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Four in 10 GPs in favour of charging patients for appointments

Exclusive Four in 10 GPs would welcome being able to charge patients for appointments, a Pulse survey has found. 

The survey of 948 GPs found that 41% are in favour of the NHS charging a fee for appointments, as it could help tackle workload and allow a better use of their time. 

This is a decrease from 2013, when just over half of 440 GPs who were surveyed by Pulse said they were in favour of charging a small fee for routine appointments, compared with 36% who would not.

Under the new five-year contract, negotiated by the BMA and NHS England in January, general practice will receive billions of funding alongside a raft of changes, including financial incentives to join primary care networks and a new state-backed indemnity scheme paid for out of the global sum.

Despite NHS England chief executive Simon Stevens saying the deal 'unarguably represents the biggest boost to primary care in more than 15 years', only 45% of GPs said they would have voted for the contract if it had been put to ballot, with some arguing against the little increase in funding

In Pulse's latest survey, the 387 GPs in favour of introducing a fee for appointments argued this could help drive demand down and tackle the increased pressures.

One GP said: 'Although I have previously opposed this, I now genuinely think that people don't value health care services, either hospital or general practice. We get numerous DNAs, as do the hospital.

'Charging 5p for a carrier bag has reduced the number of unnecessary carrier bags as people think twice. A nominal fee that makes people think about whether an appointment is genuinely needed or if they can access appropriate information in an alternate way might improve unnecessary workload.'

Echoing their comment, one respondent said: 'A small, nominal fee that can be claimed back if on low income. It would make people realise that primary care is a privilege and not unlimited, while not restricting access for those who need it.'

Another GP said: 'I cannot think of any other way of stemming increasing and unreasonable demand other than some form of financial barrier.'

The survey also showed that 41% of respondents are against the practice of charging patients, pointing out it would be 'appalling' and likely to deepen the divide between the rich and poor.

One GP said: 'This would create further health inequalities, drive the inverse care law and create increased, unreasonable expectations. A potential consequence of this would be an increase in investigations, referrals and prescriptions.'

Another GP commented: 'Public support for the NHS is already precarious. We already charge people for their NHS care, through taxes. To charge again would be appalling. The poorest would get sicker.' 

Leading doctors have previously rejected calls for the BMA to consider charging patients for GP appointments in order to fund the NHS, saying co-payments are 'a tax on sickness' and 'clearly not right'.

The issue was also debated at the 2017's LMCs conference in Edinburgh, when GP leaders tasked the BMA GPC with creating a list of the charging options available and their potential positives and negatives despite warnings that passing the motion would send the wrong message. 

Meanwhile, a 2015 YouGov poll revealed that almost a quarter of British people would be willing to pay for GP appointments


Readers' comments (29)

  • If you make something free people from all walks of life will crap on it and reduce its value. It's an obvious economic consequence.

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  • doctordog.

    We all know this is a non- starter.
    Unenforceable . Who gets the money? Patients will want their money’s worth.
    Would cost more to collect than make in profit. Unless profit is not the intention, and the idea is to punish those who use the service most frequently .

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  • Long overdue. Raise extra funds for the NHS and encourage more responsible use of services. Reward Doctors who see patients rather than those who have huge lists but no appointments.

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  • Ivan Benett

    More don’t. Charging people for appointments undermines the very principles of the NHS and would penalise the poor, the least assertive and the very ones who need to see a doctor. It is an appalling idea in every sense and will worsen current inequalities

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  • NHS. Free at the point of exploitation.

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  • I'm against billing the patient - but the three medical systems that lie geographically nearest to us - all charge for a primary care contact. (France, Ireland and the Channel Islands).

    Charges vary between about 18 and about 50 pounds. There are exemptions (in Ireland), refunds (in France) or a state contribution (in the Channel Islands).

    It is my impression that access to all three of the above primary care systems is generally rather better than in the UK.

    I note though that all three areas - like the UK - have recruitment problems. The situation in France - where the charge is lowest - is helped by the excellence of the hospital system.

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  • I am one of those 40% who thinks charging would be the only thing that could save NHS GP as well as the vast majority of patients from a future dangerous third rate service.
    The net £60-70 / patient/ year income GPs get after expenses could be doubled. That income together with the decreased demand would allow for consultations to be 2-3 X longer.
    The extra staff needed to allow that sort of lengthened consultation would come from GPs and other Practitioners encouraged by a much more pleasant work situation from leaving the service in one way or another.
    Yes, on average patients would have to pay about £60 a year to get this quality potentially life saving service. They would be issued with a card from a DOH intermediate organization that they simply scan at the Practice desk for co-payment and the organization bills the patient but pays the GP. If the patient truely cannot afford the amount they can make a representation to DOH/intermediate for it to be waived.
    That was easy!

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  • My question to Dcotrs who oppose charging patients is what solution they have to reduce demand and how they plan to reduce DNA rates and avoid patients booking unnecessary appointments. And please don't say "patient education " . I would like to some real practical sloution/answer

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  • In the UK, there exists a profound cognitive dissonance between the population’s claim of valuation of healthcare and what they are willing to pay for it.
    Just put a commercial price on healthcare and the population/electorate and their representatives can sort out the billing system (seems to work fine for mobile phone contracts, which generally are much more expensive).

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  • Important to charge for A+E as well because if not the 'patients' would just go there.
    I had to attend recently with a metal shard stuck in my cornea and would happily have paid £50 to be seen. Were this charge in place I suspect I would have been seen much faster because half the people there didn't seem to have had either an accident or be an emergency.

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