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RCN rejects introduction of charges for GP consultations


Millions of patients would die if charges were introduced for GP visits, according to members of the Royal College of Nursing.

They voted overwhelmingly against a controversial resolution proposing such charges at the RCN’s annual congress in Liverpool this morning.

In one of the most passionate debates at the conference so far, 91.77% of congress voted against the resolution, 8.23% voted for and there were nine abstentions.

The wording of the resolution was: “That this meeting of RCN Congress believes a fixed fee should be charged for GP appointments.”

It was proposed by Andrew McGovern, from the RCN Inner North East London Branch.

He said: “I know this will be tough to debate” and “I don’t suppose this will be a popular motion”.

However, he said he proposed the resolution because GPs were revealing non-attendance rates were soaring, with one doctor saying 14 patients did not show up for an appointment.

In its evidence supporting the resolution, the branch quoted research by the think-tank Reform, which estimated that the introduction of a £10 fee for GP appointments in England would equate to £1.2bn increase in funding for the NHS.

It was the most popular debate of the week, with nurses clamouring to have their views heard. There were 63 members in the queue to speak at one point, and speaking time was reduced to one minute each.

RCN members overwhelmingly spoke in favour of keeping the NHS free-at-the –point-of-use.

Queen’s nurse Heather Henry said introducing charges would create much greater health inequalities.

“I am shaking with horror at this resolution,” she told congress. “If we charge, people will present later with more symptoms.”

Most nurses felt that this would penalise the poorer people in our society, a point picked up by Dave Dawes, a member of the RCN’s North West Regional Board.

He said it was “easier to get tickets to Glastonbury than it is to get to see your GP”, but said charges for NHS services was not something that people in this country wanted to see.

“We do have a system of paying for NHS services,” he said. “It’s called taxation.”

The Times newspaper had carried a story ahead of the debate suggesting nurses would vote in favour of the resolution.

It drew criticism by nurses on social media website Twitter for suggesting that nurses were in support of it before the debate had even been held.

The Daily Mail ran a similar story in which health secretary Jeremy Hunt was quoted as ruling the move out.

None of the UK governments are currently seeking to introduce GP charges, and the idea is strongly opposed by the British Medical Association and the Royal College of GPs.

But RCN chief executive and general secretary Peter Carter said: “The future funding of the NHS is shrouded in uncertainty and we need clear direction from our politicians about the way ahead so that clinicians and commissioners can plan for the future.

“As the general election approaches, the public need to know where the parties stand on this vital issue.”

He added:“Charging patients for GP visits is a controversial issue – one that goes to the heart of what the NHS is and should be.

“Today, nurses and health care assistants have reaffirmed their passionate belief that the NHS should be free at the point of delivery.”


Readers' comments (11)

  • Perhaps the board could consider a slight amendment to the up front charge of £10 a visit to your local GP. If i miss an appointment with my dentist i will not be seen until the £30 non attendance charge is paid in full.

    I have only ever missed that one appointment slot!

    Perhaps we should be thinking of addressing the issue of non attendance at GP appointments with a did not attend price tag of £10-30. This may be an alternative to address the large numbers of patients who feel that this is acceptable in todays financial & patient centered environment.

    It is extremely frustrating in health care environments where patient slots are lost through non attendance / DNA's. This is not just about financial impacts/constraints but also about our moral duty to each other to ensure that we maximise the care offered to our citizens. For every 1 DNA that results in another patient having to wait for the same appointment even longer. (Moral DNA) this can cause varying problems for those patients who are vunerable.

    Thank you for listening


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  • How much would GPs be paying to patients who sit, in some cases in the surgery to be seen? This is the worst idea anyone could have come up with. just because it will raise 1.2 billion pounds for the NHS does not make it a good public policy alternative. So people will not see their dentist unless they really fill sick or bothered by some health issues, which by them the problem may have escalated. We might as well abandon the whole premise of the NHS. I live in Canada now, I can assure you, the UK health care system, though not perfect, is the best in the world. One does not need to introduce fee charges at the point of use to correct any anomalies.

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  • There is a term called the thin edge of the wedge.

    If this call for a fee was carried it would have cause untold misery.

    If a patient does not attend that frees the Doctors time up. Currently the average time GPs spend with a patient is approximately 10 to 15 minutes. This equates to the fee being in reality £40.00 per hour.

    It is also normal to attend for an appointment and have to wait for 1 hour so does the GP get charged for this by the patient?

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  • I am shocked that a nurse (I assume Andrew McGovern is a nurse) would propose such an idea. This will affect the sickest and most vulnerable of society the most - those who most need to see the doctor to get treatment. It would result in even greater pressures on A and E and acute hospitals as patients would be admitted sicker and the mortality rate in this country would escalate. Preventive care would go out of the window and i suppose all this would save the NHS money but at what cost!!!

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  • A similar move to charge patients an up-front fee of $A7 (~GBP3.90) has been suggested by the current Australian conservative government as a health budget measure. We are, in Australia, facing similar concerns over the capacity of our taxes to fund our universal health care system. The up-front fee is opposed by both nursing and medical unions. The plan suggested for the UK sounds very similar: "research by the think-tank Reform, which estimated that the introduction of a £10 fee for GP appointments in England would equate to £1.2bn increase in funding for the NHS."

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  • How about tackling the problems of health tourism, people not entitled to use our NHS doing so and leaving without paying and our limp wristed administrators doing nothing to recover this money. Probably cover the £1.2 billion or go a long way towards it rather than targeting the usual elderly and vunerable sections of our society.

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  • "research by the think-tank Reform, which estimated that the introduction of a £10 fee for GP appointments in England would equate to £1.2bn increase in funding for the NHS."....and the people who would be billed will be for a large part those that cannot afford even £10. Not only that, what are Reform's costings for chasing those bills I wonder?

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  • does this vote carry any weight?

    the public are very unsecured by all of this. cf the comments in the Telegraph.

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  • Precription charge is high enough, already I do not get a drug if I feel I can manage without it.
    GPs' are highly paid for the work they do.
    I have come across GPs' who are not even very good and I feel it would be better to have walk in centers open all hours, instead of the cosy opening times GPs have. Any good doctor will do for me, GPs have had their day.
    It appears the ordinary man/woman always gets hit with proping up structures that are not working as it should.

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  • Anonymous | 23-Jun-2014 3:08 pm

    I agree. maybe GPs should be phased out or at least they should be on a par with other specialists so that patients can choose who they consult as in other countries. I agree with centres which they also have elsewhere and the UK is the last country, apparently in the world to adopt this very archaic and ineffective and potentially damaging paternalistic, monopolistic gate keeping system run by GPs.

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