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Independents' Day

GPs vote against charging patients for consultations

GPs don't believe that patients should be charged for consultations, despite the pressure on general practice funding.

A vote of delegates at the Pulse Live conference in Liverpool today showed GPs remain against taking any payments from patients.

Some delegates were swayed during the course of the debate towards the idea of charding a nominal fee if this would incentivise patients to use scarce GP time more prudently, but this did not outweigh GPs' concerns that it could deter vulnerable patients from seeking care.

Arguing in favour of a fee, GPC representative Dr Dean Eggitt said that patients who most need to see a GP are being disadvantaged by the access problems stemming from unchecked demand.

He added that better education around self-care was vital, but ‘general practice is dying fast’ and charges were a way of making sure expensive GP time was used effectively, not punishing patients.

He said: ’GP is being treated like a bulk-buy, discounted product, the Government comes up with the cash and gets a six pack of dementia reviews… and the rest of the NHS feels a bit like an all-you-can-eat buffet.’

But, arguing against charging, BMA deputy chair Dr David Wrigley said what was actually required was appropriate funding from politicians.

Dr Wrigley told delegates: ’Should GPs be paid for appointments? Should patients be charged for appointments? No. 100% no. Rock-solid no.’

But he added that patients did need to be enlightened about pressures in general practice.

Dr Wrigley said: ‘We need a massive public information campaign, clinical leaders like ourselves - the BMA’s got a role, the royal colleges have got a role - all of these organisations have to be telling the public.

‘Because at the moment they don’t know how serious it is, and if they did know then I think politicians will start to be fairly concerned about it.’

He added his worst fear was general practice would ‘end up like dentistry, by introducing charges', saying: ‘Politicans will go: “look what GPs have done, they’ve privatised general practice”. And that will be NHS general practice gone forever, that is my biggest worry.’

But Dr Eggitt said the general practice was already at that junction, showcased by yesterday's decision by GP leaders in Northern Ireland to seek undated mass resignations from the profession.

He said: ‘It is a finger on the red button, if that nuclear bomb goes off, then the NHS as you know it in Northern Ireland is gone, and something else will have to take its place. And we are heading in that direction

‘We need an open dialogue right now: that GPs are worried about the current system and we need to consider other systems because how we’re being funded no isn’t working.

‘We are dying and dying fast, I don’t want to punish the patients. But I do want to get rid of the patients who don’t need my professional expensive help.’

Readers' comments (9)

  • the titanic also had a dedicated crew that went down with the ship. the more astute survived.

    the patients are the public who pay the tax and are the taxpayers who are represented by the state. the state is saying that the taxpayers/public/patients don't want to pay anymore money but that they want a free at the point of use comprehensive unlimited service AND they would prefer it if NHS staff would kindly have their t&cs changed to benefit them and keep the NHS afloat. This is not a NHS staff vs government issue - the public need to decide do they want a properly funded NHS or not?

    in saying that charging patients at this point will alienate the public completely but if funding is forthcoming there is a risk GPs will leave the NHS anyway. ultimately the decision is with the taxpayers.

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  • Charging consumers directly works for food and water.

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  • Wake up and smell the coffee,you will not change the direction of travel with a talking shop vote,some kind of industrial action needs to occur.They are not listening and don't care what you think.We need to shine a light on what they are doing.Our leaders are failing(or collaberating) with the destruction of the current model of care and a professional workforce.Very Sad.

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  • Sad really. I wish the Gpc would grow a pair and admit general practice is failing rapidly and needs to charge patients and the NHS directly for every single interaction.

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  • Generally people never value what they don't pay for, this is especially true of patients who feel a sense on entitlement and abrogate any personal responsibility for their own care. A payment, even a modest one, for each appointment would help address capacity and wasted slots as people always try to avoid paying even small amounts for things like car parking.

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  • All international evidence on charges shows it deters the poorest and sickest more than it deters the better off. It does not selectively deter trivial use. Germany tried it with a 10 euro fee for GP consultations but then dropped it as they found it led to health inequalities, deterring those in most need, and cost so much to manage it wasn’t worth it.

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  • The public is not interested and has no knowledge of the failing NHS. When I go for home visits at night in OOH, the looks I get is as though we have a fleet of cars and an army of doctors. The public does not know there is one doctor covering an area of minimum 110,000.

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  • We already pay for our GPs through our taxation so we should not be charged twice. If there isn't enough money, the Government should tax the tax-evading international corporations to raise more tax funds.

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  • Public don't care about your dwindling service, your waiting list, they don't care about the cost of staffing or declining income. They care about being seen on time, with the doctor they want to see getting the can or other test they googled that morning and seeing the specialist when they want to see them and that's that. They don't want to pay because that's just not a thing right.? Health care is free right?. Well no it isn't as you begin to explain it actually costs... 'Public are bored and disinterested in your explanation" Ok well we may either have to raise taxes "out cry from tax payers "we pay enough already tax that guy over there he doesn't pay his fair shair... Guy over there "well actually I pay as much as 100 of you put together I could leave and pay no tax else where if you prefer" government "ooh let's not be hasty" blah blah blah. There is no extra funding coming. On the other hand since I've had to pay for bags at supermarkets I remember a bag for life (most of the time) a little financial incentive changes behaviour. If a nominal fee puts you off going to see your GP when you need then that's your own responsibility. I haven't seen my dentist in years partly due to time and cost so if my teeth fall out its my own bloody fault. If we can safety net the most vulnerable I don't see a problem.

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