Charges proposed for out-of-hours GP appointments in England

Patients could face paying their family doctors for out-of-hours appointments and minor procedures that fall outside the surgery’s contracted NHS work, under new plans being proposed by some GP leaders.

The scheme would see doctors use their own time to treat and charge patients and involve the setting up of a third-party company to manage the payments to GPs.

Dr Prit Buttar, leader of Oxfordshire’s local medical committee (LMC), told Pulse magazine there had been discussions with LMCs across England about rolling out the system nationally by the end of 2017.

The move is driven by anger among GPs about the amount of money put forward for general practice by the government. Buttar said it was essential to look at alternative ways of funding that allowed practices to still operate within the rules.

He added: “They will offer practice services, for example, if someone wants a minor operation but can only do this in an evening, then they can do this by charging a small fee.

“It will allow GPs to value their own time more and puts pressure on the government. The government is a monopoly customer, they can dictate how much they are willing to pay.”

GPs would be able to provide private services to their own patients through the third-party company, which would deal with the doctor-patient transactions.

LMCs are made up of NHS GPs and represent their interests locally and nationally, and work with the British Medical Association’s (BMA) general practitioners committee (GPC).

Last year, LMCs called on the GPC to hold a ballot among GPs for mass resignations from the NHS unless the government came up with more funding, but the GPC has said it would not ballot members due to promising negotiations with NHS England.

A spokeswoman for NHS England reiterated that GPs could not charge patients for accessing normal NHS services, such as routine appointments, but said nothing about family doctors possibly levying fees for private care.

She said: “All patients have a right to access high quality primary care services which are free at the point of delivery. Strict safeguards are in place to ensure that GPs cannot charge patients for NHS services.”

Some GPs – who are not employed directly by the NHS – already charge patients for writing letters for them relating to, for example, insurance claims or holiday vaccinations.

The BMA insisted the plans set out by Dr Buttar were “not a BMA proposal” and described them as “clearly not fully developed”.

Dr Chaand Nagpaul, BMA GP committee chair, said: “All GP practices are contracted to provide free care to every patient irrespective of their financial ability to pay. This is a key cornerstone of the NHS, which the vast majority of doctors support.”

Nagpaul said GPs were not allowed to charge their own patients for private services that were not available on the NHS, including minor surgery to remove benign lumps. He said the immediate priority for Downing Street was tackling a severe shortage of several thousand doctors and the spectre of 300 surgeries facing closure.

A BMA survey found eight out 10 GPs said they struggled to provide safe, effective care because of heavy workload.

Charges proposed for out-of-hours GP appointments in England