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Vast majority of GPs support charges for non-NHS work



Eight in 10 GPs would welcome charging their own patients for non-NHS services, such as longer consultations and certain vaccinations, a Pulse survey has revealed.

Out of the 870 GPs responding to the survey, 79% would like to charge for services and some thought it was an ‘inevitable’ direction of the NHS.

However, charges were rejected by 12% of doctors, while 9% said they didn’t know where they stood on the matter.

As it stands, GPs can provide private services but not to patients who are on their registered practice list.

Public Health England is currently reviewing whether GPs should charge for a wider range of travel vaccinations, while NHS England has consulted on banning prescribing of over-the-counter and ‘low-value’ items in bids to save NHS cash.

And last year’s LMCs conference called for GPs to be allowed to charge their own patients from services which are not on the NHS list.

At the time, GPC said the Government was worried about a backlash from patients, and a GPC presentation indicated they were unsuccessful to push through the stance in 2018/19 contract negotiations.

Vice chair of City and Hackney LMC Dr Ben Molyneux said it was ‘detrimental to patients’ if practices are not able to offer services to patients who are not covered by the NHS, adding that this could include elective HPV and shingles vaccinations.

The BMA has also issued guidance on why GPs already charge for some services.

Oxfordshire LMC has gone further, by researching structures to charge for non-contractual work. 

LMC chair Dr Prit Buttar said GPs need to be more aware of what they can charge for and put it into practice.

He added that practices do not always ‘feel comfortable in charging where they absolutely can’, adding: ‘It’s such a complex subject.’

Doctors said charging could help relieve some pressures on general practice.

They could ‘reduce work and provide an income stream,’ said one GP working in Northern Ireland.

‘I’d welcome being able to charge them for long consultations or consultations out of hours,’ a GP partner in Cornwall commented.

A London GP said GPs should charge but felt that ‘patients are not well educated by NHS England on what constitutes NHS or non NHS services.’

One west Kent locum said: ‘Like most of the world a reasonable charge is inevitable.’

One GP partner, also based in west Kent, who wished to charge for consultations, said: ‘Of course they should pay. Why on earth would anyone expect work to be done for free?

’A solicitor can charge up to £300 an hour. Only then will the public value GPs and primary care staff.’

But, among the minority of sceptics, a GP in the Chilterns told Pulse: ‘I find the principle of taking money from patients for stuff very difficult, usually it is those who cannot afford who are the ones that fall through the cracks of NHS provision.’

And a GP in Glasgow said charges: ‘Would not help in a deprived area.’

‘The most vulnerable would be the most affected,’ said a GP from the Chester and Merseyside area.

Would you welcome being able to charge your patients for non-NHS service?

Yes – 79%

No – 12%

Don’t know – 9%

This survey was launched on October 10 2017, collating responses using the SurveyMonkey tool.  The 25 questions asked covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a Ninja Coffee Bar as an incentive to complete the survey. A total of 870 GPs answered this question.