Let us charge patients for extra services, GPs urge – is this “decommissioning”?

Should there be any “Extra” services in a cradle to grave health service as devised in 1948?. More and more services can be seen as “extra” depending on the political whim/philosophy of the day. Perverse incentive need to be made overt, and if minor surgery on warty lesions becomes the norm, then patients could be conned. The doctor-patient relationship has been a clean one to now…is this “decommissioning”?

Chris Smyth reports in the Times May 5th: Let us charge patients for extra services, GPs urge

Image result for sterling money cartoon

GPs are demanding to be allowed to charge patients for extra services to ease an NHS cash crisis and evade rationing.

Doctors want to offer vaccinations and minor surgery not available on the NHS, saying it will be more convenient for patients and cut down on bureaucracy.

Nine local medical committees representing GPs from Northumberland to Cornwall have asked the British Medical Association to support a change in the rules, saying they are hopelessly out of date and constitute restraint of trade. Some say the change could allow general practice to develop as a “truly commercial entity”….

Ben Molyneux, vice-chairman of the City and Hackney local medical committee in London, who will present the proposal at a conference in Edinburgh this month, said it was about “allowing patients to get the non-NHS services they want to receive from the GP they know, at a surgery near to their home”. Some patients are not covered for vaccines such as shingles or the HPV anti-cancer jab on the NHS and Dr Molyneux said it would be easier if they could pay their own GP, rather than going to another surgery. At present patients can pay other GPs, but not their own, for such procedures. The rules are said to exist to prevent distortion of the patient-doctor relationship.

Dr Molyneux said: “This adds to the pressure on short-handed GP surgeries as one patient ends up requiring multiple appointments and a new set of medical notes taking for a vaccine which is usually medically advisable.”

Prit Buttar, a GP in Oxfordshire, said allowing more private work would attract new doctors and raise money, but conceded: “It may well be more contentious when you have something like evening opening, [if] a practice could earn more opening privately in the evening than it could from the NHS.”

If the plan is backed, it will become a policy of the BMA’s GP committee, which negotiates contracts. NHS England has rejected similar requests in the past.



This entry was posted in A Personal View, Commissioning, Perverse Incentives, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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