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"Charge £10 for GPs Visits" What you think?


Demitri_C

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Charge patients £10 a time to see GP, urges doctor

Payments could stop people needlessly visiting surgery

By PA, Jan 7, 2016

Updated: January 7, 2016 2:30 AM

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Patients should be charged £10 every time they see their GP, a doctor has argued.

David Jones, a foundation year 2 doctor in diabetes and endocrinology at Worthing Hospital, said a payment for each visit would ensure people thought twice about whether they really needed to see their doctor and could raise billions of pounds.

Writing in the British Medical Journal (BMJ), he said the UK should follow the lead of Australia, which charges for GP visits.

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"Given that the average patient visits their primary physician 5.5 times a year, a £10 fee, which most GPs would find acceptable, could raise billions of pounds," he said.

He said changes may offer other benefits too.

"These include a reduction in missed appointments, which are estimated to cost the NHS £162m a year," he said.

"They might also encourage patients to take more personal responsibility, leading to fewer people attending with conditions that they could manage themselves or that would be better managed through other primary care services (pharmacists, dentists, nurses, etc).

"This would lead to greater service availability and shorter waiting times in general practice."

He said in Australia people do not see co-payments as unethical, adding "it is the norm".

Patients in the UK already pay for prescriptions and dentistry, which showed they accepted that entirely free healthcare was not sustainable, he wrote.

He also argued that annual GP attendances per person in Australia are comparable with those in the UK, which suggests that co-payments "are unlikely to affect care seeking behaviour or overall health."

In an opposing view, Nancy Loader, a GP partner in Suffolk, said co-payments altered the doctor-patient relationship.

She added: "Co-payments can deter doctors from asking patients to return for review or deter patients from meeting your request. They can deter patients from seeing the GP as advised after medical or surgical discharge from hospital.

"They can encourage patients to collect multiple problems to discuss in a single consultation and pressure doctors to deal with them all at once. And they can encourage unnecessary prescribing or referral - 'I've paid, do as I say'."

She argued that countries that have introduced co-payments have seen "increased health disparities with no change in patient demand", and rising levels of bureaucracy.

Professor Kamila Hawthorne, vice chair of the Royal College of GPs, said: "GPs have a duty to provide healthcare to patients regardless of their ability to pay and the college is against charging patients for GP appointments - a move that would fundamentally change one of the founding principles of the NHS, that healthcare is free at the point of need.

"Even introducing a standardised fee, which is then subsidised by the Government, would undoubtedly deter many people from seeking medical help in the early stages of illness when they can be dealt with cost-effectively and efficiently in primary care, rather than requiring expensive specialist care in hospitals.

"Charging for appointments would also be a lot more complicated than it sounds - where does it stop? GPs make contact with patients in a variety of ways, would a charge just be for face to face appointments, or phone calls and emails as well? And if charges extend to house calls then there are serious safety implications to consider as GPs could be targeted for carrying cash."

 

just click it

Well what do we think of this proposal? I don't know about anyone else but its a nightmare trying to get a GP appointment in its current form at the moment but I don't think this is the answer. What will start at £10 will eventually go up and up. I think this is just another way to get money out of people...

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Terrible idea

"They can encourage patients to collect multiple problems to discuss in a single consultation and pressure doctors to deal with them all at once

but what about in GPs, like mine where you are only allowed to have one "issue" per appointment?  It's  unworkable. I sympathise over missed appointments, and perhaps there's room for a strike list, missing 2/3 appointments without warning and you incur a charge then possibly, but a flat fee for every appointment? Insane, and at £10 that is a lot of money. My partner has a condition that requires regular check ups throughout the year with blood tests every few weeks. £10 a visit suddenly costs us north of £150 a year, which is no small amount for us.  If they have exceptions for ongoing conditions, which exceptions are allowed and which aren't.

 

I recognise the problem with waiting lists, I have to wait two weeks normally which is just daft, but flat fees for me aren't the answer. Penalty fines for missing ones with no good reason maybe.

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6 minutes ago, TrinityRoadSteps said:

And what happens to the people who do need to see the doctor but can't afford the fee

I saw a discussion about it on the news yesterday and only those who can afford it would have to pay, but to enforce the rule sounds like it would wipe out a fair chunk of the money they raise anyway.  I can understand fining people who don't turn up and wasting time (though I suspect missed appointments actually aid the smooth running of surgeries anyway in terms of reducing delays).

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Instead of charging patients £10 to attend, why not charge them £10 when they fail to attend without notifying the surgery? This has been a masisve issue for years and wastes of lot the time and money. just like thedentist if I dont let him know I get fined

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I like the idea of cutting out the people who waste time by turning up for nothing.

But it makes me uneasy that people might be dissuaded from going because of the fee.

"Is that a lump? Should get it checked out... can't really afford it though. It'll be fine"

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£10 and all it's admin and means testing and invoicing is a piss poor idea 

It's very rare I need to use my doctors but when I do I've never had a any issues. I don't know if my surgery has an unusual bookings system, but you phone up the day you want the appointment. By chance, I just did, I called them about 15 minutes ago and my appointment is for 3:00pm.

You can't book days in advance, so you can't forget / get better / dwell on it for a week and change your mind. If you miss today's booking slots try again tomorrow, if you can't wait until tomorrow, it's not a doctor's appointment you need.

Holiday jabs, repeat prescriptions, weighing fatties, blood samples and all that shizzle is dealt with by nurse / sister / admin. 

How **** difficult is that?

 

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The present system of deterring people from attending seems to be working fine.

Inability to get an appointment, crammed waiting-rooms, always running late, jobsworth reception staff, irritable doctors and 2 minute consultations, plus the ever-present assumption that because its 'free' and run by martyrs you are required to be grateful.

 All these things seem to deter most people, well enough already.

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32 minutes ago, chrisp65 said:

 

Holiday jabs, repeat prescriptions, weighing fatties, blood samples and all that shizzle is dealt with by nurse / sister / admin. 

 

 

I had to get my jabs for Thailand done by nurse was fairly quick, but when you need to see a doctor its a bloody nightmare. You ring up all appointments are gone, then they say call next day do the same and then you get exactly same response. in the lucky occasion you do get appointment, I have 10:30 am but then you point out you have work. "Sorry thats all we have"

 

the 7 day in advance system was so much better. I am guessing this was introduced to reeduce the amount of DNA's from patients

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I've had a bad cough since the end of September after lots of pestering I've booked an appointment. It's likely to be nothing apart from a cough that is just taking its time to shift but it's hardly going to help people like me who don't want to waste gp's time but sometimes probably should get things ruled out before it's too late. 

 

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tough one  .. I commented before about the TV show ( think it was on Ch 4) based in a Doctors surgery where about 90% of the visitors were lonely old ladies wanting someone to talk to  and the other 10% were people who wanted medicine just so they could tell everyone they were on medication to elicit sympathy  .... chances are the £10 might put a stop to this , though arguably it needs to be a higher fee in order to work ?

but the thought of someone saying I've got this lump but I don't have £10 so I wont bother getting it checked is also quite abhorrent

 

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2 minutes ago, chrisp65 said:

am I right in thinking you guys over in england are paying for your prescriptions?

 

Yeah, it's about £8ish per item I think (for an adult). Do you not have to pay in Wales?

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Yeah, it's free here - but they do tell you when their internal invoicing / prescription costs are more than the medicine and then you can choose to buy it yourself, i.e., they'll hand you a prescription for cough meds and point out that the script is free to you, but costs the NHS about £8 minimum but the cough meds are available off the shelf for £3.99. It's still free if you want it, it's just a sort of self regulating thing for the virtuous folks with money.

Next question. Talk up above about ages to get an appointment - I guess you folks can book a slot by internet but just don't bother? There's no listening to recorded messages or getting past nosey receptionists anymore.

Or do I live in some little NHS nirvana bubble?

 

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its an unworkable system. 

It'll be means tested so if you work and pay for it via tax on your salary, and pay for the prescriptions, you will also now have to pay to see the Doctor. A triple whammy. The people who don't pay already, by whatever means, won't be charged for this. Its just another tax for the worker.

 

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