the resulting pulmonary embolism she DID HAVE would have been a lot worse and would probably have killed her.

All for the sake of £25 which seems like fucking chump change if you are a doctor, but is a fifth of my sisters weekly income.

[Silvermoonsparkling]

A GP friend told me ages ago that if they could charge just £1 per patient, it would cut out a considerable number of time wasters who just rock up to the surgery for a chat.

[differentnameforthis]

We are in Adelaide, so I know we pay less than some places. But yeah, it isn't bad. My dr knows me (he treats the whole family), so always bulk bills :)

But script charges can be a killer..

[Theas18]

Half the time I thnk charging is a great idea, the rest of the time, of course it's daft...

BUT reality is we needs to cut down those who don't attend, and those who don't self manage apropriately,attend for non medical reasons (how can the GP fix your work/relationship/finance problems?) or don't follow instructions and are back again because " it isn't mended"

[Nancy66]

If there's a workable way of doing it - i.e so that patients with known on-going conditions are exempt - then I don't think it's such a terrible idea.

There are so many no-shows at surgeries every day and so many time wasters.

I know people who get a cold and make an appointment with the their GP - if you ask them why they just say 'well they might be able to give me something.' Yes, something you can buy over the counter in Boots.

If it weeds out idiots and time wasters and saves the NHS shed loads of money then I'm for it.

I also think ambulance calling time wasters should be heavily fined.

[SconeInSixtySeconds]

That's really reasonable for oz, different. I used to get charged $80 and receive $32(? I think) back.

[differentnameforthis]

We already pay here (Australia). My dr charges $52 per visit. Or they can bulk bill (they do this for those on a health care card, which you get on a v low income, or for children)

We get to claim about 80% back afterwards.

We also pay full price on prescription charges. The last script I had cost me $64 & that was contraceptives.

[purplemurple1]

We have this where I live (abroad) and it works quite well as there is a yearly limit on what you can pay, pensioners and those on benifits get a discount. Also once you have one visit about something you don't pay for followup visiits about the same thing, inc hospital visits if needed. So you just budget this money each year and if you don't need it all then it's a bonus. But the big difference is the benifit system here gives people enough to live on and afford these charges, thats the issue in the UK I suppose - more costs with no more money doesn't really add up.

(They do prescriptions in the same way, yearly limit and discounts.)

[Uptheairymountain]

Like Edam said upthread, £25 is a large chunk of many people's income. A charge would restrict healthcare access to those with more money - unless the charge was means tested, so the financial impact would be equal for whoever used the service.

[giraffesCantWearSuncream]

Ihave bad asthma, I probably just wouldn't go

[colleysmill]

As a patient with a compromised immune system when I'm sick, I'm sick. I won't often get better on my own and the "wait and see " approach just means I deteriorate further. Doesn't happen very often admittedly but I dont want the added stress of "can I afford it?" instead of "i.need to.see a doctor".

As a professional who often signposts people back to their GP if we think there is an.underlying condition which needs exploring I would worry people wouldn't follow that advice and not get the intervention they need.

I would be concerned this will only led to higher costs for the nhs - a lot of the time the focus is on catching things early not later for better outcomes but by putting a barrier to accessing health advice or treatment people will leave it too long and ultimately it may cost for the nhs to treat.

[notfarmingatthemo]

We pay here in NZ but then are prescriptions are reduced a bit because of it so I think it works out very similar to the uk. I have been twice since I have been here (not been here long but have a few long term things) each time I have been seen the same day. The waiting room is not full of kids with sniffles all seen kids in there that have been obviously ill. Each time I have been asked if I minded if they went first. I think it would solve people going to the Drs for silly things. If you have to pay it makes you think

[ReallyTired]

Our GP surgery strikes off people who miss more than three appointment without explanation. This brutal approach is understandable, but can leave innocent children or an elderly person with dementia without a GP. I missed an ante natal appointment due to being in strong labour, but the midwife did say that was totally forgivable. We need a system that is compassionate and reasonable.

I think its perfectly valid to punish adults of working age for missing GP appointments which they have booked themselves. Ofcourse there is a cost with punishing crimes, but it is to act as deterent. Prehaps there needs to be option of commuity service for those who cannot pay fines.

[edam]

Even administering a charge for missed appointments would be costly, not least because half the time it's the NHS's fault for sending appointment letters too late, sending them to confused elderly people who can't make sense of them so their relatives find them too late* and so on combined with often making it extremely difficult to phone up and say, hang on, you've stuffed up/I can't make this date.

The various services involved with my MIL all know she is confused and on her way into a home as soon as a place comes up/we can get the £8k deposit required by her favourite home out of her investments. Yet they send her letters, failing to copy in SIL or dh, despite by SIL or DH having requested to be informed so they can make sure MIL turns up for the appointment.

[Viviennemary]

Not sure what the answer is. But the NHS is unsustainable as it is now. With resources getting ever more stretched.

[eurozammo]

moo at least some missed appointments are due to poor administration though. I know of more than one person in the last 6 months who has received an appointment letter AFTER an appointment was supposed to take place. And I have tried to cancel (by telephone) an appointment for a procedure I had had privately through my health insurance (my GP must have received the results from the private procedure weeks before this appointment letter was sent but it was still sent) only to be told it was not possible over the phone - I had to write in. I did bother but I can imagine there are some people who can't be bothered or don't want to pay for a stamp. These points apply more to hospital appointments than GPs, but I think it's important to acknowledge that patients are not always at fault for missed appointments.

[edam]

The Pulse survey that sparked this off was a self-selecting sample of 440 docs who wanted charges of £5-£25 Of course, if you are a GP partner on a salary north of £100k £5 or £25 probably sounds like nothing much. Very different if you are working poor, retired, disabled, or on benefits, though.

Would actually be very expensive, both because of admin costs and because people who do need medical care would be put off going until their condition gets really serious and needs costly treatment. It's a stupid idea, ultimately.

[Snazzyenjoyingsummer]

And for that reason, I'd agree (just about) with payment charges for DNAs, but not for all appointments.

[Snazzyenjoyingsummer]

The other very important thing not to overlook is that the NHS is supposed to be free at the point of access. If we're having to pay for initial access to the system, then the concept of the NHS is gone. We should be resisting this and asking for a clear evidence base that shows it will improve the system.

[Snazzyenjoyingsummer]

RaspberrySnowCone It's a good point that you don't always have to see a doctor. My practice nurse can also prescribe a fair range of stuff so I can see her a lot of the time. The difficulty come when the system requires a doctor to do something for the practice to be paid - e.g. a few years ago (don't know whether this has changed) the 'new patient' check up for people joining a new surgery had to be done by a doctor for the practice to be paid the fee earned for that work. In fact, it was almost all stuff that could be done by a nurse or even, tbh, a non-medial professional - e.g. weighing people, taking their medical history down, asking about drinking/smoking habits and so on.

[ReallyTired]

This the article

www.express.co.uk/news/health/417591/Doctors-want-you-to-pay-150-for-an-appointment

I can understand why Dr Shailendra Bhatt thinks there should be charges as works in a local walk in centre where some hyprocontrics really do take the piss. The walk in centre in question triages people and prehaps non emergency people should be refused accesss to the doctor. (They can make appointments through their own GP practice for non emergencies!)

However I fear that a charge would deter those who really need the doctor. We would have a situation like we have with denistry where the working poor cannot afford treatment.

I think that fines for people who miss appointments is far more constructive.