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Should the NHS charge patients for GP appointments? No

Dr Kailash Chand

In the current economic climate it is not hard to see why the old spectre of ‘NHS fees’ has raised its head again. But despite the idea’s renewed fashionable status, its supporters have still not managed to address its fundamental flaws.

The most obvious of those is that charging would be an administrative nightmare. Charging for appointments would require yet another bureaucratic machine to collect payments, pay them to the Treasury and deal with the inevitable paperwork and appeals. How much would this cost to set up?

More importantly, there is a clear moral dilemma. Fees are quite simply against the ethos of an NHS designed to give free, high-quality healthcare to all UK citizens no matter what their economic status. Charges would inevitably result in many people not visiting their GP when they need to, especially those on low incomes.

The growing band of people in our society who need food banks to feed their families could not afford a £10 visit to their GP. I particularly fear that patients would not come forward with those niggles and aches that, while appearing trivial, signify the early onset of life-threatening diseases. A question for proponents of charges, therefore, is how much ‘extra’ illness would be acceptable?

However much patient fees are dressed up as promoting self-care or deterring time-wasters, the fact is they are a tax on the sick and would reposition our NHS as one where the depth of a patient’s pockets determines access to care.

GPs are in a testing period, under pressure from rising demand and budget cuts. We need to address, head-on, how to cope with these challenges but the answer will not be to introduce an expensive new tax system that divides GP access between the haves and the have-nots.

Dr Kailash Chand is the deputy chair of the BMA and a retired GP