18 Jun 2014

The doctor will see you now – for £10?

Nurses vote overwhelmingly against charging patients a fee for appointments with their family doctor. Do you think you should pay to see a GP, if it saves the NHS money? Vote in our poll.

The Royal College of Nursing (RCN) has traditionally backed the belief that the NHS should be free at the point of delivery.

And nurses maintained this stance on Wednesday, with 91 per cent of RCN members voting against the motion at the annual conference in Liverpool.

A hospital nurse in London, Andy McGovern, had proposed the motion, and told the Daily Mail that research suggested a fee could be anything from 57p to £10. With 12 years experience, he said that a fee could deter patients with minor ailments or “self-managed” symptoms from going to the doctor and could potentially reduce the number of missed appointments – which in turn would save the NHS money.

The motion at the RCN conference follows a similar debate among doctors just weeks ago. Making certain patients pay a fee for some services would “emphasise the value” of GPs, the British Medical Association’s (BMA) local medical committees conference was told in May.

GP charging is a controversial topic and one that goes to the heart of the debate about what the NHS is and should be Dr Peter Carter

While nurses overwhelmingly rejected the proposal, an RCN spokesman said the organisation welcomed the debate, and said that there needs to be clarity over how much money the health service will have in the future – only then will officials be able to properly plan what the NHS will look like in the future.

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Cost of missed appointments

In April, a commission set up by the King’s Fund think tank said that the current health and social care model is not longer fit for purpose, and suggested that charging patients for some NHS services could be one way to tackle the crisis.

The commission led by economist Kate Barker is yet to make firm recommendations, but its interim report said that “hard choices” needed to be made and said a number of options should be considered, including: charging patients for hospital and GP appointments, extending dentists’ fees and removing the blanket exemption for over 60s prescription charges.

The commission’s report also suggested introducing fees for missed appointments. Figures from March suggest that over 12m GP appointments are missed each year in the UK, costing over £162m each year.

In terms of outpatient hospital appointments, an additional 6.9m are missed each year, costing an average of £108 per appointment (according to 2012/2013 figures).

‘Survival of the richest, not treatment of the sickest’

The proposal to charge patients for GP appointments has been slammed by a number of leading medics including the former chairman of the BMA’s GP committee Dr Laurence Buckman, who said it would lead to: “survival of the richest, not treatment of the sickest.”

However RCN Chief Executive and General Secretary Dr Peter Carter said nurses were not afraid of having “difficult debates” about the future of the NHS.

“Charging patients for GP visits is a controversial issue – one that goes to the heart of what the NHS is and should be,” he said. “Today, nurses and health care assistants have reaffirmed their passionate belief that the NHS should be free at the point of delivery.

“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.”

A Department of Health spokesman said: “We are absolutely clear that the NHS should be free at the point of use, and we will not charge for GP appointments.”