This is a guest blog by Anita Wong

The planned spending of the Department of Health and Social Care for 2019/2020 is 140.4 billion. This spring, the government initiated an emergency response fund (set at £5 billion) to enable the NHS to treat patients with coronavirus, with Matt Hancock further announcing that a ‘£13.4 billion debt write off will wipe the slate clean and allow NHS hospitals to plan for the future and invest in vital services.’ This can be seen as a step forward in alleviating some financial pressure from the NHS.

However now, more than ever, with the growing severity of the COVID-19 pandemic, there are increased pressures of understaffing, a growing aging population and (at times) inadequate funding which threaten to overwhelm the NHS. With this message, there are increasing concerns for the future of our health service and a focus in trying to tackle its growing demand for money, in order to reduce these pressures. Consequently, if patients have to pay to see their GP, it would be a way to decrease the financial strain on the NHS. But with a lack of workers in the primary sector, would this cause a significant change? Ultimately, the NHS is struggling due to a surge in patient numbers due to our ever-growing population, thus meaning paying to see a GP may become a practical way to aid the NHS.

Financially speaking, paying to see a GP would no doubt bring more money into healthcare. Some GPs even argued that there be £10- £25 charge per GP appointment but in 2014 GPs voted against this, with the BMA stating: ‘it was not the solution to solve the financial crisis facing the NHS’.  Nonetheless, there are 350 to 450 million visits a year to GPs (King’s Fund Website) and as a result a £10 charge would raise between £3.5 and £4.5 billion a year, with a

£25 charge raising between £8.75 and £11.25 billion per year. This money would decrease the financial stress as it would be able to pay for all day-case treatments or approximately half of the total community prescriptions bill every year, with additional funds left over. This evidence advocates the integration of GP fees into the healthcare system, thus suggesting its ability to decrease the financial burdens on the NHS.

Already the NHS has introduced charges to prescriptions and dental treatments. So why not charge for a GP appointment?

On one hand, charging to see a GP possibly would minimise the number of unnecessary visits to a GP practice and promote a healthier lifestyle to the general public as they would want to take care of their physical and mental wellbeing to minimise the need to go to a GP and pay. This would result in a decreasing number of appointments for conditions which could be treated by other healthcare professionals, thus decreasing the pressures GPs face, as hypothetically there would be less patients for them to see on a daily basis.

On the other hand, the fee of £10 may be unfeasible for certain groups within society – for example those of a lower socioeconomic background and subsequently act as a deterrent for the public to seek help from GPs for their health problems. This may progress into more serious diseases, requiring much more complicated and costly treatments, which would ultimately render charging for a GP appointment ineffective, as the costs for treatment would be much more to cover. This would cause more barriers to patients and a discriminating factor to those who require care but cannot afford it, therefore making care more inaccessible for those who need it. Consequently it may them to resort seeking help at emergency departments in hospitals, which would overwhelm the already long waiting times in A&E. Although paying to see a GP would decrease pressure in the primary sector, it would be impractical, as the pressures would instead be shifted to secondary care services, therefore not reducing the overall financial strain on the NHS.

To conclude, although there is an ever-increasing burden on the NHS, making patients pay for their GP appointment will not solve this. One of the founding principles of the NHS is: an access to services based on clinical need, not an individual’s ability to pay. This reiterates my former points against paying to see GPs as it directly undermines the point of the NHS- to provide free healthcare for everyone. By imposing GP fees, it will bar those who need it the most. Overall it would cause more harm than good as less may feel inclined to book an appointment (to avoid payment), even if their health is at serious risk, therefore it should not be necessary for patients to pay to see their GP.