I note that many readers who have posted rapid responses regarding this issue have used a similar line of logic to answer the question.
I will illustrate this sort of thinking in a common scenario (albeit an emotive one).
We should not have chemotherapy treatment for cancer drugs because of the problems related to a small number of patients. What if some of them cannot tolerate the drugs and the side effects? What if the drugs are too expensive to buy or too costly to give, involving specialised procedures and specialised nursing room and staff to carry out treatment? What if the drug doesn't work?
Similarly the logical answer to "Should patients pay to see the GP?" should first address the benefits and harm of all patients having to pay the GP. Does it interfere with treatment? Does it make patient follow up harder? Does it make patients more involved about their own health?
Only after we are satisfied with the answer to that, can we discuss how we help those who cannot pay the GP out of pocket.
There are many who have concerns about equity and access to healthcare amongst those who are not able to pay*. The underclasses also usually have issues with access to affordable foodstuff, clothing and housing; are we going to apply more tax on their income or unemployment benefits on food stamp, clothing voucher and rental assistance to make sure they have equity to these as well?
Some are worried that having 2 classes of patients (paying vs non-paying) will worsen the pride of non-paying patients. Not that having the unemployed go to job centres and local council offices and various other departments to seek benefits or exemption has done no damage to their self-esteem. Furthermore, it is common for clinicians to ask patients about their employment so as to determine whether they can return to work for the illness they present with. It is also a standard thing to advise patients an estimate of any out-of-pocket costs of any treatment (not every thing is covered by NHS) and check if they have problems with that.
*(as opposed to those who scream they can't afford to pay but actually have a very healthy middle-class income)
Rapid Response:
The horse before the cart
Dear Editors
I note that many readers who have posted rapid responses regarding this issue have used a similar line of logic to answer the question.
I will illustrate this sort of thinking in a common scenario (albeit an emotive one).
We should not have chemotherapy treatment for cancer drugs because of the problems related to a small number of patients. What if some of them cannot tolerate the drugs and the side effects? What if the drugs are too expensive to buy or too costly to give, involving specialised procedures and specialised nursing room and staff to carry out treatment? What if the drug doesn't work?
Similarly the logical answer to "Should patients pay to see the GP?" should first address the benefits and harm of all patients having to pay the GP. Does it interfere with treatment? Does it make patient follow up harder? Does it make patients more involved about their own health?
Only after we are satisfied with the answer to that, can we discuss how we help those who cannot pay the GP out of pocket.
There are many who have concerns about equity and access to healthcare amongst those who are not able to pay*. The underclasses also usually have issues with access to affordable foodstuff, clothing and housing; are we going to apply more tax on their income or unemployment benefits on food stamp, clothing voucher and rental assistance to make sure they have equity to these as well?
Some are worried that having 2 classes of patients (paying vs non-paying) will worsen the pride of non-paying patients. Not that having the unemployed go to job centres and local council offices and various other departments to seek benefits or exemption has done no damage to their self-esteem. Furthermore, it is common for clinicians to ask patients about their employment so as to determine whether they can return to work for the illness they present with. It is also a standard thing to advise patients an estimate of any out-of-pocket costs of any treatment (not every thing is covered by NHS) and check if they have problems with that.
*(as opposed to those who scream they can't afford to pay but actually have a very healthy middle-class income)
Competing interests: No competing interests