Should people have to pay to see a GP?

docjames_2

ringo_24601 wrote: »

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.

I would agree with a cap on GP wages - in fact i think GPs should be paid a salary like hospital doctors for the work that they do for the NHS - unfortunately for the NHS this would mean that the total cost for salaries would actually be higher than they are now. The headline stories of GPs earning £100,000 a year are for the samll minority with the rest earning somewhere between £50 and £75, 000. I think most GPs would happily move to a salaried service like hospital doctors.

Also i think if charges came in, you could refer yourself to the private specialist rather than having to go through the GP - far more efficient!

Taliahmai

It sometimes seams near impossible to get an appointment at my gp's lol...you can be trying for a good half hour before you can even get through in a morning (and then the appointments are usually gone lol), you can not make advance bookings, you ahve to call in the morning and hope. The receptionist will then ask what is wrong and if its for something the nurse/nurse practitioner can deal with she makes an appointment with them. if you feel you need to see the dr they take your details down and then the dr will ring you back! Then they either give you advice over the phone, refer you to a chemis t or make you an appointment. It can be an absolute nightmare but it does cut down on a lot of unneccessary appointments.

The thing that would worry me about charging for appointments, is not everyone will pay, some because they just cant afford it and others because they are just tight and dont see that we should so they just wont go and could potentially miss out on a life threatning diagnosis.

My grandad was very much one of them that wouldnt go to a dr, he went years and years without seeing one despite having problems. When he finally was persuaded to go, it was too late, it was cancer but it was so far advanced nothing could be done about it. I know if he had of had to pay for an appointment there is no way he would of gone at all just because he was so pig headded and stubbern.....and i think there are a lot of people like that.

Charging for missed appointments i think is a great idea! Our dentist charges still if you dont turn up as do a lot of other places...so why not a dr!

FelinePrincess

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.

I'm certainly not suggesting that you do this, but sadly alot of people seem to think that because they pay their taxes it is their right to see the doctor straight away regardless of how minor the issue is..

Just because I pay X amount of tax each year does it give me the right to go to the drs every time I have a bit of a cough? Wasting their time and nhs money which could be used towards people who are truly ill. We are privalaged to have a service where we get healthcare when we need it, sadly many countries don't

FelinePrincess

bargainbetty wrote: »

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?

That is an issue, perhaps different fees could apply depending on the size of the family, so a single person might pay £15 but a family of 6 might be £4 each.. Perhaps those on benefits could have the fees deducted from their benefits (spread out over time if necessary) so anyone could see the doctor even if they didn't have the money in their pocket.

docjames_2

What about compulsory medical insurance which would cover a certain number of attendances and then everyone would have cover. Those with incomes under a set amount could have insurance premiums paid for by the government. This would then allow a top up charge for people with risky behaviour and lower premiums for healthy fit people? I think Germany has a similar set up and has an excellent health care system with fast access and far better outcome measures in virtually all areas!

Bronnie

Anyone else wondering if the OP is really a GP?

That aside, interesting topic for discussion in general terms.

docjames_2

I have simply asked a thought provoking question. I may have my own opionions but i for sure dont have any answers!

LillythePink

We have to pay for GPs in Guernsey - it costs £38 per time and that is with a subsidy from the states (local govt).

We pay for A&E visits, ambulances, dentists - the list goes on.

Our NI contributions were upped a few years ago so that we didn't have to pay for operations/specialists.

One of the normal benefits given to employees of companies in the finance sector is health insurance - our company pays full wack for everyone and their families - it's very useful as you can go private!

To be fair, our waiting times for ops/specialists isn't that long and you can usually phone up and get a GP app that day - sometimes within a few hours.

welshdent

Ah james welcome to our world!!! Although despite NHS dentistry being paid for by co payments for some 50 or so years ... people are still to this day surprised it isnt free!

The problem comes when anyone suggests ANY changes such as this there is a hysterical cry of privatisation etc etc etc.

Point a from me is ALL failed appointments should be chargeable. Not a huge amount but there should be a charge. We used to have this option and it was an excellent deterrent for failure. However thr DOH in their wisdom outlawed them and what happens .... an increase in failure rate! Who would have thought?!?!?

Personally I do not in principle have a problem with such co payments. We ALL pay NI but those of us working in the system are well aware of how pitiful the NI contributions are to the actual cost. Its a case of paying for a scoda but expectingv a rolls royce. So the obvious choices are pay more ... a LOT more ... or allow co payments IMO ... or a core service, which in medicine is clearly not workable unlike in dentistry. In dentistry you CAN achieve health with a basic service (not what all people WANT ... but health none the less) ... thats not really feasible in general medicine.

I do not think repeat charges for the same problem is right and I do not think that advised review appointments for the same problem is fair. I think a charge for the initial consultation is not OTT however.

Personally I have no problem with a private GP service for those that want it. Before I annoy people even more with the following views ... i do NOT agree with reducing funding FOR the NHS with the following discussion nor do I want a mass privatisation... nor however do I believe that hysterical dogma should be making or preventing decisions. I believe in the individual and their right to choose. I extend that to both the patient AND the worker.
I do not think it is right that the NHS has a monopoly and I do not think it is right we as people have little in the way of choice. Sure there is a private system of sorts but its not well developed and largely limited to elective procedures and the like. There is IMHO a major disinformation that health workers "go private" for financial gain. I absolutely disagree with this in the most part. It is VERY easy to swallow these stories up but to be honest unless you are involved in service provision you do not really get how it all works. Most undertake private work because usually the job is much more pleasant to do and you do not have pressures that are applied from all sides to meet the numerous centrally set targets. Many get the chance to do their job as they are trained to do.

Its not fair that the NHS/DOH have almost complete control over their staff simply because they have trained these guys up. They artificially create massive job shortages by holding back funding. there is no shortage of work to do but there IS a shortage of employment positions. I have a number of friends in medicine and surgery who are on various training pathways. They have no idea where they will be from one rotation to the next. They may be in cardiff one time and then sent to bangor for the next. Thats simply unreasonable IMO because these guys have no real choice. They HAVE to stay within the NHS system as there is no alternative other than leave the job completely. An old girlfriend left phyiotherapy because they continually failed to replace staff as they left leaving her covering 4 peoples posts. She just had a guts full and went off to do something completely different. After training a load of physiotherapists up they now do not have enough positions to employ them in!!! Its madness! Many end up doing something completely different. What a waste of tax payers money!

There should be a decent private alternative not just for us as patients to use if we want but also to employ those highly skilled individuals that can not get a job in the only sector able to employ them or those that would actually like to put some roots down.

ALSO this would probably benefit the economy. Private business creates tax money unlike public sector positions. Not to mention these peoples training will not be going to waste.

I also think they should free up practitioners to undertake outpatient work on an independent basis. Why not allow physiotherapists to set up their own clinics and allow them to accept NHS referrals as well as provide private care?? When its YOUR business you would be amazed how much more you will bend over backwards to provide a good service when your livelyhood depends on it!! If an individual was allowed to set up a private clinic and take in say musculo skeletal rehab they would need to a) employ staff thus benefiting the local economy and would be able to tailor appointment slots to fit in with patient needs and if the NHS will only pay for 1 session a week and it is felt more are needed. If the patient is prepared to pay for it and would have otherwise sought services privately anyway ... there is continuity of care!

I have access to a private GP surgery which I need to use because I can not just take a day off work on the off chance that I may be able to get an appointment if I ring between 8 and 8.30. I want to be able to make an appointment in advance at an acceptable time. There should be a better system in place where I can do this. I do not expect special treatment nor do I expect the NHS to provide this as its already strained. But likewise dogma and hysteria should not place an artificial paralysis as it does now.

None of the above need reduce NHS funding and they may even benefit from a decent competitive service!!!


I know I am likely to attract a great deal of hostility for my views ... but we are all entitled to an opinion.

FWIW I think many of the inflated salaries people brandish about to justify why medical practitioners need pay cuts bear zero correlation to reality. With dentistry there is a major misconception we are on a salary. Utter nonsense. Oh and if I were on the figures in the press, believe me I would be a very happy bunny!! Not correct though.
Lets not let what people earn cloud suggestions for improving a service ....

like i said, in principle no problem with co payments docjames!

docjames_2

Thank you to LillythePink and welshdent for their interesting comments!

I hear from many sources that the healthcare system in Germany is excellent! In fact, some Uk patients are going privately to German clinics for some treatments!