Paid GP Services

The introduction of some paid services across GP's practices. Appointment/Consultations/test/ etc.

Why the contribution is important

With primary care requiring more investment and IOM Gov trying to save money funds need to come from other sources.

The introduction of paid services across GP's practices would increase additional income, it would also potentially reduce pressures on practices as patients would be more likely to use the service if they genuinely require it.

It would also make other services which are under utilities such as the pharmacy Minor Ailments Services more attractive to the population.

Exemptions and/or discounts would be required for some groups (acute long term conditions for example) as not to place unfair financial burden.

Practice could take this into their own income directly but the introduction of a POS system that is Gov (centrally) linked would perhaps be fairer and clearer.


This sort of charging already exists in other areas such as the Channel Islands.

This would not be popular and would not win any elections (requires a cultural change) but it might help ensure the best primary care system possible.


It might also create income in the private sector for a Manx based private medical insurance.

by Keliom on April 04, 2017 at 11:08AM

Current Rating

Average rating: 2.4
Based on: 11 votes


  • Posted by George April 04, 2017 at 11:53

    Sorry no, I disagree with this - you can't expect the elderly living on a basic pension to have to pay for healthcare and they are the ones who will likely need it the most and the people who it would hit the hardest based on their low incomes.
  • Posted by Nedloh April 04, 2017 at 11:55

    I imagine this would work in a similar way to how it does for prescriptions - most paying for prescriptions, but exemptions for those with long-term conditions or for pregnant women etc. Also those on lower incomes who are eligible for benefits would be able to have costs covered under their benefits.
  • Posted by Nedloh April 04, 2017 at 11:56

    The elderly on pensions could be one of the exempt categories... though saying that, some pensioners on the Island have a lot more income than others
  • Posted by Keliom April 04, 2017 at 16:30

    I certainly wouldn't want those with low income to be or feel penalized and some pensioners would fall into this category.

    May be this would be a group who are exempt initially but in 10 - 20 years would be included. Perhaps some form of means testing which discounts everyone at between 0% - 100%. This would also take into account any number of other factors and groups such as infant/child care which should be in my view reduced and as mentioned before reduced further for those who suffer with certain conditions which require more time and care.

    We all want the best health care system yet primary and secondary care is under every increasing loads and pressures in the IOM & UK. Who or how is this going to be paid for?

    On average the older we become the more medical attention we require. So with ever increasing average life spans this is going to get worse, not better. I believe we need to start looking at realistic ways to increase income to maintain and hopefully bolster/improve services.

    The other answer is to look at increasing NI, Taxes, VAT and cap/reduce pensions and other social benefits.

    This not I am sure a perfect answer but it is a serious issue and needs considering.
  • Posted by Gigabyte April 04, 2017 at 20:43

    No privatisation of health service please
  • Posted by DocMills April 05, 2017 at 14:10

    If something is free, then it isn't properly valued.

    A nominal amount, say £10, should be affordable by most and should at least make people think twice before missing an appointment or going to a GP for frivolous reasons.
  • Posted by Dzippy April 10, 2017 at 18:04

    Agree with DocMills. Elderly, poor, long term sick exempt, everyone else pay small fee to reduce admin costs on NHS. Also, stop spread of viruses and bugs with promotion to stay in bed for 3 days instead of spreading the bug to colleagues, friends, family and those in the waiting room of a doctors. No one thanks a die-hard!!
  • Posted by ninjadispenser April 12, 2017 at 02:32

    Think £10.00 when you are on a pension is a bit steep! Right that elderly are more affected but I also think more use should be made of Supplementary and Independent prescribers who work within the Surgeries to review and do repeat prescribing .These are highly trained people who can alleviate the pressure on G.P.s They are not 'Doctors on the cheap' as they are regulated and overseen by the resident Doctors,but are invaluable for long term conditions.Surgeries in England are having Pharmacist Independent Prescribers 'in house' and this seems to work well.
    The whole prescribing/exemption/appointments system needs overhauling frankly and this is both on an efficiency and money saving basis.
  • Posted by castlearcher April 15, 2017 at 10:04

    Interesting idea. Any upfront charge will put people off attending and the inverse care law means that those that need healthcare the most (the poorest) will be hit the hardest (financial hit vs poorer health). On the otherhand, even the poorest people in society fnd the money to smoke cigarettes which are not cheap...

    With regards to the idea; it depends on whether a co-payment or fully private fee-for service system was proposed.

    co-payment: the people that visit their GP most often would likely be exempt (e.g. under 5s, over 70s, those on benefits, etc). This mirrors the current situation with prescription charges where the vast majority do not pay.

    fully private GP system: cancelling the NHS GP contract would save the Government approx £10m per year. However, the costs would be borne by the patient directly. The commercial rate for a private GP service would be approx £40-60 per appointment if you look at the Channel Islands and Eire. Interestingly the GPs in Northern Ireland look set to resign from the NHS and copy the Irish model.

    "Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community." Bevan - founder of the UK NHS.

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