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Patients could be charged for GP appointments, BMA chair warns

GP appointments could be incur a charge within the next five years because of the poor state of NHS finances, according to the chair of the BMA.

Dr Mark Porter told The Guardian that said it was ‘inescapable’ that the next government would consider introducing fees for GP appointments and other health services when the NHS budget is under pressure.

He added that such a move would ‘destroy the whole ethos of the NHS’.

NHS England has forecast that a £30bn budget gap will open by 2020 unless savings are made and investment raised.

Dr Porter said that he thinks parties will look to charging to fill this gap.

He said: ‘I think they will be tempted. They said in 1950 that a Labour government wouldn’t introduce charging and it did.’

Dr Porter said that ministers might feel able to extend fees as they already exist in some areas of healthcare, such as for prescriptions, dental work and social care, with around 1% of the NHS’s income in England coming from charges.

He added: ‘You say it’s politically toxic. It’s not, really, is it? Look at dentistry and look at social care. They carry with them exactly the same offer to the public by which the NHS was set up; that we will remove from you – this society, us acting collectively – the terrible fear of bankrupting yourself by having an illness, by needing healthcare.

‘And yet we allow people to be bankrupted by social care and we allow people to be deterred from seeking dental care because of charges.’

Dr Porter said charging for GP visits or similar services would ‘destroy the ultimate ethos of the NHS’.

‘It’s inescapable that you’re deterring people from seeking healthcare. You deter poor people and sick people from seeking the healthcare they need.’

He added that there was no evidence that fees would deter frivolous use of the NHS and that the revenue gained would be nullified by the administrative complexities which would arise.

Spokesmen for the Conservatives, Labour and the Liberal Democrats all ruled out charging new fees within the NHS in response to Dr Porter’s comments.

A Pulse survey of 440 GPs in 2013 revealed that 51% said they would support charging a small fee for GP appointments, compared with 36% who would not. 

However, a significant majority of GPs at the 2014 LMCs Conference voted against a proposal to back patient charging for GP appointments.

An Ipsos Mori poll for the Health Foundation thinktank found last week that 59% of people would back tax rises to provide extra funding for healthcare, whereas only 16% would support new fees.

Readers' comments (28)

  • And this is why the bma is useless for gps. Has no understanding of grassroots feeling. fees are the only way to manage demand and encourage self care. The fee should not be set so high as to discourage health seeking behaviour and in this country would be affordable to everyone. Yes even the unemployed have iPhone. We are spoilt in this country and the public are taking the pee with this amazing thing they have. But unfortunately advocating responsible use without hitting people in the pocket will not happen. The fee should be for everyone with no exclusions. Only difference should be who pays and if the government wants exclusions they should still pay per contact.

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  • Centrally set fees - disaster as govt would continue to stiffle GPs and would reduce their contribution.

    Free market in top up fees, or right for private GPs to prescribe NHS scripts and refer to NHS services - primary care would be saved.

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  • And to add the current situation is providing free at he point of contact healthcare but so bad due to volume and underresourcing that it results in death ala Stafford and I'm sure this is happening in many other health localities at the moment under the radar. It's usually expensive secondary care which can result in bankruptcy and that should be free for everyone for illness and injury. Anything outside this should be excluded from free secondary care.

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  • Bring it on ASAP.

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  • The consultation fees should be paid to the doctor who actually sees the patient and the doctor then pays the surgery 30% of the consultation fee to the partners for using their premesis to see those patients. This will enable patients to have a choice in choosing a doctor as they would be getting value for their money.

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  • All posts are anonymous including mine - that tells you that we believe that this is the right medicine but does not like to show our identity ! Politicians are the same as we, they believe in something but can't tell the truth to the public !
    I think we should have charging system at least nominal fee like £5 per contact. It will immediately reduce burden on the GP appointment system. Usual coughs and colds will go to pharmacy and pharmacist are well trained to deal with them. Another category of neurotic pt with all heart sink and worried well will prop up the NHS! This is no brainer ! Bring it on - save our NHS

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  • Let's not live in cookoo land with 'ethos' of the NHS. Patients have evolved into customers due to NHSE and Public Health England - customers who have no 'ethos' themselves, with more voice and an all too readily eagerness to take you to the GMC and ruin your livelihood at a whim with NHS support.

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  • GP consultation fees will only achieve one thing. Everybody will go to A/E (except perhaps those patients who value our service)

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  • "It’s inescapable that you’re deterring people from seeking healthcare. You deter poor people and sick people from seeking the healthcare they need.’"

    Then please explain, Dr Porter, how every other civilised westernised country charges fees but it doesn't deter the poor and sick?

    Stop being a high priest for the political ideology cult religion of the "free" NHS and start being a union leader looking after your members. If you can't do that, resign.

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  • BMA has lost credibility and Mr Porter's 'warning' just proves how out of touch with reality this organisation is.
    Truth is, although we all believe and support Bevan's vision of a free health services, the world has moved onsince the sixties. Soaring patient expectations stirred by short sighted politicians and backed by some sections of the press have left the NHS crawling on it's knees. The only way forward is to put a small payment per visit to stem the unrelenting demand and make people think twice before they ring the doctor. I am aware of the fear colleagues have in putting their names to mails as this is going to be one really unpleasant stand to take. We need to be realistic and not stick our hands in sand - co-payment is inevitable and it will be a gross mistake not to introduce this. This might be the only factor that could save the NHS at this point in time.
    BTW -did the dental services collapse after introduction of payments?

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