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Government pledges could require patient charges, financial experts say

The Government may have to introduce GP appointment charges unless it comes up with another plan to fund its seven-day access pledge, an influential accountancy institute has said.

The Chartered Institute of Public Finance (Cipfa)’s detailed financial analysis of the NHS five-year plan and Government pledges concluded the Government has just three options: charge patients to see a doctor; reduce services; or increase funding by significantly more than the £8bn pledged.

NHS England has claimed its Five Year Forward View’s plans to switch to new models of care - including GPs working at scale and with hospital trusts - could save a required £22bn by 2020.

But Cipfa’s analysis found that it had failed to take into account the Prime Minister’s plan for evening and weekend GP appointments, same-day appointments for over-75s or increasing pressure on health services stemming from social care and benefits being cut.

The report also said the ‘unproven’ experimentation with different models of care ‘carry a big risk of delay or underachievement’.

This means the Government may have to consider ‘charging for “hotel costs” in health’ or ‘flat rate contributions towards visits to the doctor or A&E; paying a proportion of treatment costs (as in France); or insurance approaches’.

The economists concluded: ‘As things stand, the Government is left with three choices: charge patients to use some services such as a flat rate contributory fee to see the doctor, reduce services, or increase funding.’

Cipfa chief executive Rob Whiteman said: ‘The NHS is presently beset by a Five Year Forward View and resource assumptions that will not add up.’

It comes as GP leaders have pleaded with the Government to focus on solving the problem of an over-worked and under-staffed GP service five days a week rather than stretching it across seven.

Readers' comments (21)

  • So it begins. Run for the hills!

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  • 'Square peg not possible to fit into round hole, think-tank suggests.'

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  • Its not rocket science!!!

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  • '' the ‘unproven’ experimentation with different models of care ''

    Well said

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  • Very interesting times. I can't see the government openly charging people. It would be a huge vote loser.

    However if they are going to do it, now is the best time, at the start of their term in office. By the end people will have become used to it. There will be a drop in demand for access because of the payment upfront and access times for those wanting it will be vastly improved, probably same day for many services.

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  • " The economists concluded: ‘As things stand, the Government is left with three choices: charge patients to use some services such as a flat rate contributory fee to see the doctor, reduce services, or increase funding."

    FFS Why does it take so bleeding LONG to state what was absolutely blatently obvious to all of us from many years back!!!......... The cowardice of politicians to address the issues in a common sense adult manner has led to incredible stress amongst the proffesion and worst still harmed patients.

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  • 4th choice - Admit to patients that despite politicians' earlier claims, routine evening and weekend services are not affordable and cannot be staffed as things stand. Tell employers that they have a duty to let employees have reasonable time off for medical appointments without making them take annual leave. Focus on providing an excellent in-hours core services and allot funding to ensure an excellent OOH service (perhaps by cutting 111 and various non-productive quangos).

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  • The same think-tank will now be moving on to proving a link between bears and defaecation in woodland areas.

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  • Oh good!
    Dear Patient,
    Because the doctors wouldn't work weekends without more pay we've has to introduce charges; we're really sorry but not our fault.
    Love
    HMG

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  • Copayment is almost certainly where we are eventually going.

    One word of warning, in Ireland and other countries the government's part of the payment has been reduced drastically. GPs have increased the amount they charge accordingly and sometimes patients are having difficulty paying. However we may have to accept this and there will be patients who will fall through the net. It would then be up to us as to whether we will still provide our service for those patients. Mind you I have not seen many benevolent dentists.

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