NHS advised to charge for GP appointments

Professor David Bell, a senior adviser to the Scottish Parliament, has suggested a £20 patient fee to see a GP, as a way to deal with impending budget cuts. 

In a paper published on 9 September, Professor Bell advised that this is the type of action necessary in order to deal with expected extensive spending cuts to Scottish public services, and suggested that ministers should follow Sweden’s example and introduce a patient fee for each visit to a NHS doctor or hospital stay.

The plans could potentially raise up to £300 million a year for the NHS in Scotland.

Prof Bell commented that there is a “widespread lack of public appreciation” of how severe the hits to the public service could be.

Under Professor Bell’s proposed system patients would have to pay between £5 and £20 to see their NHS doctor. In Sweden, user charges like these provide three per cent of the total health budget.

Prof Bell said: “Hotel charges for hospital stays and other charges in Sweden provide what would be the equivalent of £300m to the Scottish health budget.

“Charges for the NHS would be means-tested so those who can afford it contribute the most."

His advice came after finance secretary John Swinney opened discussions to end the three-year freeze on council tax, following stark warnings from council chiefs about the state of their finances.

Prof Bell stated that a lack of plans on how to deal with the impending cuts would leave the public sector with a short time to make preparations, and called for ministers to look beyond areas already identified for savings.

Speaking to The Scotsman, Scotland Patients Association chair Margaret Watt said: “Imposing charges is not the way to do it. A lot of people don't have enough to feed themselves, so if charges like this were brought in, people would not have the money to go to see a doctor and get help with their conditions.

"It would put public health at risk and if people didn't go to see a doctor, their condition could get a lot worse and it would end up being more expensive."

Health economist Professor Alan Maynard, of the University of York agreed: “Certainly it is an obvious way of raising revenue and it is also likely to have a deterrent effect. But it is essentially a tax on the ill. And while you may get fewer people with trivial illnesses utilising the service, they may only then come back a few years later with a more serious illness which is more expensive to treat in the long term.

"And if many people are exempt from charges, it basically hits middle-class people the most."

A spokesman for Mr. Swinney said: "The Independent Budget Review is helping shape the debate surrounding Scotland's future spending. The SNP government is engaging with opposition parties, organisations and the people of Scotland to help determine spending priorities. We won't know just how bad the Westminster cuts to Scotland's budget are until next month when George Osborne announces the spending review.

“We are completely opposed to the idea of charges for NHS services."

In Sweden, patient fees are capped at around £80 for every one year, with a similar solution in place for prescribed medicines. Children under the age of 18 and family planning services are exempt from all charges.

Polls have shown that very few Swedish citizens have refrained from seeking medical treatment on the grounds of cost, and that implementing fees have kept demand from getting completely out of hand.