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A faulty production line

One in three GPs believe charges are most cost-effective way to cut unnecessary A&E attendances

A third of GPs would support charging patients a small fee every time they attended A&E and only refunding it if the visit was found to be necessary, according to a new survey.

The poll of more than 800 GPs by found 32% believe a charge of between £5 and £10 would be the most cost-effective way to reduce unnecessary attendances.

Some 39% said that placing a GP surgery with extended opening hours alongside every A&E department would help cut unnecessary attendances and hospital admissions, while 11% backed more walk-in centres and 8% called for an improved 111 service.

The results come after a Pulse survey conducted last summer found that half of GPs would support charging a small fee for routine GP appointments.

But the GPC and the RCGP were both quick to argue against the introduction of charges as a way of managing demand.

GPC chair Dr Chaand Nagpaul said: ‘We will not solve the problem by penalising less well off patients by erecting financial barriers within the health service. It could be counterproductive as patients who are deterred from seeking medical attention at A&E may end up becoming more ill, requiring greater hospital care later on.’

‘Patients could also inappropriately seek treatment at their GP practice, even if they genuinely need hospital care. This could act as a perverse incentive that sends patients in the wrong direction for their care.’

Dr Helen Stokes-Lampard, an RCGP spokesperson and a GP in Lichfield, said: ‘The overwhelming majority of GPs still respect the founding principle of the NHS: that healthcare should be provided free at the point of need.’

‘Charging patients for the use of emergency departments would put us on the slippery slope towards the Americanisation of healthcare - where only those who can afford it get the care and attention they need. Doctors have a duty to provide healthcare to patients regardless of their ability to pay.’

Readers' comments (8)

  • Ivan Benett

    so 2/3 don't!

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  • Agreed, we as doctors have a duty to provide healthcare. But the public as citizens have a duty not to abuse healthcare services.

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  • If there's no price-signal to reduce demand there will continue to be abuse of A&E and general practice as well. We all pay something for dentists, plumbers etc why should we expect doctors to be totally free? It's unsustainable.

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  • Well,I had a patient recently who demanded antibiotics for sore throat of one day and if I didn't give it he will simply goto AED where a proper doctor will give it to him.

    It's this culture GPs fault? Absolutely not, I'm afraid this is the fruit of many years of successive governments campaign.

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  • 10.48 The situation you describe is frankly absurd but unfortunately all too common. Introducing some basic charges would undoubtely help us combat the alarming rise in antibiotic resistance. It's time to allow patients to behave like rational consumers rather than passive recipients of limited state spending. This is how the rest of our lives work, the NHS is just a ghost of communism and desperately needs to be brought into the 21st century where choice and competition empower citizens and drive up the quality of services whilst bearing down on costs.

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  • Nice to see (10.56) that Andrew Lansley still reads Pulse. Healthcare is not free. We pay for it through our taxes. And how is the everyday punter expected to know if a visit to the GP or A&E is necessary? It may come as a surprise, but only a small minority of people have completed a course in medicine at university. There's mixed messages. Campaigns tell people to visit their doctors if there's blood here or pains there. How are they to know what symptoms indicate what condition? That's the doctor's job.

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  • Since the NHS has been directed by corporate remits & contracts patients have had to suffer no research & diagnosis at primary care level often causing chronic & undiagnosed conditions to become worse often fatal NB Low priority procedure? now this !?.Don't the figures show this . Is this why the hippocratic oath no longer taken with Nurses & administrators diagnosing 101 refers back to GPs deferring to LA holding the purse strings ignoring the medical regarding the social.

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  • Surely the simplest way would be to triage patients on arrival and send away those that don't warrant A&E services?

    Asking patients to pay may deter those folk that really do need help.

    Most of those that abuse A&E are probably on benefits anyway and would get free care, those with snotty nosed kids, a graze on the knee etc. they just waste time.

    Numbers in A&E could be reduced by banning anyone under the influence of drink and / or drugs! Whatever their injury, they can come back when they are sober or 'living in the real world'!

    Triage at the door, turn away those not warranting emergency care!

    I used the 111 service once and never agains would I allow myself to be advised by them again.

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