This site is intended for health professionals only

At the heart of general practice since 1960

Appointment charges undermine principles of NHS, say GP leaders

The RCGP has said charges for GP appointments to be introduced would ‘fundamentally change’ a founding principle of general practice, after a motion was proposed for the 2014 LMCs conference.

Pulse revealed yesterday that LMC leaders would vote on whether to charge for appointments, after a motion from Wiltshire LMC called on ‘GPC to explore national charging for general practice services with the UK governments.’

But the proposal has attracted criticism by the profession’s leaders, with GPC deputy chair Dr Richard Vautrey taking to the social media site Twitter to say charging patients was ‘not the answer’ to the workload crisis.

A Pulse survey from last year found that just over half of GPs were in favour of charging a small fee for routine appointments.

The RCGP’s honorary treasurer, Dr Helen Stokes-Lampard, said: ‘Introducing a charge for appointments would fundamentally change one of the founding principles of general practice – that healthcare is free at the point of need.

‘Asking patients to pay would undoubtedly deter many people from seeking medical help in the early stages of illness when they can be dealt with cost-effectively and efficiently in primary care, rather than requiring expensive specialist care and increasing admissions to emergency departments.’

Dr Vautrey said on Twitter: ‘Charging patients for [NHS] care is not the answer to GP workload crisis. Increased funding from [NHS England and the Department of Health] certainly is.’

The motion, which is to be debated at the LMCs conference in York at the end of this month, read: ‘[This conference] believes that it is no longer viable for general practice to provide all patients with all NHS services free at the point of delivery.’

Readers' comments (25)

  • Charging is one way forward if not the only answer. Patients should be charged at time of booking and be refunded when they turn up. Same with hospital appointments! Evey one as a choice in life - if you can spend money on cigarettes knowing that it is harmful to you then you would have to face the consequence of bad health and pay to see doctors to help you choice of lifestyle. Everything is about choice!

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    At the end of the day , the only demon here is the government which would absolutely loves to see GPs unilaterally ask for a charge or even privatising general practice .Because it can then fund even less and less in the service or pack it in altogether .
    Current form of NHS is non sustainable , fact . Is that the fault of doctors ? Is that the fault of people ?
    It is more interested in cutting corporation tax further to lure more foreign power to come to this country than carrying on funding any public sector . So we can turn ourselves into the demonic slaves of this government .
    Yes. Charge a fee can help only on conditions including patients can really afford . How do we know whether a patient can afford? That is the catch.
    If a government really has a will to get it right, you really think it cannot find a way ? I do not believe it....

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    When the days are cold
    And the cards all fold
    And the saints we see
    Are all made of gold

    When your dreams all fail
    And the ones we hail
    Are the worst of all
    And the blood’s run stale

    I wanna hide the truth
    I wanna shelter you
    But with the beast inside
    There’s nowhere we can hide

    No matter what we breed
    We still are made of greed
    This is my kingdom come
    This is my kingdom come

    When you feel my heat
    Look into my eyes
    It’s where my demons hide
    It’s where my demons hide
    Don’t get too close
    It’s dark inside
    It’s where my demons hide
    It’s where my demons hide

    At the curtain’s call
    It's the last of all
    When the lights fade out
    All the sinners crawl

    So they dug your grave
    And the masquerade
    Will come calling out
    At the mess you made

    Don't wanna let you down
    But I am hell bound
    Though this is all for you
    Don't wanna hide the truth

    No matter what we breed
    We still are made of greed
    This is my kingdom come
    This is my kingdom come

    When you feel my heat
    Look into my eyes
    It’s where my demons hide
    It’s where my demons hide
    Don’t get too close
    It’s dark inside
    It’s where my demons hide
    It’s where my demons hide

    They say it's what you make
    I say it's up to fate
    It's woven in my soul
    I need to let you go

    Your eyes, they shine so bright
    I wanna save that light
    I can't escape this now
    Unless you show me how

    When you feel my heat
    Look into my eyes
    It’s where my demons hide
    It’s where my demons hide
    Don’t get too close
    It’s dark inside
    It’s where my demons hide
    It’s where my demons hide

    Unsuitable or offensive? Report this comment

  • Charging a small fee (co-payment) for those who are not on benefits is the only way forward.
    I think this has potential to SAVE and modernise the NHS.
    This is the only way to increase funding and bring some PATIENT RESPONSIBILITY back in.

    Unsuitable or offensive? Report this comment

  • Aren't GPC leaders supposed to be reflecting us GPs?!!! Before they decide what should or shouldn't happen why don't they ask the GPs they represent! This is why we are in this awful mess. The BMA and RCGP don't ask what grassroots GPs really want in order to represent us!

    Unsuitable or offensive? Report this comment

  • – that healthcare is free at the point of need.
    Need seems to becoming increasingly rare in comparison to "want" in day to day general practice.
    Wait for the implosion of general practice if charging is not introduced.
    When did the GPC / RCGP last survey primary care Drs for an opinion on charges? As far as my 5 partners are concerned they seem to be pressing ahead with a minority opinion.

    Unsuitable or offensive? Report this comment

  • Healthcare is only free in the uk and Cuba the NASTY TORYS wish to destroy the socialist NHS and they are succeeding our leaders are inept the only way forward is payments at the point of use.I have worked in Australia and New Zealand where patients pay and the doctor patient dynamic is much better unlike the arrogant paternalism we see in the NHS from doctors.We have a system that was designed in the 1940s we live in a capitalist democracy not the USSR times have changed as a profession we will do well out of this move on!

    Unsuitable or offensive? Report this comment

  • RCGP statement: "It is true that GPs are struggling to deal with increasing demand whilst receiving a record low share of the NHS budget, but charging our patients for appointments is absolutely not the solution. What we need is more investment into general practice so that we can provide more services to our patients and the care that they need and deserve."

    RCGP can bleat on about government requests for increasing investment- it isn't going to happen!

    As far as "providing the services to our patients and the care they deserve"- there are too many worried well patients that need reassurance at the detriment of the sick- they show NO responsibility for anyone else but themselves! Where is the collective responsibility for the care of the vulnerable- it can't come just from GPs. The RCGP is deluded if it thinks that statements like this is actually going to help sustain NHS general practice. GPs have had enough and are leaving the profession and are not being replaced.

    Unsuitable or offensive? Report this comment

  • @Anonymous | GP Partner | 07 May 2014 7:27pm
    who wrote "Charging a small fee (co-payment) for those who are not on benefits is the only way forward"

    Spoken like a true marxist.Why not impose a small token co-payment.If they can afford a pack of fags surely they can pay a couple of quid.Perhaps my American colleague was right when he described Britain as a nation of bums.

    Unsuitable or offensive? Report this comment

  • Thanks to the Daily Mail we are already unpopular enough without voting for charging patients.
    This subject is to be debated in a proper forum and those who wish to make their feelings clear should lobby their LMC Reps. This is not primarily a BMA or RCGP matter.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say