Introduce charge to see GP, ManDoc or receive treatment through A&E

There should a nominal fee (£10-20) to see your GP.

To prevent people just turning up at the hospital to avoid the fee, the charge would also have to be applied to ManDoc and A&E.

These services effectively become (very) heavily subsidised rather than free.  

 

Why the contribution is important

This may help reduce the amount of missed appointments and would prevent people taking up the GP's time with minor ailments which could be dealt through pharmacies or by getting advice online.

It would encourage people to be proactive in managing their own health.

It would create a small revenue stream for the health service.

by AndrewIgoea on June 28, 2018 at 12:57PM

Current Rating

Average rating: 2.0
Based on: 14 votes

Comments

  • Posted by eric June 28, 2018 at 13:21

    Need to be careful not to put off the most vulnerable in society going to the doctors because they are worried about the cost. Perhaps allow a certain number of visits (accounting for follow-on appointments) before charging? Also perhaps have some form of means-testing for this idea?
  • Posted by Manxresident June 28, 2018 at 13:40

    Perhaps it would be worthwhile to consult GPs and Practice Nurses to see where they think their resources should be focused and where they feel they are not as effective. For example, it may be that many appointments are given to people who do not need to see any medical practitioner - that their concerns could be addressed by a pharmacist or that they do not need medical help from anyone. Whilst many of us may have the view that some customers are time wasters, only those properly trained medical practitioners will know this and who could then advise on how to dissuade these people from booking appointments, perhaps by introducing a fee. I personally would not mind paying to see a Practice Nurse or Doctor: they are professional people like dentists and lawyers and those of us who pay to see them would not question the acceptability of doing that. I would have concerns about a means-tested system whereby people who work hard for whatever level of income they have, must pay to see a Doctor or Nurse when they genuinely need to, when those who may not have to pay due to limited income, could see the Doctor or Nurse whenever and for whatever they may wish, whether the medical profession think they need to see them or not. Perhaps the medical staff should have the power to not accept appointments where they don't think there is a need for them?
  • Posted by NatureGeek June 28, 2018 at 13:46

    Would it be right to charge people that are pregnant, have a low income, have a disability or chronic illness, or are retired? There also may be people that suffer from mental health issues that have a problem with leaving the house, either through anxiety, depression, etc. There would be a few but very tragic cases where people fell through the cracks and those are often the people that need the help the most; the consequences of them not getting the support they need ends up being a lot more expensive to the healthcare system in the long run. I think before you start charging there should be a campaign to educate people about how much each missed appointment costs the NHS and that people who persistently miss appointments should be called personally and interviewed to ascertain the problem. I think you would find that only very few individuals persistently miss appointments through negligence and that those specific offenders could be dealt with in another way, be that a fine or something else, if it has to come down to money. Wasn't there a case only recently where a young child died of an asthma attack because the mother was struck off the GPs list for missing appointments. It turned out that the mother struggled to make appointments as it was difficult to get the child out of the house with her condition. If she'd have been called and maybe had a home visit her little girl would still have been alive. Children that are soon to leave school could have a lesson in what medical services they can get remotely or from a pharmacist and an advertising campaign could be used to tell people how to use services more appropriately. If someone is not regularly ill do they know what services a pharmacist or the NHS website can give?
  • Posted by CheapAsChips June 28, 2018 at 14:16

    This is a bad idea. We should be looking at ways to save money, not introducing extra charges!!
  • Posted by BK June 28, 2018 at 21:56

    Don't charge those that want/need to seek help, charge those that waste time and don't attend scheduled appointments
  • Posted by ClairIOMGov June 29, 2018 at 21:10

    This has been effective in the New Zealand model of healthcare. Unless you are within an exemption category, child, pensioner with low income, chronic illness or pregnant then a nominal fee of £10 per visit should be considered.

    Why the contribution is important:
    Reduce pressure on GP practices - though could increase demand on A&E. Might reduce number of Did Not Attends.”

    [Added by moderator as moved from same/similar post]
  • Posted by Blackadder July 04, 2018 at 16:11

    A modest charge - say £10.00 - to see a GP is sensible. It will deter time wasters and this works well in other places, notably in Sweden, France, New Zealand and I'm sure many others.

    Sure there can be safety provisions for the genuinely poor, but how many of those do we really have on this island?
  • Posted by Manxmann July 04, 2018 at 19:47

    Not a good idea to charge sick people to visit the doctor. Being ill is not a lifestyle choice. The number of people on the island who are poor enough to qualify for benefits is small but the number who are 'just about managing' is growing. We don't want to put them in the position where they have to make a choice between putting on the heating in the winter or paying to visit the doctor.
    Secondly, visiting a doctor in the community at no cost to the patient is a much cheaper option than allowing the patient's condition to deteriorate and then needing to hospitalise them at a later stage. Unfortunately people do not always make the best choices & if some people have £10 to spend they may buy a couple of pints at the pub to deaden the pain rather than go to the doctor to have their symptoms checked. Getting some people to go to the doctor is hard enough at the moment, a 'modest' £10 charge will certainly have the effect of reducing the waiting list at the surgery but their delay in attending will undoubtedly make it too late to start effective treatment for many.
    Thirdly, comparisons between the health care systems in Sweden / New Zealand and the Isle of Man are not really valid since the populations are generally younger & wealthier.
  • Posted by LucyLu August 01, 2018 at 22:39

    This happens in the Channel Islands, but their system is different anyway and always has been, generally it’s a private healthcare system, and any new residents have to have their own policy and pay for services including appointments.
    Don’t think this could be introduced here now, not with so many low income families.
  • Posted by resident01 August 01, 2018 at 22:48

    we already pay through NI and taxes

    is the idea to raise revenue or discourage time wasters ?

    if it is to raise revenue then the NI and taxes should simply increase to spread out the revenue generation in a better way rather than penalising those who are ill at a vulnerable time.

    if the idea is to reduce time-wasters, what will the time wasters do instead? where will they go? pharmacies / internet ? that could create greater problems in society. only the gp's can provide input to government about how many, if any, time wasters there are.
  • Posted by PhilIOMGov August 03, 2018 at 09:58

    Focus groups and workshops are being arranged to consider key aspects of the review in more detail. A cross-section of the local community is needed to represent views from different perspectives. If you would like to participate in a workshop related to this topic please contact the Independent Review’s Secretariat at DHSCReview@gov.im to be added to a contact list. The focus groups and workshops will support the overall gathering of evidence and be used to determine a practical and workable model for the future.
  • Posted by manxklookie August 07, 2018 at 11:38

    I had to visit the GP yesterday as prompted to get a yearly checkup on my prescribed meds for a thyroid condition when I collected the last prescription. All the GP did was issue a form for a blood test and ask if anything changed since the last yearly review. I used up an appointment when all I needed was a blood form...all that could have been done online or via email and freed up a slot for someone that needed to be seen by the GP. I think charging will just discourage those from going to seek help and in the long run the condition will worsen and cost more to resolve when it becomes intolerable. A process is needed to deal with those that abuse the system.
  • Posted by Nicola2IOMGov September 11, 2018 at 19:30

    All consumers of medical services should have to pay a nominal charge - say £25 for a visit to dentist or GP, £100 per day in hospital.

    [Feedback received through offline engagement and 5* rating attributed - Site moderator]
  • Posted by Nicola2IOMGov September 11, 2018 at 19:41

    A charge system, similar to dentistry, should be in place for all checks, tests and routine procedures.

    (Feedback received through offline engagement - Site moderator).
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