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GPs say no to offering top-up payments for private primary care



GPs gave a resounding ‘no’ to offering NHS patients the option to pay extra ‘top-up’ payments for private services at their annual BMA conference today.

The LMCs conference overwhelmingly voted against a motion put by Gloucestershire LMC, which called for general practice to be allowed to offer both private and NHS treatments – and for the GPC to include this in contract negotiations.

The motion stated: ‘Conference believes patient care would be improved were practices to be allowed to offer ‘top-up’ private services to their NHS patients and requests that the GPC include this in their contract negotiations’.

Putting the motion, Dr Jethro Hubbard argued the move would level the playing field between GPs and other providers like foundation trusts.

Dr Hubbard said: ‘NHS Foundation Trusts and private companies are allowed to provide NHS and private services to the same population.
‘Safeguards and regulations protect patients while allowing them the choice to pay if they wish. Allowing the large providers this flexibility while denying it to small businesses that constitute general practice is an inherent double standard.’

He added: ‘If GPs were able to supplement NHS work with paid-for minor operations then the investment in training and equipment becomes worthwhile and benefits both patients and the NHS profit. If large providers can be trusted to work with the population via both the private and NHS routes, then why are GPs not afforded the same trust?’

However, Dr Jackie Applebee from Tower Hamlets LMC said offering top-up payments would be a ‘slippery slope’ to the introduction of a wider fee-paying system – and questioned how patients would benefit.

Dr Applebee said: ‘Top-up private services will usher in a two-tier GP service as practices priorities those who can pay and be the start of a more slippery slope to more widespread fee-paying.The motion professes these fees will improve care – but how will this improve care for the poor? Indeed would it actually improve care for more affluent, paying patients who may feel entitled to demand more investigations and referrals that might actually do them more harm than good?’

Dr Applebee added: ‘Care for all our patients – rich or poor – would be improved if Government funded general practice adequately. The NHS budget has fallen to 6.2% of GDP – one of the lowest in Europe – and general practice is getting a smaller and smaller share of this. We should not be calling for private top-ups to increase choice for the more affluent but demanding that the whole of the NHS, including general practice is funded adequately.

Motion in full

GLOUCESTERSHIRE: Conference believes patient care would be improved were practices to be allowed to offer ‘top-up’ private services to their NHS patients and requests that the GPC include this in their contract negotiations