Should people have to pay to see a GP?

piratefairy

i have to admit i have only read the first page, but i can say that i certainly wouldn't pay for the appalling service i receive from my doctors - at my practice you see whichever one has a free slot at that time, whcih is fine, but i wouldn't say i was particularly happy with any of them. they certainly don't listen and are quick to dismiss my concerns and ongoing illness.

hunka

welshdent wrote: »

Firstly I dont mean to be rude or inflammatory but please can we keep political dogma out of it. We have zero idea what any party has in mind so currently by saying that about the conservatives is based on dogma.

it's not really dogma though, it's proven time and time again what the blue noses do to public services. Not that labour has done a great job either, granted. You just need to look at the benefit 'reforms'

this need to change, I don't agree with the way things are being changed in England now, but I live in scotland, we aren't changing things on such a systemic level.

Charging for DNA's to GP appointments IMO, is acceptable. HOWEVER the mere suggestion of private healthcare insurance leaves a very bitter taste in my mouth - primarily due to the, pardon my frech, the !!!! poor job the US have made of it. How do you factor in Mental health issues? Addiction issues? Too many variables.

Eton_Rifle wrote: »

Yes, absolutely but the one good thing about the US system (probably the only thing) is that it pays for the research for all those drugs we take for granted.

If the US had a NHS style system, that multi-billion health industry wouldn't exist because there'd be no huge profits to be made from people's illnesses - there just wouldn't be all that research and development money for the drugs from which we all benefit worldwide.

Almost no-one develops drugs for the love of mankind, they do it for profit and the're doing it so they can sell the drugs for cold hard cash not give them away like sweeties to the needy.

So we may criticise that system but be aware that it's been pretty good for us because it's the US citizens who foot the research and development bill for our drugs.

do you have any knowledge of the pharma industry? Your post clearly shows you have no idea.

When a new drug comes onto the market the company that makes it has exclusive rights to said drug (only under certain circumstances this isn't the case) and as such gets all the profits from said drug. That market itself pays it's own way. Yes, there is a fair bit of funding that goes from the health industry in the US to the pharma companies, but they certainly don't 'foot the bill' for all the research. What nonsense

RadoJo

I think I get a pretty good deal with my GP - they have moved into a new building and upgraded a lot of their services, so they now have an online appointment booking system, an on-site pharmacy and you are offered the opportunity to see a nurse practitioner for issues which don't require a doctor.

However, one thing which I assume must take up a certain amount of time is repeat prescriptions - I am asthmatic and get a new inhaler about once every three months (used to be more like monthly) and have been doing so for over 25 years. I manage my medication well, have my own peak flow meter so I can accurately monitor my breathing if and when I need to and turn up dutifully for the asthma clinic whenever I am invited. In my ideal world, I would have a prescription card of some sort which allowed me to go direct to the chemists to get my medication. At the moment, I am lucky enough to be able to order the repeat script online, but the script is always signed by a doctor. I think it's reasonable to allow patients who require regular prescriptions and who have demonstrated that they understand and can manage their condition to have easier access to their medication with check-ups at suitable intervals to identify any new issues or potential new drug regimens which might suit them.

I'm not suggesting that this should be compulsory, but for those who would be happy to manage their medication in this way it might be an option which would free up at least some of the doctors' time (perhaps someone can tell me whether it would actually help with workload!). There must be thousands of other people out there who could take a little more responsibility for their conditions to free up the system for those who can't.

I also wanted to say that I believe passionately in a free health service - it is one of the things that makes our country so fantastic and although the system isn't perfect I don't think that replacing it with a paid system is the answer. I was in the states when the healthcare bill was passed and it saddened me that people couldn't even imagine what it must be like to just get help when you need it without having to worry about money. One of my friends there has the most basic health insurance and it cost her about $150 a month which represented over 10% of her take home wages. There was also a case of a baby born with a congenital heart defect whose parents couldn't get any insurance to cover his treatment as it was considered a 'pre-existing condition' despite the fact he was less than a day old. It's those kind of situations that really make you appreciate the fact that you don't have to worry about money when you've already got plenty on your plate!

welshdent

hunka wrote: »

it's not really dogma though, it's proven time and time again what the blue noses do to public services. Not that labour has done a great job either, granted. You just need to look at the benefit 'reforms'

The point of my post was to try and get this topic away from a party political discussion. What Doc James was asking by my interpretation was how would people feel about alternative forms of funding. That wasnt a this is going to happen or that is ... it was a simple question of opinion. It has, as all discussions do ... branched out and its healthy for us to see all sides and discuss ways we feel problems can be managed or addressed. Its all hypothetical so "throwing somehing out there" is to be encouraged. The problem is some people see it as an excuse to slag one political party off or another. That just makes a mess of the thread and introduces elements of irrelevance for the aim of the discussion. It would be nice if we just kept party politics out of it. all parties have dogma

welshdent

One thing I would note is that when people talk of private healthcare ... and I do not for a second believe we should JUST have a private system .... why is it assumed it would be like the USA? Why would it have to be like the USA? They arent the only place to have a private system.

I personally believe in choice and I believe that a monopoly is a bad thing which I believe is borne out in modern times with the complaints people have about the system as a whole. I believe we could have a well functioning private system, more involved than we have now ... AND a good quality NHS .. running along side each other. I think it would be healthy (excuse the pun) not just for patients but also staff and indeed the economy because ultimately any additional tax income will pass along to the NHS in some form or another. I believe that currently the NHS can not create enough jobs to employ all those that train in various healthcare disciplines ... how in anyones world or logic can that be right?? At least an expanded private sector would create more employment opportunities meaning those expensively trained individuals do not have a wasted qualification. Complaining that the NHS trained them so why should the private sector benefit is a ridiculous arguement IMO. Is it REALLY better that NO ONE benefits?? They can still use their skills to benefit the public. They would still be paying tax etc.

FWIW I think they need to manage less and allow the clinicians to do what they are trained for. I think the service could be so much better but I question how much it ALLOWED to be better.

As I said, we SHOULD think outside the box a bit. Medicine is a lot more expensive than when a certain mr bevan cam up with his little idea. There is always room for your beliefs but there does need to be some realism where the emotion is kept out of things a little more.

We should encourage people to think of solutions, discussing and debating them is healthy even if the suggestions are ultimately unpalatable.

angel_snowfey

I think 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.

lostinrates

welshdent wrote: »

As I said, we SHOULD think outside the box a bit. Medicine is a lot more expensive than when a certain mr bevan cam up with his little idea. There is always room for your beliefs but there does need to be some realism where the emotion is kept out of things a little more. .

I think this is a great post. As well as being more expensive people have higher expectations an far more ''named'' conditions.

My condition (which was diagnosed and most aggressivel treated privately) well, the drugs I received privately were not available on NHS. The NHS just shrugged their shoulders and said that treatment options were limited but Harley Street helped (and indeed, a GP who goes to USA every second year for a month of ''new research'' training). They found, at the same time a plehora of things going wrong, some minor that the NHS would treat if they new about but maybe shouldn't have too, some more serious...possibly pre indicators of the life threatening problem I had, or possibly resultant from a body working under strain... It rankles that while these are shoulder shrugged by NHS and dismissed NON health implication things are treated...ears pinned back...and , and I say this as an infertile woan who would love a child, extensive fertility treatment. I also feel a shudder at the idea of insurance looking at pre-existings. I've now worn through most of those....and, 8 years of ill health and inactivity sees me overweight (not helped by the compounding and relevant medical condition).

I've lived in lots of countries and I'm afraid, despite the free at point of use and the fairness, it is not the best treatment I've received...far from it. There is however tremendous benifit in knowing it CAN be received in an emergency. We are not alone in that. n fact, the best out of hours treatment I received was i Italy.

docjames_2

angel_snowfey wrote: »

I think 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.

Its good to get all these different opinions to generate more ideas and thoughts. Public education has been tried and failed...think chlamydia screening, the flu vaccination campaign etc etc...

Unfortunately there is no way in crediting people if they self care with minor illnesses or try over the counter medication appropriately first. Also there is no way in reprimanding people who waste NHS time and money - such as missing appointments, requesting unnessary doctor or ambulance call outs, repeatedly losing their medications...the list is endless...

ceebeeby

But the majority of people just don't care - this thread being the perfect point. It's on a major internet forum with over 5million users, it's got a captivating title (well, I think so) and only been viewed less than 2000 times since going live a few days ago.

Yet .... you could start a thread "why are carrots orange, long and pointy" and you would probably get 400 responses in an hour! Particularly if the carrots claim benefits!

People are used to the NHS being what it is, mostly adequate with a few exceptions, but generally provides a service that people are willing to accept. In their minds maybe, why fix it if it aint broke for the majority?

I fear we're probably in the minority of wanting positive change. And really, what does positive change look like, because our idea of it, may well again be very different from many others, again, as the lack of interest in this thread shows? I think it would have to be amazingly spectacular for the general population to be wowed by what they would just view as more change.

Just a thought

moggylover

Thanks for the explanation of the changes Welshdent, I still have reservations about how well or poorly paid a NHS dentist might end up if he were hard working (and, of course, that is difficult to assess individually) but there was certainly food for thought in what you explain and I can, perhaps, see why there is such difficulty in getting dentists to stay within the NHS.

However, places like Denticare manage it, do I assume that the foreign dentists that seem to be the norm there are poorly paid or do they just manage to do it because of sheet volume of numbers? Whilst not the most spacious and salubrious of dental surgeries I have ever used, we went to them when our dentist left (as they were the only NHS dentists available, and that 40 odd miles away in Aberystwyth) and they are efficient and clean and I haven't got a problem with the service they offer.

I will also admit that I had not realised just how big a problem there was with no shows, it's not something I would consider doing and so it never occurred to me that others would. It does shock me, and I think it needs addressing and I do think a substantial charge for not attending is perfectly acceptable, as is refusing further appointments for repeat offenders.

I'm also very much in favour of charges for those that end up in casualty due to excessive alcohol consumption and/or the violence that this often produces.

However, I admit I am still fundamentally opposed to charging for appointments in general and would hate to see our NHS watered down from its original, very admirable, intentions. I believe that it should remain a point of pride in the UK that we have this institution and whilst I agree that a great deal should be improved (and, like LIR, I haven't had the best of results from the NHS myself) I think the largest wastes of money are in the administration departments and those services (i.e. IT systems) which get put out to the private sector.

As an instance of another kind of waste, many moons ago I worked for Bristol Myers for a while as a temp. Whilst I was there they had two cancer drugs CCNU and BCNU, which were at that time new and very promising and much sought after. I admit that I was entirely angered by the fact that these drugs were sold much more cheaply abroad and to private clinics than they were to the NHS with the attitude being that the NHS could afford it! If that sort of attitude continues within the pharmaceutical trade then they need to be given some swift, sharp shocks.

Certainly a thread that has made me think: although I admit I haven't come to many conclusions yet:)