GPs vote against charging patients for appointments

http://www.theguardian.com/society/2014/may/22/gps-vote-against-charging-patients-for-appointments

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GPs have voted against a proposal to charge patients for appointments in a bid to help cash-strapped surgeries.

A motion advocating charges was defeated at the British Medical Association's annual local medical committee (LMC) conference in York on Thursday. GPs, however, backed part of the motion that said "general practice is unsustainable in its current format". A large number of GPs queued up to discuss the proposal, with twice as many wanting to speak to oppose it as to back it.

London-based GP Dr Laurence Buckman, a former chair of the BMA's general practitioners committee (GPC), described the proposal as dangerous.

"We do not control demand by making patients pay," he said. "You then get survival of the richest." He said the proposal, if adopted, would lead to lower pay for GPs, who would be expected to top up their income with fees paid by patients. The current chair of the GPC, Dr Chaand Nagpaul, also opposed the motion, arguing that it would lead to a less equitable NHS. "In the UK we don't tax illness, that's what charging would do," he said.

But Dr John Grenville, from Derbyshire, said supporting the motion would give the government a needed "kick up the backside", adding: "It grieves me to have to speak in favour of this motion but we have heard an awful lot about what is wrong with the NHS and general practice."

Dr Lee Salkeld, from Avon, also favoured the motion, arguing that charging would facilitate better access and longer appointments.

The most contentious part of the five-part motion proposed by the BMA's Avon LMC called on the GPC "to explore national charging for general practice services with the UK governments" and was not passed. But a less contentious part that criticised the "inadequate support for many practices" was carried by delegates. The motion did not specify a charge but a fee of £25 was believed to be under consideration.

There has been a growing clamour for people to be charged for using some NHS services, amid concerns that the status quo is financially unsustainable. Former Labour health minister Lord Warner, who served under Tony Blair, has proposed that everyone pay a £10-a-month NHS "membership charge" to save it from sliding into a decline. The King's Fund has said fees for hospital and GP appointments may need to be introduced. But health service campaigners have expressed alarm about the impact charging would have on accessibility.

The Department of Health said before the vote that it was "absolutely clear that the NHS should be free at the point of use, and we will not charge for GP appointments".

Motions to charge for GP services have been rejected by the BMA in previous years. A ComRes poll in March found that while one in four (27%) people said they would be willing to pay £10 to visit their GP rather than see the practice shut down, more than double that – 56% – were against any charges.