Comparing the UK with other G20 health systems – there are none without co-payments. The pragmatic decision to ration care has been faced and taken by others. Why are we so incapable? What would a 2014 Beveridge report say?
It’s desperation time.. Suggestions for registered patients paying to see registered GP are illegal: so the rules would need to change .
Dennis Campbell reported in the Guardian 8th Feb 2017: Fears of ‘two-tier NHS’ as GPs allow fee-paying patients to jump the queue MPs claim Dorset Private GP service, at up to £145 per appointment, will mean NHS patients without money will wait even longer for care
GPs are considering charging patients for certain services to avert what they say could be a total collapse of general practice.
They will also vote on whether to close their lists to new patients in protest about a lack of resources.
Yesterday doctors at a British Medical Association meeting in Edinburgh asked the organisation’s general practice committee (GPC) to consider alternative funding options. The move would pit doctors against the government, which says that it has no plans to introduce charges for consultations.
Richard Wood, of the Buckinghamshire local medical committee (LMC), said: “I’m not asking us to choose privatisation. I’m not asking us to choose to charge the vulnerable in society. I’m asking to educate ourselves, to put us in the best possible position. We don’t have to choose the options, but we do need to know they’re there.”
Chaand Nagpaul, chairman of the BMA’s GP committee, told doctors: “The plight of general practice remains parlous and on the brink of collapse”.
He highlighted research showing that one in ten practices surveyed by the BMA said they were not sustainable. “Even a seemingly secure practice is just one partner away from retiring to set off a domino effect which could lead to collapse,” he said.
The conference also voted for a ballot on whether GPs would be prepared to unite in closing their practices to new patients. The motion, which was passed narrowly, said that NHS England’s plan for primary care, the GP Forward View, was “failing to deliver the resources necessary”.
Jackie Applebee, from Tower Hamlets LMC, said: “Time after time we say the GP Forward View is an inadequate sticking plaster for the GP crisis. We rail against the hoops we have to jump through for tiny little pots of money. Let’s stop banging heads against the wall. If the government was listening they’d have increased GP money ages ago.” While closing lists might hit patient access in the short term, she said that “it wouldn’t take the government long to realise our value”.
She added: “If we do nothing we will collapse and there will be no access for anyone . . . How can we carry on as we are? If not now, then when?”
Mark Sandford-Wood, an executive member of the GPC, said that a similar question posed in a survey had been supported by only 34 per cent of respondents. The BMA had taken legal advice that suggested such action would “likely be a breach of contract”. He added: “‘The BMA could be found to be inducing it. There are risks to this.”
In 2015 NHS England said that practices could “informally” close their lists if they faced short-term problems in finding adequate cover but would need to then ask for help to fix the problem.
A day earlier doctors backed calls for the government to allow GP practices to charge their own patients for non-NHS treatments. NHS England has rejected similar requests in the past. Such treatments could include services such as flu jabs for patients not eligible on the NHS.
The call was led by Ben Molyneux from City and Hackney LMC. He said: “We shouldn’t be sending patients off to unknown private services, they should be able to see their own GP in the comfort of their own practice.”
Richard Vautrey, the GPC’s deputy chairman, told Pulse magazine: “We will have to put it back on our negotiating agenda and try to persuade them that it is actually a safe thing for them to do, and it is in the patients’ best interest that a practice that they trust is able to do these types of procedures.”
Charging people to see their GP may seem a somewhat perverse idea. Wasn’t the central founding principle of the health service the rejection of price as a way to allocate health care? Wouldn’t charges be unfair and the very abnegation of this principle?