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Should we charge for GP appointments?

  • Comments (2)

A few weeks ago nurses at RCN congress hotly debated a controversial resolution to introduce a standard charge for GP appointments. Thankfully it was overwhelmingly rejected.

My concern is charging, while dressed it up as an attempt to discourage non-attenders, is just a strategy to control supply and demand.

What happens when a patient with difficult asthma or COPD puts off seeing their GP, ends up in A&E and is admitted with uncontrolled asthma?

The recent report on asthma deaths provides clear evidence of poor outcomes for patients who fail to access services and we need to be wary of putting barriers in their way. We need primary care to be more open and accessible for these patients to prevent them becoming trapped in the revolving door of readmission with its associated costs.

“We have a problem with funding health care, but charging for GP services is not going to resolve it.”

We already see patients rationing their own health care because of worries about prescription charges. GPs and pharmacists report incidents where patient ask to prioritise the most important drugs and take a chance on not taking the others because of costs.

We all have to resist this steady creep towards rationing state-funded health care services and ensure that the NHS remains true to its founding principles of free at the point of access. We need to think carefully about the effects of charging on our most vulnerable patients and for the public health of the nation and make sure we speak up for the people in our care.

We have a problem with funding health care, but charging for GP services is not going to resolve it.

Surely, this will just put pressure on another part of the system. What we actually need is a grown up conversation about how we pay for healthcare through taxation.

But once charging is introduced the system will no longer be universal and those who can afford will benefit most. Is that right? Is it just?

  • Comments (2)

Readers' comments (2)

  • michael stone

    I agree with you Eileen.

    I recently heard the 'charge for visiting your GP' issue debated on BBC Radio 4, and the 'against' arguments included:

    1) As soon as people are paying, they see it as a 'service' much more: in consequence, the 'wealthier worried-well' turn up in much greater numbers, so GPs become even busier;

    2) The genuinely-ill poorer patients, are discouraged from seeing their GP early, by the charges: so when they do visit, they are already quite well-advanced in terms of their illness, and this makes treating them more difficult and expensive.


    However, this one gets 'political' very quickly - both sides will come up with their own arguments, specifically to fit their position: only a minority of people are going to examine all of the arguments, and then arrive at their position.

    I must admit, to being influenced that way myself: I think that the NHS should be paid for from general taxation, pretty much 'full stop'. Which I take to be your own postion, from the end of your piece ?

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  • bob cat

    Agreed Eileen.

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