Belfast Telegraph

GP visit fees 'inevitable'

Medics say 'hurdle for access' will curb time-wasters

By VICTORIA O'HARA

The introduction of charges for medical treatment in Northern Ireland is "inevitable", a leading doctor has warned.

The British Medical Association NI said despite wanting the health service to remain free and universally accesible, growing demands on staff could mean politicians will put the fees in place.

Dr Tom Black, chairman of the BMA (Northern Ireland) General Practitioners' Committee, was speaking after a poll of GPs in England revealed 32% of family doctors said introducing fees for some visits would be the most cost-effective way of cutting unnecessary A&E attendances.

He said the number of people in Northern Ireland wrongly choosing A&E or GP surgeries for treatment, consequently blocking up services, was rising.

Dr Black said educating the public had so far failed to work and warned that to address the problem a "hurdle for access" would have to be created.

More than 800 GPs from across England answered the survey for Doctors.net.uk, carried out for the Press Association. It said charging patients £5 or £10 every time would stop many visiting A&E at the "drop of a hat".

Refunds could then be given if the trip was found to be necessary.

Dr Black said while the poll was of GPs in England, the findings reflect the feelings of family doctors in Northern Ireland.

"I can sense the frustration coming through in this poll," he said. "Education has to date failed to manage demand. How do we manage demand? We bring in cost. But I would really worry about the health inequalities," he said.

Dr Black added: "Given the huge increases in patient demand, I think it is inevitable that politicians will bring it in.

"As a profession and representing the BMA I would prefer if it wasn't brought in. I'd prefer that the service was free and universal and the best way to maintain that is to limit demand." He added: "There is an inevitablility about this if the demand exceeds the provision and we can't educate the public to base their demands more on need more on want.

"There is an inevitability that somebody will have to create a hurdle for access.

"The hurdle for access that is classical in the rest of society is cost – that undermines our principles of trying to keep the health service free and universal because if you don't create health."

Dr Black said better education of the public was "absolutely vital" to shift the mindset for instant access for minor complaints that could be self-treated.

FACTFILE

Around two-thirds of Western countries charge patients to see their GP, ranging from 80p in France to £18 in Sweden. Half make patients pay for hospital visits or stays. Last July, half of GPs polled by Pulse magazine said they were in favour of charging for routine appointments. Last November, think-tank Reform suggested UK patients should pay each time they visit the doctor.

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