Should people have to pay to see a GP?

docjames_2

So here are the facts...

A GP appointment currently costs the NHS about £60
Demand for GP appointments are increasing at about 6% a year
It is getting more and more difficult to see a GP at a time or day that suits!
Rationing of medicines and treatment is already underway in the NHS
etc etc..

SO...the question is..

Should we all have compulsory medical insurance (as in Germany)?
Should we pay to see the GP (as in a lot of countries)?
Should we pay for access to ALL parts of healthcare?

A patient asked me what cases i see on a typical morning surgery of 20 patients....i said well yesterday morning i saw the following :

5 cases of D+V (no treatment given to any..advised about fluids etc)
6 cases of viral throat/ear infections (again simple advice about analgesia and fluids)
2 urine infections
2 people for medical certificates
1 abdominal pain - urine infection
1 chest infection
1 case of a funny heart rhythm
1 skin rash
1 foot infection

So - how many of the above actually needed to see a doctor?
Il let you decide...i would say about 7 of them - almost a third! meanwhile im sure there were another 10 people wanting appointments to see me that day that couldnt get them!+

So my patient says to me - why dont doctors charge a nominal amount - say £15 for an appointment? This would only be 25% of the actual cost....any further tests/referrals to hospital etc would be free.....opinions?

FelinePrincess

Should we all have compulsory medical insurance (as in Germany)?

I'm un-decided on this, but I don't think it's a bad idea.


Should we pay to see the GP (as in a lot of countries)?

This isn't something thats crossed my mind before but I think it's a really good idea to charge a nominal fee, some kind of help might need to be considered for those on benefits or with very large families.


Should we pay for access to ALL parts of healthcare?

Not sure on this one..


I think it would be a really good idea if people did pay a small fee to visit the doctors as it would dis-courage the time wasters. It really annoys me when people go to the doctors with little problems like colds, ect. In my experience most things will go away themselves - unless I'm in an awfull lot of pain I will wait at least a week and see how things are, alot of things go away by themselves. A rash might be a bit uncomfortable but it's not going to kill you if you leave it for a few days to see if it gets better (well, unless it's meningitis). I see the nurse every 3 months for an injection, and if I have any other conditions it's usually something she can deal with at the same time.

I know not everyone is blessed with good health and I wouldn't want those needing to see a doctor to go without but I wish some people didn't see it as 'their right' to see the doctor over a common cold!

And while I'm ranting on the subject of healthcare, it does annoy me when people moan about the nhs - yes I know sometimes they get things wrong, but everyone in this country does get medical treatment regardless of who they are which is alot more then some other countries have.

bargainbetty

Forgive me, but I already do pay for my GP visits. It's called National Insurance and I have been paying it monthly since I was 16 years old regardless of whether or not I saw a doctor that month. I am a higher level tax payer and therefore contribute a reasonably decent amount to this pot.

Non-attendance at appointments could be chargeable, because you have wasted someone else's time, but that starts off a whole argument about GPs sticking to schedules. I routinely wait over 20 mins beyond my appointment time.

docjames_2

I agree with the above post whole heartedly.

Nothing is more frustrating than seeing one cold after another and also multiple people looking for medical lines because they have a cough and dont wish to go to work! There needs to be a deterrent for simply coming to the doctor because its free rather than going to the chemist and getting simple medications or waiting for things to improve like people used to do in years gone by!

bargainbetty

FelinePrincess wrote: »

This isn't something thats crossed my mind before but I think it's a really good idea to charge a nominal fee, some kind of help might need to be considered for those on benefits or with very large families.

Sorry, wanted to add a second point on this - to get to my doctors I have to book at least two days in advance, take time off work and rearrange my schedule to allow for prescriptions (quarterly injections etc). I am highly unlikely to not turn up for an appointment.

If those on benefits and with large families get help with this, can you explain how this is anything more than another tax on working and middle class families?

docjames_2

bargainbetty wrote: »

Forgive me, but I already do pay for my GP visits. It's called National Insurance and I have been paying it monthly since I was 16 years old regardless of whether or not I saw a doctor that month. I am a higher level tax payer and therefore contribute a reasonably decent amount to this pot.

Non-attendance at appointments could be chargeable, because you have wasted someone else's time, but that starts off a whole argument about GPs sticking to schedules. I routinely wait over 20 mins beyond my appointment time.

I agree there is an issue about National Insurance! At the moment it no where near covers the cost of the NHS - should we remove this and allow people to get their own insurance?

GPs cannot stick to 10 minute appointments rigidly because what can you do if someone comes in with 2 or 3 problems? also what if they are unwell and need referred to the hospital? also what if they are 5 monutes late for their appointemnt...do we only allow them 5 minutes when they are in the room? if everyone takes just 2 minutes extra then the last patient of a morning surgery would be waiting 40mins!

docjames_2

bargainbetty wrote: »

Sorry, wanted to add a second point on this - to get to my doctors I have to book at least two days in advance, take time off work and rearrange my schedule to allow for prescriptions (quarterly injections etc). I am highly unlikely to not turn up for an appointment.

If those on benefits and with large families get help with this, can you explain how this is anything more than another tax on working and middle class families?

Again agreed....maybe the flat rate should be paid for by all - either through insurance or through the person themselves directly?

ellay864

Presumably you'd class many of the viral throat/ear infections as something that shouldn't necessitate a GP visit? But it amazes me how some doctors seem able to instantly diagnose viral or bacterial infections without anything more than a cursory glance. My old GP would write out scripts for anything; one of the partners now will rarely prescribe them but also hardly seems to look properly at the patient. I totally agree with limiting the use of antibiotics, but what would be better is proper use when appropriate. I know at my surgery many patients would request to see the one who they knew would give them the antibiotics, whereas others struggled without anything only to end up on them later (and responding to them)
When my son was 4 he was taken ill on holiday in Florida with a sore throat. He was in a lot of distress and we were taken to a clinic where he had a throat swab taken. 10 minutes later they had a diagnosis of a strep infection and he was given the antibiotics. A couple of years later he had a cold and sore throat, and the throat didnt ease. We were at the doctors anyway for something else so I mentioned the throat, and was told it was a viral infection and to give him fluids, calpol etc. Two days later he was no better so I got another appointment (different doctor) who took one look and told me to get him straight to hospital as he had one of the worst cases of tonsilitis they'd seen, and that turned out to be bacterial.
I think what bothers many people, me included, is the feeling that's too much variation in perceived quality of care by the GP. I certainly have particular GPs I would rather see and those I'd avoid, and I don't go often. In some cases for the more minors it would probably be more effective to see a nurse who could then refer as appropriate. But it must be remembered that many serious illnesses or diseases can have apparently insignificant symptoms and it may only be picked up when there is a noted recurrence - which you wouldnt get if the patients are discouraged from visiting

[Deleted User]

How about putting a maximum cap on GP salaries? That would save their practices a lot of money.. they'd be forced to hire more staff to use up their budgets.

I believe the NHS should remain 'free at the first point of care' - no charges for A&E and GP visits. More public education should be used to reduce visits, not fees.

It's bad enough the only way I can get my little boy seen effectively is to pay a fortune in private insurance, now you want to charge me so someone can sit and agree with me that he needs a consultant referral.

While we're at it, can i please buy my asthma sprays over the counter? That would save me taking time off to see the GP quite a bit.

docjames_2

I can only concur with the above - however, the only way to be able to afford tests such as the immediate throat swab result would be to increase funding dramatically in primary care. In the USA, you can be told within 10mins with a blood test if you have had a heart attack...in the Uk, you need admitted to hospital and then 24hr of monitoring and blood tests to get the same answer. Unfortunately the funding does not exist at present to do these things properly - hence an argument to start charging i guess.....if people pay you get a better result as in the private sector due to proper competition etc.

Torry_Quine

I definitely think this is a bad move. There are people who abuse the present system but equally there are people who don't go to the doctor when they should. There may well be people with 'minor' self-limiting illnesses but this isn't always clear to the patient and could be a sign of something more severe which does need intervention. Many people just don't have the skills to differentiate between the two.