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GP leaders to vote on whether to support patient charges for appointments

Exclusive GP leaders are set to vote on whether the GPC should ‘explore national charging for GP services’ at the LMCs Conference later this month.

The motion, put to conference by the agenda committee and set to be proposed by Wiltshire LMC on the day, suggests general practice is ‘unsustainable in its current format’ and that ‘it is no longer viable for general practice to provide all patients with all NHS services free at the point of delivery’.

The motion concludes: ‘That conference… calls on GPC to explore national charging for general practice services with the UK governments.’

A Pulse survey of 440 GPs last July showed that just over half of GPs are in favour of the NHS charging a small fee for routine appointments, with many believing it is the only way of managing their workload and curbing rising patient demand.

Other topics scheduled for debate at the annual policy meeting, set to be held 22-23 May in York, include whether or not CCGs should commission primary care, with several LMCs arguing that this will ‘fatally damage relations between CCGs and their constituents’.

However, in a counter motion, Merton, Sutton and Wandsworth LMCs will argue in favour of CCGs commissioning primary care. This comes as NHS England invited CCGs to bid to commission primary care last week.

GP leaders will also be voting on a motion to ‘reject the concept of routine general practice care 8-8 seven days a week’, a concept that has been heavily pushed by Prime Minister David Cameron over the past six months and which is likely to form part of Conservative policy ahead of next year’s general election.

The agenda document also highlighted LMC concerns over the Government’s care.data scheme, which is now set for a delayed rollout in the autumn. An agenda committee motion, to be proposed by Bedfordshire LMC will say that ‘the introduction of care.data has been nothing short of a disaster’ and call for a patient ‘opt-in’ system to replace the current process of patients having to opt out if they disapprove of their records being shared.

The motion says: ‘That conference believes the introduction of care.data has been nothing short of a disaster and.. asserts that extraction should only take place with the explicit and informed consent of patients opting-in.’

The conference will also see LMCs debating the ‘unsustainable workload in general practice’; deplore ‘the CQC’s plans for a simplistic rating system for practices’; and condemn the ‘disorganised mess’ resulting from the NHS reorganisation, including delayed payments to GP practices.

Highlights from the 2014 LMC conference agenda

AGENDA COMMITTEE to be proposed by WILTSHIRE That conference:
(i) believes that general practice is unsustainable in its current format
(ii) believes that it is no longer viable for general practice to provide all patients with all NHS services free at the point of delivery
(iii) urges the UK governments to define the services that can and cannot be accessed in the NHS
(iv) calls on GPC to consider alternative funding mechanisms for general practice
(v) calls on GPC to explore national charging for general practice services with the UK governments.

AGENDA COMMITTEE to be proposed by NOTTINGHAMSHIRE: That conference views with alarm proposals contained in NHS England’s (NHSE) interim response to the ‘call for action for general practice’ to make CCGs co-commissioners of GP contracts and
(i) believes that this will fatally damage relations between CCGs and their constituents
(ii) warns that this will undermine CCGs’ chances of success in other areas of commissioning
(iii) predicts this will undermine the credibility of CCGs
(iv) asserts that conflicts of interests would be unacceptable
(v) insists that GP core contracts should not be held by CCGs.

AGENDA COMMITTEE to be proposed by WIRRAL That conference:
(i) rejects the concept of routine general practice care 8-8 seven days a week
(ii) believes that GPs will only provide routine planned care 8-8 seven days a week if resources are provided to the satisfaction of the profession
(iii) commends GPs for already providing unscheduled general practice care for 24 hours every day, seven days every week.

Source: BMA

Readers' comments (57)

  • Everyone has a right to propose what they like, but I agree it is shameful to suggest this in a supposedly civilised society with a welfare state. Consumerism gone mad. This will be a very sad day for the profession and the beginning of the end for one of the best healthcare systems in the world.

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  • Being free at the point of delivery is crucial. Some conditions are hard to spot and patients attend on several occasions until conditions are diagnosed. Do they keep paying until diagnosis? Does this encourage non-diagnosis to encourage patients to return (ie increase money coming in)? The poor, those with poor health and those with difficult to diagnose conditions will suffer.

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  • Can the do-gooders please switch off the GP practice lights on their way to an early grave? Shocking that many of you have so little self worth that you are prepared to flog yourselves to death. Do you really crave attention from you patients that much? Neither the government or your patients respect any of you anyway. They might if you charge them have more respect for the profession.

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  • totally agree with 9.01pm comments. Have GPs so little self respect now that they worry about what others think rather than what is right for them and their colleagues in terms of acceptable working conditions. As a GP trainer, I can assure you things do not look pretty for the state of primary care at this time. Just today I have had a conversation with an ST3 GP reg (who is excellent by the way, and passed all exams with easy) coming to the end of training. They are adamant that GP in its current form is not for them and is already looking at ways to exit the profession even before its started!! Even more worrying is the fact that she reports a lot of other GP trainees on her VTS feel them same way and are planning to locum before either emigrating or changing career.
    So all those who feel self flagellation is the only way to get to heaven and capture the hearts of our leaders, patients and the media, really need to answer one question. What happens when the well runs dry and there are insufficient GPs to service the UK population? And believe me it will if drastic action is not take to change the current trajectory that the GP workforce is on.

    Disillusioned GP Partner (1yr)

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  • It isnt sad, it is just matter of fact, the NHS is unsustainable. All you do gooders how do you propose the funding is acheived.
    I have worked in the system down-under, and patients made a co-payment for services. It did get rid of lots of the trial questions, and patients came in with more of a defined question. If they wanted a longer consultation, they got double charged. Home visits got double charged too (due to the time it take to do them).
    Overall it worked well. Alas family ties brought us back.

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  • Una Coales

    If you allow the government carte blanche, not only will they privatise healthcare but insist everyone pays 100% copayments. Please listen to your NHS GP who wants to ensure the poor and elderly are not overlooked. Semi private Irish/Canadian/Australian healthcare systems are the best modern way of treating both those who cannnot afford to pay and those who can and it keeps doctors from self flagellating themselves as @9:47 so aptly described. I lost an overworked dear GP partner colleague to suicide this year. I will do everything in my power to ensure GPs are safe too!

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  • Patient dictate terms to us now and if they start paying for consultations we will be virtually at their mercy; do that, do this,

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  • Just to be clear- having worked in Canada almost 5 years- it is not semi-private- in fact in theory "private " medicine is supposed to be "illegal" but in practice happens but not frequently and mainly for occupational medicine issues or cosmetic procedures.
    It is more honest I would say though.In most Provinces/territories each person or family says a monthly premium for their medical care- in BC we pay $69.25 for a single person, $125.50 for a family of 2 and $138.50 for 3 or more in a family- all per month. In Alberta, I believe its free ( lots of oil!!) This gets you your card which you must show when joining a GP, and every time you go to a lab, for an X-ray, into ER etc. We soon know if fraudulent as we can't bill for that patient. NO-ONE expects free care if they can't produce the card and I have no problem being "gatekeeper" as it were. I also have no issues billing patients if they no show and "firing" them if they won't pay
    I bill BC gov per visit- it's a set amount per patient dependent on age/length of visit etc. I have to say reading all this on Pulse I can honestly say I feel I am paid fairly for the work I do. I chose to have see about 30-35 a day- mostly 15 mins a time- a few "fit ins", have a "closed" list, do very rare home visits and chose my days/hours .Patients in general ( but not all) are appreciative and pleasant.
    Patients ( all ages) pay for their medication though which can be expensive but some have extended benefits via work, and there is a means tested scheme for those on low pay, if on disability etc- its free. Also a palliative care scheme etc. Ambulances also have to be paid for, unless urgent people seem to be able to make their own way to hospital!!

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  • Bob Hodges

    ". I lost an overworked dear GP partner colleague to suicide this year. I will do everything in my power to ensure GPs are safe too!"

    That explains the new zeal we are witnessing from you Una. Respect.

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  • Bob Hodges

    "So ashamed of Wiltshire for proposing this. It will backfire."

    Jesus Wept!

    Can it get ANY worse than it now? How CAN it 'backfire'?

    THERE ARE NOT ENOUGH GPs

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