Charges to see a GP

On June 29th 2017 at the annual BMA meeting of UK representatives I proposed a resolution that stated -


That this meeting opposes charges for patients:-

i)  to see a GP;
ii) if an appointment is missed. 

The resolution was passed with a significant majority and now becomes BMA policy. It was an important moment at a time when many commentators and some politicians are saying 'we need an honest debate about what the NHS can afford' which is doublespeak for 'lets bring in some charges to use NHS services'.

This was the speech I gave......


The BMA has clear policy supporting the 1948 founding principles of the NHS – comprehensive care free at the point of access available to EVERYONE funded from general taxation

We see a growing call to introduce charges to see a GP.

This will introduce a consumerist approach to healthcare. A consumerist approach will become part the doctor patient relationship. That will corrode the relationship we have with our patients and would paradoxically increase demand. Charging to see a GP would discourage patients from seeking both necessary and unnecessary treatment.

It would be penny wise but pound foolish.

What do charges do – they discourage the poor and disadvantaged from getting the care they need

In Germany they introduced a charging system in 2004 called Praxisgebuher. Studies have shown that fewer patients received the treatment they needed. There was a subsequent increase in non evidence based treatment and those with a lower consultation frequency were particularly affected.

One U.S. study published in the New England Journal of Medicine involving fairly healthy adults showed that patient charges led to a 20 per cent increase in risk of death for people with high blood pressure because people were less likely to see a doctor and get their blood pressure under control.

Faced with charging, the evidence shows that people often do without preventative care and chronic disease management. Patient charges means they have to decide whether or not symptoms warrant medical attention. For example, when a child has a fever, most parents don't know whether it's the flu or the onset of meningitis. Do we really want parents to make the decision about whether to take their child to the doctor on the basis of whether these very charges will leave enough money to pay the rent?

Charging patients is a ZOMBIE policy

It’s a policy that is killed off repeatedly by scientific evidence but, just like zombies, it keeps bouncing back to try and wreak havoc on our NHS.

We must not punish our patients for political failure.

Please send a strong message to politicians, policy makers and those who wish to turn our NHS into a marketised, consumerist, insurance policy driven health care service.

Please vote unanimously for this motion.


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