Re: Should patients pay to see the GP? No: GP charges drive A&E demand for richer, for poorer.
I agree with Dr Nancy Loader.
User fees and copayments in primary care are regressive, reduce accessibility and promote a doctor-patient interaction full of moral hazard.
Whilst we are in the midst of the current NHS Crisis with Emergency Medicine Departments struggling to cope with existing demand, those supporting a GP user fee system must contemplate and recognise the impact posed to free Emergency Departments.
A household survey in 2012, not far from home, in Jersey, Channel Islands, identified that GP user-fees create cost-related demand for the Emergency Department. [1]
Charging primary patients is counter productive from a wider health service perspective and fails to support the most vulnerable patients in society.
1. Arun-Castro S DO GP USER-FEES AFFECT A&E USAGE? GP CHARGES DRIVE A&E DEMAND, FOR RICHER, FOR POORER Emerg Med J 2014;31:786-787.
Competing interests:
No competing interests
10 January 2017
Sriskantharajah Arun-Castro
Emergency Medicine Registrar & Medical Education Fellow
University Hospital Lewisham / King's College London
Rapid Response:
Re: Should patients pay to see the GP? No: GP charges drive A&E demand for richer, for poorer.
I agree with Dr Nancy Loader.
User fees and copayments in primary care are regressive, reduce accessibility and promote a doctor-patient interaction full of moral hazard.
Whilst we are in the midst of the current NHS Crisis with Emergency Medicine Departments struggling to cope with existing demand, those supporting a GP user fee system must contemplate and recognise the impact posed to free Emergency Departments.
A household survey in 2012, not far from home, in Jersey, Channel Islands, identified that GP user-fees create cost-related demand for the Emergency Department. [1]
Charging primary patients is counter productive from a wider health service perspective and fails to support the most vulnerable patients in society.
1. Arun-Castro S DO GP USER-FEES AFFECT A&E USAGE? GP CHARGES DRIVE A&E DEMAND, FOR RICHER, FOR POORER Emerg Med J 2014;31:786-787.
Competing interests: No competing interests