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GPs say no to offering top-up payments for private primary care

GPs gave a resounding ‘no’ to offering NHS patients the option to pay extra ‘top-up’ payments for private services at their annual BMA conference today.

The LMCs conference overwhelmingly voted against a motion put by Gloucestershire LMC, which called for general practice to be allowed to offer both private and NHS treatments - and for the GPC to include this in contract negotiations.

The motion stated: ‘Conference believes patient care would be improved were practices to be allowed to offer ‘top-up’ private services to their NHS patients and requests that the GPC include this in their contract negotiations’.

Putting the motion, Dr Jethro Hubbard argued the move would level the playing field between GPs and other providers like foundation trusts.

Dr Hubbard said: ‘NHS Foundation Trusts and private companies are allowed to provide NHS and private services to the same population.
‘Safeguards and regulations protect patients while allowing them the choice to pay if they wish. Allowing the large providers this flexibility while denying it to small businesses that constitute general practice is an inherent double standard.’

He added: ‘If GPs were able to supplement NHS work with paid-for minor operations then the investment in training and equipment becomes worthwhile and benefits both patients and the NHS profit. If large providers can be trusted to work with the population via both the private and NHS routes, then why are GPs not afforded the same trust?’

However, Dr Jackie Applebee from Tower Hamlets LMC said offering top-up payments would be a ‘slippery slope’ to the introduction of a wider fee-paying system - and questioned how patients would benefit.

Dr Applebee said: ‘Top-up private services will usher in a two-tier GP service as practices priorities those who can pay and be the start of a more slippery slope to more widespread fee-paying.The motion professes these fees will improve care - but how will this improve care for the poor? Indeed would it actually improve care for more affluent, paying patients who may feel entitled to demand more investigations and referrals that might actually do them more harm than good?’

Dr Applebee added: ‘Care for all our patients - rich or poor - would be improved if Government funded general practice adequately. The NHS budget has fallen to 6.2% of GDP - one of the lowest in Europe - and general practice is getting a smaller and smaller share of this. We should not be calling for private top-ups to increase choice for the more affluent but demanding that the whole of the NHS, including general practice is funded adequately.

Motion in full

GLOUCESTERSHIRE: Conference believes patient care would be improved were practices to be allowed to offer ‘top-up’ private services to their NHS patients and requests that the GPC include this in their contract negotiations


Readers' comments (22)

  • Bob Hodges

    Well done LMC conference/BMA - yet again placing the sacred NHS cow squarely in front of the cart!

    In case you hadn't realised - you are there to represent GPs and NOT the 'free at the point of abuse' NHS system at all costs.

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  • sadly lost opportunity ...

    one credible way the GPC could have moved this debate was to model the cost to patients if GPs went private.

    the state and public need to be aware that we are supporting their care and we would be better off if we were private practitioners. we don't want to as we know many deprived members of the public would suffer crippling costs for their care.

    the problem is that the public don't believe this but believe the lie that GPs are fat cats ripping off the public purse and are lazy - they believe this because they feel they are personally paying our income (80 k year average) and have to wait 2 weeks for a 10 minute appointment and then don't get what they want. they think we are playing golf the rest of the time and don't realize we are seeing other patients and other work. If they knew how much we got for their care and the real cost of their care they may think twice about moaning about the GP service.

    by totally rejecting this and not exposing the public to this we have lost a major negotiating issue. I fear the GPC have shot us in the foot.

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  • - the public will interpret this as protectionism i.e. GPs want the 'security' of having their public contracts and 'golden' pensions and are avoiding offering other forms of providing services.

    - private/nhs mixed model would have helped with demand

    - potential for private income could have been an incentive for recruitment/retention and innovation

    - the extra revenue from private work could have helped service expansion.

    by blocking off innovative ideas the GPC has indicated to grassroots that they have run out of ideas and have effectively doomed general practice.

    if funding doesn't come we are totally stuffed as one potential source has been ruled out.

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  • surely something like this should be debated in a GP referendum rather than through the LMC?

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  • I am convinced this is the only way to protect general practice in this country. A market derrived copayment wood solve access, continuity and retention problems immediately. Patient could find the money to pay for their own care that they wouldn't want to spend on everyone else's car via tax. This would especially benefit the working population who currently are the losers with the current poor access. We are never going to get enough money to provide a good service through the tax system, so why do we continue to defend this? Most other countries in Europe and the world can handle a copayment system.

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  • Remember, it is we who select LMC members. If you feel that LMCs have shot GPs in the foot, next time don't vote the same people who sweet talk you into voting but don't share your views.
    We are ourselves to blame as we continue with memberships of BMA basking in a false sense of security. Every GP is an island and it has never been more true.

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  • Oh dear....

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  • Yet again the BMA showing that they are in touch with the grassroots.....NOT. So glad I resigned from this useless body 4 years ago. We now just need a good strong union that represents us, and not the patients like the GMC, CQC, Patient watch, ........

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  • Just wonder if the attendees represented grass roots...

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  • No they don't ....all the grass roots resigned and were working during this god forsaken meeting!

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