Third of GPs back charges for A&E patients to tackle crisis

Third of GPs back charges for A&E patients to tackle crisis

A&E specialists believe up to 40% of all visits unnecessary, but medical bodies warn charges would penalise poorer patients

One in three GPs want patients to be charged each time they visit A&E in order to reduce frivolous use of the NHS and the growing pressure on emergency departments, a survey has found.

In a poll of more than 800 family doctors, 32% said such fees would be the most cost-effective way of cutting the number of people who go to A&E who could have gone to their GP or a pharmacist instead or did not need medical attention at all.

Charging all patients £5 or £10 would significantly reduce the number of people turning up at A&E, which has been rising so much that emergency doctors have complained that A&E units have become worryingly overcrowded and that they cannot cope with the demand for care. Patients would receive refunds if their condition was shown to need attention.

A&E specialists believe between 30% and 40% of all visits are unnecessary and that many patients could have sought help elsewhere because their illness was minor or not urgent.

The survey, carried out by Doctors.net.uk, a professional networking site which most UK doctors belong to, has prompted renewed debate about whether the NHS should stop offering all care free at the point of need and instead introduce some charges to tackle rising demand and help balance its books.

Dr Tim Ringrose, chief executive of the organisation, which carried out the survey for the Press Association news agency, said: "It may be a clear departure from the traditional NHS vision, but many doctors are now saying that radical action has to be taken to reverse the 'free at the point of abuse' culture that is a key contributor to the current emergency care crisis in some areas."

But the Royal College of GPs (RCGP) and British Medical Association (BMA) opposed the move and warned that charges would unfairly penalise poorer patients.

"Charging patients for the use of emergency departments would put us on the slippery slope towards the Americanisation of healthcare, where only those who can afford to get it get the care and attention they need," said Dr Helen Stokes-Lampard, a spokeswomen for the RCGP and a GP in Lichfield, Staffordshire.

Dr Mark Porter, chairman of the BMA, said: "The majority of GPs and hospital doctors are committed to an NHS that delivers care on the basis of need and not the ability to pay. In this survey, two thirds of GPs state they are against [charges] for using A&E services … it runs the risk of deterring vulnerable patients who genuinely need help from seeking treatment at a time when many people, from all backgrounds, are struggling financially."

In the survey, 74% of GPs said that health secretary Jeremy Hunt's plan to give every older person a named family doctor in overall charge of their care would not cut the number ending up in A&E, while 81% rejected his claim that GPs opting out of providing out of hours care back in 2004 was a major reason for rising A&E attendances in recent times.  Guardian