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Vast majority of GPs support charges for non-NHS work

Eight in 10 GPs would welcome charging their own patients for non-NHS services, such as longer consultations and certain vaccinations, a Pulse survey has revealed.

Out of the 870 GPs responding to the survey, 79% would like to charge for services and some thought it was an ‘inevitable’ direction of the NHS.

However, charges were rejected by 12% of doctors, while 9% said they didn’t know where they stood on the matter.

As it stands, GPs can provide private services but not to patients who are on their registered practice list.

Public Health England is currently reviewing whether GPs should charge for a wider range of travel vaccinations, while NHS England has consulted on banning prescribing of over-the-counter and ‘low-value’ items in bids to save NHS cash.

And last year’s LMCs conference called for GPs to be allowed to charge their own patients from services which are not on the NHS list.

At the time, GPC said the Government was worried about a backlash from patients, and a GPC presentation indicated they were unsuccessful to push through the stance in 2018/19 contract negotiations.

Vice chair of City and Hackney LMC Dr Ben Molyneux said it was ‘detrimental to patients’ if practices are not able to offer services to patients who are not covered by the NHS, adding that this could include elective HPV and shingles vaccinations.

The BMA has also issued guidance on why GPs already charge for some services.

Oxfordshire LMC has gone further, by researching structures to charge for non-contractual work. 

LMC chair Dr Prit Buttar said GPs need to be more aware of what they can charge for and put it into practice.

He added that practices do not always ‘feel comfortable in charging where they absolutely can’, adding: ‘It’s such a complex subject.’

Doctors said charging could help relieve some pressures on general practice.

They could ‘reduce work and provide an income stream,’ said one GP working in Northern Ireland.

‘I’d welcome being able to charge them for long consultations or consultations out of hours,’ a GP partner in Cornwall commented.

A London GP said GPs should charge but felt that ‘patients are not well educated by NHS England on what constitutes NHS or non NHS services.’

One west Kent locum said: ‘Like most of the world a reasonable charge is inevitable.’

One GP partner, also based in west Kent, who wished to charge for consultations, said: ‘Of course they should pay. Why on earth would anyone expect work to be done for free?

’A solicitor can charge up to £300 an hour. Only then will the public value GPs and primary care staff.’

But, among the minority of sceptics, a GP in the Chilterns told Pulse: ‘I find the principle of taking money from patients for stuff very difficult, usually it is those who cannot afford who are the ones that fall through the cracks of NHS provision.’

And a GP in Glasgow said charges: ‘Would not help in a deprived area.’

‘The most vulnerable would be the most affected,’ said a GP from the Chester and Merseyside area.

Would you welcome being able to charge your patients for non-NHS service?

Yes - 79%

No - 12%

Don’t know - 9%

This survey was launched on October 10 2017, collating responses using the SurveyMonkey tool.  The 25 questions asked covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a Ninja Coffee Bar as an incentive to complete the survey. A total of 870 GPs answered this question.


Readers' comments (14)

  • I support charges for ALL work.

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  • Vinci Ho

    You all know I have been saying any GP(patient’s own GP) appointments on Saturday and Sunday should be charged with a fee , although I do not, in principle, object patient’s to be seen in a hub for so called extended access.

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  • Vinci Ho

    And I am a Liverpool GP for 23 years .

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  • wWhat do you mean 'the vast majority'? Who on earth things doing non contractual work for free is a way of functioning? we really haven't got a hope in hell of surviving in this current political and financial climate if we dont approach this in a more professional way. How can we say we have no capacity and no appointments left and our workload is excessive if we are doing workload that we SHOULDN'T? the reason we charge for non nhs work is because we have to take time away from other things to do it (and that other work doesn't magically 'disappear' so we stay late, arrive early, miss eating lunch AGAIN, to catch it up. We have to pay indemnity, secretarial time, nursing time, ordering stock etc for these non nhs things- all these things cost.
    Please, to the 12% who 'do it for free',: stop signing the death warrant for all of us to make balancing the books and making primary care sustainable.

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  • Unlikely to ever happen. Allowing GPs to charge will eventually lead to financial independence from the NHS. The DoH will then be less able to control GPs. In any other sector, it would be classified as "restraint of trade". For some reason, it doesn't apply to GPs.

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  • Has anybody explored what is the legal basis on which DH does not allow GP to work privately like they allow consultants in hospitals ? It might be worth challenging DH if there is any legal basis to support us.

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  • I expect a distorted version of this article will be appearing in the national newspapers in the next few days and will probably feature the words "money grabbing"....

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  • Pradeep I have wondered this and indeed there are practices I know who provide skin surgery to their own patients in breach of their contract in our area and NHSE is aware. When I raised it with NHSE informally I was told they could do nothing but it was the responsibility of the CCG. I have thought of doing the same. The worse that can happen is a slap on the wrist and told to stop but as a precedent has already been set I don't think they can do anything else and would more than likely do nothing.

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  • NON NHS WORK IS CHARGED BY GPS NOW. it does not include long consultation. long consultation has no definition.

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  • My experience of charging patients in GP abroad is that it empowers the patient as much as the doctor. We need to get away from "free at the point of access" and start talking about "good quality means-tested healthcare". Co-payments do not result in absent healthcare for the poor - they finance it. In case you have not been paying attention this is how prescriptions work in England already.

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