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Independents' Day

LMCs vote against patient charges for GP services

English LMCs have voted against bringing in patient charges for access to GPs after it was suggested the controversial measure was required to address the ’dire state of general practice’. 

Delegates at the English LMCs Conference in London today heard that radical change was needed to support general practice as the current GMS contract 'was not working'.

However, following a heated debate, the motion was voted down by 83 votes to 131. 

A number of GPs voted both for and against the motion in a much closer vote than at previous LMCs conferences, with speakers saying they have come round to the idea of co-pyaments in general practice due to the worsening situation

Kent LMC delegate Dr Zishan Syed - who proposed the motion - said that the approach from the BMA's GP Committee had 'not worked' and a radical new approach was needed. 

He said: 'Co-payment does exist in the UK - it is not a foreign concept. 

'We have co-payments in sensory aid, dental care and prescription medicines. Yet it remains a taboo topic when talking about access to see a GP.

'We are overwhelmed. Disgusted with the GPC, many GPs have chosen to vote with their feet. they have left to countries with the co-payments model. Such areas include Australia, New Zealand, Holland and France.'

Dr David Wrigley, a GP in Lancashire, said he agreed general practice was in a 'dire state' but that charging patients to see a GP was not the solution.

'We are on our knees but the answer to this problem we face is not a co-payment model where patients are asked to pay for part of their care.

'The co-payment transaction will be made with us as doctors in ours surgeries and it opens up Pandora's box.

'The insurance industry will be watching on today and hoping this motion is passed.

'Be in no doubt, co-payments mean insurance-based healthcare.

'All that flows from that is increased bureaucracy for us as doctors, along with inequitable access to care for those unable to afford the payments - and worse health outcomes for those who don't have deep pockets.

'We are a broken system that politicians are to blame for - but don't make patients pay as a knee-jerk reaction.'

GP Dr Annie Farrell said: 'We all already pay for our NHS so it is there when we - whoever we are and whatever out circumstances - can access it when we need it.

'The idea that this would reduce workload on the basis of the use of carrier bags after a charge was introduced is laughable.

'How is a payment going to address the supply and demand issue unless we are talking about abandoning  those who can't afford to pay?

'Patients in the US, where all care is paid for, are some of the most demanding in the world. They expect to get something for what they pay for.' 

But Dr Syed later added: 'You talk about wanting to pursue the same tactics year after year. And year after year, surgeries are shutting down.

'Those GPs come up to me and tell me how tired and exhausted they are. They are fed up with being told they are not resilient enough. 

'Your strategy isn't working - you need someone to tell you to be radical and to do something different. Co-payment is working in other countries and the world is not collapsing.

'GMS funding is not increasing and repeatedly saying to the Government 'we want the GMS funding to increase' isn't working.'

He said: 'You need to think about doctors' interests because those doctors are being ruined with their surgeries collapsing. 

'You tell me you're worried about patients - what happens to those patients at surgeries that collapse?'

Motion in full

KENT: That conference recognises the dire state of general practice and demands a co-payment model - FAILED

Source: BMA

Readers' comments (31)

  • Cobblers

    It is unlikely that Revolution will come from within a 1940s style socialist Health Service. It will come from without in affluent areas first. The NHS GP service gets steadily worse (it's 3 weeks now for a routine appointment with a GP here) and some brave souls start up a private service.

    So Dr Syed your next motion should not be the get co-payments going but to allow private GPs access to NHS secondary services e.g. Bloods, XRays and Referrals not to mention state based prescriptions.

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  • National Hopeless Service

    What relevance and purpose do LMCs have any longer? Who care what they vote for, NHE must just laugh at them. They have little purposeful voice and are achieving nothing for us locally. I am increasingly resentful of the subscription.

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  • Bring on private GPs. As a patient I'd welcome them. But don't hook them up to the NHS data. When the only way you can opt out of data sharing is by signing in to the system you don't want to be part of ... that's catch22

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  • LMCs are no longer relevant and these bleeding heart GPs will see General Practice burn before introducing co-payment which works perfectly well in other countries.

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  • I try to approach this from a non political perspective. A system free for all can have huge benefits- equitable, avoids services catering only to the worried well that can afford them, stops patients dictating to doctors (at least theoretically). I can’t imagine the pressure you’re under to bend to a patients demands if they’re paying you. But it isn’t working for GPs at the moment. We deal with demand, not diseases, at that is rising exponentially with no similar increase in funding. Essentially patients are demanding an “I know best and what I want” system but free at the point of care. We either change the system or change their expectations

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  • Turkeys vote for Christmas.

    Get out of you can; maximise alternative income streams and look to take on PPs if you can't. The cavalry ain't coming.

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  • Bob Hodges

    The People's Republic of Tower Hamlets anarchosocialist collective have once more wedded us ALL to their world view.

    General practice can no longer meet NEED because it was swamped by demand.

    They expect us all to sacrifice our family lives and our own health stocking the eat you can free buffet of healthcare.

    In a system where funding and staff are limited (aka CAPACITY) is distinctly limited, the last person in the system we can afford to let decide who see's the doctor is the PATIENT (aka DEMAND).

    We are increasingly raising the triage bar to heights that satisfy NO ONE in order to simply survive the day.

    If GPs want to have the option to work in another way, stopping the foundation of an alternative system simply traps GPs in a system that is breaking them. When the revolution comes, the majority will be baying for the blood of the few with enough time and fairy dreams to attend these conferences and vote in this way.

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  • Dr Syed shame there are not more like you at the LMC. You have hit the nail on the head with BMA failed tactics. Dr Annie Farell your comments are laughable - how do you propose we reduce demand, much of which is inappropriate?

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  • What was the point of this vote? Had it gone the other way (i.e. co-payments), would the LMC have seen it through?

    Chocolate fireguard

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  • Dr.Syed, be proud of your motivation and keep going what you do. The poorest in this coountry can afford to buy a pack of ciggret daily but cannot afford to coontribue to their health?? and sadly some GPs disagree with it!!!
    Dr.Seyd , Don't worry Soon or later you will win and those who oppose you now, later they themselves would vote before you ,I hope it would not be too late when remaining of GPs fly to australia, Canada, NZ, gulf coountries and NHS would pay more to recruit GPs if could to repalce those who left country):

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