would the British public be happy to swap a shorter GP consultation time for a longer one that involved payment of it and additional services?

The quality of your GP appointment is important. This of course includes clinical skill, communication and cultural affinity, and understanding “where the patient comes from” or in RCGP terms their “ideas,concerns and expectations”. Older and more complicated patients need longer than 10 minutes, but the RCGP exam is predicated on this time for each consultation. Brutalising the profession is also brutalising the patient, but this is more likely when there is general and longstanding undercapacity. Sweden and New Zealand have shown that co-payments reduce demand. A pragmatic compromise thus encourages patient autonomy and self-sufficiency, allows resources to go further, and consultations to be longer. Should the price to ration appointments by co-payment be equivalent to two pints of bitter ad a packet of 20 cigarettes?

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Sarah Kate-Templeton reported 8th January 2017: GPs tell patients: Just one illness per appointment and then Chirs Smyth, also in The Times, reported 9th November Patients in Peru get more time with their GP than in Britain

LENGTH OF GP APPOINTMENTS – A Times letter from Annika Nestius-Brown 11th November 2017
Sir, You report that British patients visiting their GP are allocated half the time of people in places such as Sweden, where patients are given 22.5 minutes (“Patients in Peru get more time with GP”, Nov 9). What is missing from this information is the context. How and why can Sweden offer this superior service? Perhaps it is because patients in Sweden pay part of the cost of visiting their GP at each visit, and do so even if they are unemployed, a pensioner or a child. Patients in Sweden also part-pay for their stay in a hospital, such as in the case of my 76-year-old father, who received a nominal invoice for his week-long stay when he had a brain tumour removed last year. Moreover, some local authorities in Sweden also charge a small fee for transport to the hospital by ambulance or helicopter.

In Sweden, not even the chronically ill two-year-old child of a single unemployed parent is exempt from prescription charges, although these are capped at an equivalent cost of about £100 a month.

Which raises the question, would the British public be happy to swap a shorter GP consultation time for a longer one that involved payment of it and additional services?
Annika Nestius-Brown

London W14

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This entry was posted in A Personal View, General Practitioners, 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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