Should people have to pay to see a GP?

Torry_Quine

MrsE wrote: »

I think it would be much better if doctors were not allowed to write prescriptions for any items you can buy over the counter in the chemist.

That would soon cut down on needless appointments.

Also, charge (fine) for missed/late appointments:D

I sometimes get drugs from a prescription which are OTC. This is because I use the drug every day and so can get a larger amount than is available without a prescription and as I have a PPC would be paying out every few days.


It isn't always as simple as people sometimes make out, I don't go to see the GP every time I need something and do buy most things at the pharmacy but as I am on several drugs I often need to check if things are suitable.

docjames_2

welshdent wrote: »

The problem with HMG is they generally listen to the wrong people. They listen to accountants who tell them how much things cost but can not apply a value, they listen to the DOH who seem to be stocked with people protecting their own positions and they listen to people that tell them what they want to hear! They would be better served getting those that actually do the job to convey concerns and provide solutions. Seeing as we are the ones actually delivering their service you would think we had a bit of an idea

The problem is that the NHS is unsustainable in its current form so if they listen to front line services, the results will be a change in the service which is usually a vote loser! The general public (through no fault of their own) are unaware of how inefficient the service actually is and how much better it could be! Imagine a service where you phone to see a doctor in the morning for lets say gallstone type pain - you get seen at the time of your choice that afternoon - the investigations are arranged for later that week and the operation is done a week later. Happens like this privately in the UK and i assume in lots of other places in the world. on the NHS you would be looking at abot 6 months for that entire journey unless it became life threatening.

sweetcheeks33

People dont value the current system due to the fact that usually it is extremely poor. For example my friend recently had a baby and was sharing a room with another girl. She was taken to the bathroom in the room to have a shower and left in there. She fell and hit her head and as brought out the bathroom to be treated there was a trail of blood. The blood trail was still there 4 DAYS later when my friend left despite it being poointed out several times a day!!

My grandmother was allowed to walk into my granfathers hospital room and find him dead when he was in hospital without any warning before had despite him being pronounced dead 30 mins before hand.

I am sure every one has horror stories to add also. I have medication each month and I pay for my prescriptions pass every four months to cover this. My Gp is regularly running very late( i appreciate that peoplles individual app's do run on) well passes time. I would happily take longer precriptions for items rather than going back but unfortunately i require to go back also most every three months.

I work in social work/health care, peoplles attitude of people on benefits or lacking in money will just not go to appointments if they have to pay nor will they take there children on routine app's if such things are introduced. The social work services in this country are crippiling with numbers my caseload in extrmely high double numbers and I do my best for evey numberr however is near impposible to add health care provision and encouraging clients to attend this also.

I dont know what the answer is but it certaily isnt to follow the way of the dentist very few of my clients attend despite trying to encourage and support to do so.

Although the way the torries are going this could be the next move .....

Eton_Rifle

Yes, I think nominal fees should be charged (with exceptions for pensioners and severe long-term disability etc) for every single access of NHS services.

It would encourage people to take responsilbility for their own health.

ceebeeby

A hospital outpatient appointment costs approx £125 at the moment, and suffers from probably a greater degree of DNA's because the appointments were made longer ago / people get better / get worse and die / can't be bothered.

How many times should someone be allowed to DNA and still get new appointments? 1, 2, 3 ... infinity?
What if the person DNA ing is a child - same rules?

Being "free at the point of delivery" means it is massively open to abuse by the very people it's set up to serve as the 'patient' has nothing to lose as the system currently stands. Yes - you can be referred back to GP as a DNA for a non-urgent referral, however, your GP can just re-refer you (another charging opportunity perhaps??). Most doctors / hospital will over-book into the anticipated DNA rate (whether this is 10 - 30% dependent on specialty) the massive disadvantage to this is that if on the odd occasion, everyone does turn up, you then have all these extra patients you have to see in the same slot, pushing everyone on the clinic into shorter appointments, longer waits in clinics (the alternative is to have dr's sitting around twiddling thumbs with massive waiting lists building up behind).

Not everyone contributes to the NHS Insurance Contributions. I strongly strongly disagree with any concept of some sort of tiered payment system. If you don't make benefit claimants pay the same as a salaried person you are missing your greatest percentage of DNA "offenders" and once again charging those who do, for those who don't (a bit like us all paying extra for all those pesky shop-lifters I suppose!) The difference is, with DNA ing someone is taking away someone elses' opportunity for good quality health care and do they care?

Then there's the flip of the coin ... if the NHS is going to charge patients for missing appointments, should patients charge the NHS for short notice cancellations / major over-runs especially if the patient is able to demonstrate actual charges incurred (half days salary; travelling expenses; child care etc.) because if the system is going to be set up as a pay at point of service then there has to be an enhanced quality. I don't mean in some sort of litigious environment way - I mean as point of fact - i.e. 1 hours late = £10 / 2 hours late = £20 plus free reappoint if patient wishes.

Free re-arrangements if greater than 24 hours notice
No charge appointments if patient willing to take -24 hour cancellation slots and appointment has already been charged to someone else (might help those on low income)
Reduced charge appointments for 'unpopular' times of the day (08:00 - 09:30) / (17:00 +)
Premum charges for popular times of the day (09:30 - 17:00)

I can't see this happening anytime soon, but I wouldn't be holding up any objection flags to payment for appointments!

funguy

Anything that encourages people to take responsibility for their health is good. But how do we discourage people to do things that are bad for their health when they want or demand the NHS to solve these problems repeatedly despite not listening to advice from the healthcare staff....im sure they would listen if they had to pay for another consultation! If they didnt listen then at least it would have less impact for the taxpayer!

welshdent

sweetcheeks33 wrote: »

I dont know what the answer is but it certaily isnt to follow the way of the dentist very few of my clients attend despite trying to encourage and support to do so.

Although the way the torries are going this could be the next move .....

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.

re going the way of dentistry .... when do you think dentistry went "that way" (through no fault of the dentists I hasten to add) ... and what IS that way?? co payments?? they came in some 50 years ago. free dentistry was actually only available for a couple of years. For those in financial hardship most can get an exemption and even if it isnt, in desperate measures, necessary extractions can be provided for less than £50 ... ALSO all dental problems discounting oral cancer are preventable. Decay, gum disease - all self inflicted. My job is to try and get patients back to health not just by immediate management of their condition but by educating them so they do not experience the problems again. Personally I think I provided a damn good service!

freyasmum

welshdent wrote: »

vedder missed appointments is a HUGE problem across the whole of the NHS. Many people have no value on the sevice they are provided. Maybe its because there is no perceived cost to the individual hence the lack of value? Just a thought

Before I start, I am NOT comparing my business to a doctors surgery or a dentistry practice But, missed appointments are a huge problem everywhere.

It all has a knock on effect, and I defintely agree re the no perceived cost; people have a strange logic whereby the more the spend, the better or more important something is. People have a lot less respect for others and their time these days It's such a shame neither of you can do the three strikes and you're out rule!

Btw, I don't agree with the totally free prescriptions for all either.

sweetcheeks33

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.


The conservative goverment do not believe in the welfare state and nor do they hide this so it is not political dogma ......

welshdent

Oh come on guys! Let's keep it to the thread discussion not political point scoring. None of us claim to be in politics and have little if any clout. Fwiw labour claim o be the champions of all things nhs and social yet IMO they did a hell of a lot to screw things up today. Tear claims to have reduced waiting lists is IMO laughable as someone that regularly tries to get my patients seen! What does that tell you about them? To me it says both sides are rubbish at handling the health service!!!