A SCOTS doctor has spoken out against Sajid Javid’s call for GP appointment charges after seeing the impact of fees in New Zealand.
Former UK health secretary and Tory MP Javid believes charges will reduce unnecessary consultations but Dr David Mitchell, who worked in Orkney and the Scottish Borders for 20 years before emigrating to Christchurch with his New Zealand-born wife, said that assumption was wrong.
“When I left Scotland to work as a GP 16 years ago, I wondered if I would ever see the common cold again as surely no sensible Kiwi would pay £10 to £25 to be told that was their problem,” said Dr Mitchell. “Far from it. My surgeries remained full of minor, self-limiting illnesses.”
Of more concern, he said, was the fact that the charges deterred people with lower incomes from seeing a doctor until they were sometimes so unwell they needed hospital admission.
In addition, important follow-up appointments were missed and emergency care, which is free in New Zealand, was “overwhelmed”.
“The poorest, often Maori and Pasifika, suffered most and their appalling health statistics reflect that,” said Dr Mitchell.
“I think it’s important we don’t go down this road in the UK. Charging in no way deters patients from turning up to their GP with minor illnesses so it won’t help reduce waiting times to see your GP in the UK and there are other more important ramifications.”
These include the potential for overuse of antibiotics as patients with viral infections, who might have paid 50 New Zealand dollars for a consultation, “quite naturally” expected a prescription.
“Antibiotics are expected and are, of course, useless in viral infections - and dangerous because their overuse by GPs has resulted in resistance in bacterial pathogens which is becoming a huge problem,” said Dr Mitchell.
“Also when the patient has paid so much, there is a kind of subliminal internal pressure on the GP to give them something such as an antibiotic for their money. But it means that the perennial battle to resist the request for antibiotics is tougher to fight – although I must say that Kiwis are starting to get it.”
Dr Mitchell pointed out that the average weekly grocery and food bill for a single parent with a dependent child in urban Auckland, for example, is about £100 and a GP bill could be up to £25 for one visit, although there are some concessionary charges of around £10 available.
He added that the proposal to bring in charges had a “slightly punitive ring to it” and would penalise those least able to manage.
Dr Andrew Cowie, deputy chair of the BMA’s Scottish GP Committee, said: “The BMA believes that healthcare in Scotland should be free at the point of use, so does not support any charging for GP appointments.
“Doing so would only threaten to make it even harder for some of the most vulnerable in society, in our most deprived communities to access healthcare and hence risk widening the health inequalities which already do so much damage in Scotland.
"It would be far better to resource general practice adequately and ensure that there is a strong primary care and enough GPs in Scotland to be able to meet the health needs and demands for care of the population.”
Downing Street has said the UK Government is not “currently” considering Javid’s proposal to “extend the contributory principle” as part of radical reforms to reduce NHS waiting times in England.
During his Tory leadership campaign Rishi Sunak laid out plans to fine people who miss hospital and GP appointments in England but had to withdraw the pledge after it was widely condemned by health leaders.
