GPs vote against charging patients for their services

Authors: Abi Rimmer 

Publication date:  24 May 2014

GPs have rejected a motion put to their annual conference proposing that the BMA should work with UK governments to introduce a mechanism through which patients could be charged for GP services.

Representatives attending the BMA’s conference of local medical committees in York voted against the parts of the motion that called on the BMA’s General Practitioners Committee to “explore national charging for general practice services with UK governments” and “to consider alternative funding mechanisms for general practice.”

However, the sections of the motion stating that “general practice is unsustainable in its current format” and that urged UK governments “to define the services that can and cannot be accessed in the NHS” were passed.

Presenting the motion, Helena McKeown, from Wiltshire Local Medical Committee, said that general practice had suffered from years of underfunding, causing “immense damage.” Practices were unable to recruit and retain GPs, and increasing workloads were becoming “unmanageable and unsustainable,” she said. “The time has come to lead our profession to putting a true price on the value of general practice.”

McKeown said that if “the cornerstone of the NHS is to remain firm,” then money had to be put into general practice. “A fee for some services to some people would sustain us whilst we build up a workforce who wants to join us and make general practice more attractive than retirement or general practice abroad. We need an honest government to say who and what will be completely covered by GPs as an NHS service,” McKeown said.

She said that a fixed fee for some services for some patients would emphasise the “value” of general practice and that the increased funding generated would help practices take on more GPs.

McKeown emphasised that any system of charging patients should not “profit the private sector but would directly support general practice.” Practices “would still have a registered list of patients, and our patients would have a usual GP,” she added.

Speaking against the motion, Laurence Buckman, a member of the BMA’s General Practitioners Committee, said, “This motion links unsustainable general practice with charging patients and is therefore mistaken as well as dangerous.” It was not possible to control demand by making patients pay, he added. “You then get survival of the richest, not treatment of the sickest.”

Buckman said, “It is not for the [committee] to consider alternative funding mechanisms unless the NHS is threatened with closure . . . [The committee] would be offering the privateers a way out by doing it to ourselves and our patients.

Chaand Nagpaul, chairman of the General Practitioners Committee, advised delegates to vote against charging for services. He reminded representatives that in his opening speech to the conference that morning he had said he was proud to be a GP. “I’m proud to be a GP in the NHS because when I see a patient I know there is absolutely no financial transaction between myself and the patient,” he said.

The introduction of charges could destroy the trust between GPs and their patients, Nagpaul warned. “If this motion is passed I think this would put us in a very difficult position in promoting the trust agenda.”

Abi Rimmer BMJ Careers

Cite this as BMJ Careers ; doi: