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Large majority of GPs vote against charging patients for appointments

A significant majority of GPs at the LMCs Conference has voted against the proposal to back patient charging for GP appointments.

In all, 224 delegates voted against the motion, which received intense media coverage after first being covered in Pulse earlier this month. But in the end, only 59 delegates voted in favour, while four abstained.

Proposing the motion, Wiltshire LMC’s Dr Helena McKeown said the time has come to ‘put a true value on general practice’. However, the GPC led a host of delegates in opposing the motion, which was branded as ‘mistaken and dangerous’.

Dr McKeown said: ‘The time has come to lead our profession in putting a true price on the value of general practice. Currently, the Government both commissions, and controls, completely the funding of general practice. They dictate both what they want, what they will pay for, and indeed how much they will pay for it. We are left rationing care both in CCGs and in our consulting rooms.’

‘A fee for services, for some people, would sustain us whilst we build up a workforce that wants to join us and make general practice more attractive than retirement or general practice abroad. We need an honest Government to say who and what will be completely covered by general practice as an NHS service. A fixed fee, for some services, for some patients, wil emphasize our value.’

But the number of GPs wanting to speak against the motion vastly outstripped those speaking in favour. Among those queueing to make their opinion heard was former GPC chair Dr Laurence Buckman. Welcomed to applause, Dr Buckman, who stepped down as GPC chair last year, said the motion was both ‘mistaken and dangerous’.

He said: ‘You do not control demand by making patients pay. You then get survival of the richest, not treatment of the sickest.’

He added: ‘It is not for GPC to consider alternative funding mechanisms, unless the NHS is threatened with closure. Although we know that all the main political parties want a private health services, and some parts of the Treasury would love to get rid of the NHS, the vast majority of the public of all political views would prefer to keep it. GPC will be offering to privatise as a way out by doing it to ourselves and our patients, as well as another opportunity to bash greedy GPs. That we already have some co-payments in the NHS is regrettable. To introduce it for UK general practice would appal most of the public and the profession.’

‘Conference, I don’t think most of us became GPs to collect taxes for the Government, but that is what [this motion] would do.’

Commenting on the outcome of the vote, GPC chair Dr Chaand Nagpaul said: ‘In this climate, it is understandable that the LMCs Conference wanted to debate the need for extra funding for overstretched GP services. But introducing a charge for services would be a tax on illness, hit the most vulnerable the hardest and threaten to undermine the principle of an NHS free at the point of delivery.’

‘Introducing a financial transaction would undermine the trust between doctor and patient. If patients are deterred from seeing their GP due to an additional cost this could result in their illness deteriorating and costing the NHS even more.’

‘GPs have today sent a resounding message that charging patients is not the solution to the financial crisis facing the NHS. The BMA is committed to a health service that is free at the point of need and accessible to all and we should proud to have an NHS GP service where no one has to pay to get the treatment they need.’

Live blog: LMCs Conference 2014

The motion in full:


That conference:
(i) believes that general practice is unsustainable in its current format – CARRIED
(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 – NOT CARRIED
(iii) urges the UK governments to define the services that can and cannot be accessed in the NHS – CARRIED
(iv) calls on GPC to consider alternative funding mechanisms for general practice – NOT CARRIED
(v) calls on GPC to explore national charging for general practice services with the UK governments. – NOT CARRIED