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Can patients really not afford to support the NHS?

Dr David Turner writes

‘I want to be referred for that laser hair removal from my upper lip.’

If the woman in question had been a model who spends her day being photographed close up for glossy magazines then the request would not have been entirely without merit. Even then, I probably would have suggested she might like to pay for this procedure herself instead of burdening the tax payer with the cost.

But in this instance the woman was not a model - in fact she is not employed in any capacity. Add to this the fact she is morbidly obese, hypertensive, diabetic and almost certainly has polycystic ovaries, the phrase that immediately came to mind was that one involving deck-chairs and the Titanic.

As usual though, it seems I am in the minority. Earlier this year it was reported that there has been a dramatic increase in the popularity of plastic surgery in Britain. So even during a period of austerity, apparently, people can still find the money to pay for collagen lip injections and breast implants.

I suppose it is human nature that when faced with an enormity of difficult tasks we choose the easiest ones to tackle first. That, combined with the endless trash that pumps out of television sets, encouraging the population to focus on appearance rather than substance.

Yet, it is staggering what nonsense people worry about. Like the patient I saw recently with probable cardiac chest pain, who really was not interested in my discussion about how we should investigate her possible heart problem. No, she was more interested in asking me why one of her arm pits smells more than the other.

Seemingly even the poorest in society have deep pockets when it comes to paying for eyebrow piercings and neck tattoos. Yet ask them to contribute even the tiniest amount towards their NHS care - for example, ‘Maybe you could buy some paracetamol for 20p from the supermarket rather than ask me to write a prescription, which will end up costing the tax payer several pounds?’ - and they look at you like you have just suggested the wholesale dismantling of the welfare state.

Dr David Turner is a GP in west London

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Readers' comments (15)

  • Agree. Entitlement is a mostly subjective word with objective parameters- it is meant to cover broad principles, not small details. It is perfectly valid to explain to patients that entitlement to everything under the NHS is a myth. They can be unreasonable about it (I find that most people are reasonable) but in the end, we draw the boundaries for them within the boundaries set for us. Sometimes unpleasant, but necessary...

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  • Of course they can afford to support the NHS. but they don't want to, and the politicians don't want to make them either, cos it might lose them their vote.

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  • unfortunately most people are not reasonable about it and i do wish we stop saying that they are. the NHS is being abused and we have to wake up about this

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  • There needs to be a mechanism to capture this. Most countries do this with copayments, or by the state giving a fixed contribution that can be topped up according to patient demand.
    Such countries, like most in Europe, are not full of the untreated dead and dying, a fact that those who worship the NHS forget.

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  • Its human nature to take the pi$$, eventually. The End

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  • Why oh why still work in the NHS......private GP land is bliss....its all relative! Get out whilst you can!!

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  • Spot on. Politicians lose votes so prefer to manipulate the media, silence whistle blowers and put patients in dangerously understaffed and underfunded hospitals and seek to make general practise a low skill low wage enterprise. The senior 'decision makers' have no stake as they go private any way. Its the rest of the 'peasants' who will be stuffed.

    Funny how the the rest of Western Europe delivers far better health care for their most needy without our state run, politician headed, monopoly driven nationalised socialist utopian system

    Meanwhile the likes of Maureen Baker coo with gratitude at the latest government propaganda in the hope of ingratiating themselves, Garade trousers 25 monopoly practices and makes a fortune and young doctors who are the life blood emigrate and leave rather than get completely screwed by the above.

    The problem brewing is the fact that the middle class are paying for poor health care and could get far better if they took out their own insurance. They are already paying for everyone else who is taking out.

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  • Bob Hodges

    The average British person, after more than 60 years of free NHS, would rather cook and eat their own children than pay a penny for anything healthcare related.

    This is why the privatisation by stealth agenda will fail, and no plan B will develop in parallel.

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  • People do not expect to get a free loaf of bread from the supermarket, so why do they think free healthcare could be provided forever? Its a death spiral for NHS funding. People are getting older, their needs are getting complex. We have to decide if we want to be a fully socialist country with communist under tones where the state is acting like a nanny for all, or do we have to be a progressive, proactive country that looks after the people who cannot genuinely pay for their healthcare whereas charging appropriately for those who can. Govt has to come clean about it. They cannot beat about the bush and try to introduce privatisation by stealth. It will be a train wreck.People need to have an open discussion about it and come to terms with the situation. Their is a need to create political space for this idea to flourish. Otherwise forget about our NHS, free at the point of use.

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  • I now work in Australia and if someone asked me for a referral for trivial stuff they'd be paying their gap fee on the way out. All scripts cost a fee at the chemist, big discounts for the poor but still more than the cost of a packet of ibuprofen at the supermarket. - so no incentive to waste GPs time for pandol, brufen or worming tablets. It's a much saner system over here...

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