DOCTORS 2

Doctors believe patients should have to pay £20 for the privilege of seeing them in the evening or at the weekend. GPs, whose salaries have soared to over £100,000, argue that evening appointments tend to be made by people who are working during the day and so can afford to pay for the convenience of being treated outside office hours. However, many will see the call for patients to pay as smacking of arrogance, with greedy GPs out of touch with peoples' needs.

New contracts, introduced by Labour three years ago, saw 90% of family doctors opt out of providing care in the evenings, at weekends and on Bank Holidays. But, while their hours have been cut, their salaries have soared by 60%, to an average of £118,000. Patients, meanwhile, are left to negotiate and out-of-hours maze, with many passed from pillar to post as they try to get an agency doctor to come and out and see them.

Michael Summers, vice-chairman of the Patients Association, said, "We already have an NHS that people pay for. Doctors have already had a generous increase. Now isn't the time to suggest we should fork out more money to enhance their salary. It is quite wrong. "We need to extract any call from the BMA to extract more money form patients. The conditions that people suffer from out-of-hours are just the same as those they suffer from during the day. Why should they have a second-rate service?"

Dr Andrew Green, a GP from Hedon in Yorkshire, and a conference organiser, said that people who needed an evening appointment could afford to pay. He said, "People who want the evening surgery are going to be people in employment, almost by definition, and, therefore, to ask them to bear the extra costs involved seems reasonable. I do not think a fee of £15 to £20 would be exorbitant. This should not be paid for from general taxation."

However, patients' representatives and politicians say it will add to the chaos of the already "shambolic" out-of-hours service. They fear patients' health will suffer, with the elderly and the low-paid being particularly likely to put off visiting their doctor until they can get a charge-free daytime appointment. A Department of Health spokesman said, "We will never change the values of the NHS, which is universal, tax-funded, free at the point of need. Let's be clear: nobody should have to pay for these services." (Source: Daily Mail, Jun/07)

Patients are being made to pay more than £250 a year to guarantee an appointment with their family doctors. Surgeries across the country are encouraging National Health Service patients to switch to a private service if they want to ensure that they can see a doctor within 24 hours or have home visits. Critics of the growing trend call it is "extremely alarming" and say it in effect guarantees a "two-track" health system. Many fear that it is only a matter of time before a significant number of general practitioners go the same way as dentists and offer only a private service. Some have already quit the NHS, such as Dr Richard Willis, who set up his Salisbury Independent Medical Practice as a reaction to "intolerable political interference".

The revelation comes just days after official figures disclosed that millions of people are unable to get urgent appointments with their GPs. A survey from the Healthcare Commission, the Government watchdog, showed that almost five million patients have to wait longer than the 48-hour target set by ministers. One practice in west London introduces its patients to an alternative "private" service on its website. The Bedford Park Surgery devotes a section on the site to the merits of private health care, describing it as "a comprehensive service with same-day appointment guarantee, 24-hour on call, reasonable charges".

The site lists its charges which include £255 a year for an adult, £395 for a couple and £575 for a family. There is an extra charge of £100 for a weekend or night home visit and £55 for a day home visit. At the Mayfair Medical Clinic, also in London, patients can either see the doctor on the NHS or pay £50 to go as a private patient. A private out-of-hours visit costs £100. When telephoned, the practice manager said: "Obviously, if you wanted to come as a private patient the only advantage is that we would give you an appointment. That's what you're paying for." Other surgeries, from Yorkshire to Hampshire, offer similar private options where patients can get quicker and longer appointments with their GPs in exchange for paying an annual fee.

The findings were condemned last night by Michael Summers, the chairman of the Patients' Association pressure group. "The existence of a two-track health system is extremely alarming. Patients have already paid for their healthcare on the NHS and they continue to pay for it, and they shouldn't have to pay further fees in order to get an appointment," he said. "It all seems a little strange, if you're a doctor, either you have availability or you don't. Frankly, allowing patients to pay for a private booking may be legal but it doesn't seem appropriate."

Andrew Lansley, the shadow health secretary, said, "This is ridiculous. It shows that GPs are having to engage far more in satisfying local bureaucracies rather than their patients. This is yet more evidence of doctors being under pressure to live in this bogus world of targets met and targets set, when from the patient's point of view the service hasn't improved." A spokesman for the British Medical Association, the professional group representing doctors, said, "The position on private GPs is quite clear. No GP should charge NHS patients for something that they are entitled to on the NHS.

He added, ''Our policy is to support a free, universal healthcare system such that everyone can get free healthcare at the point of delivery if they need it. We're not against private practices, some of our members are private practitioners, but universal free healthcare is the policy we support." Michael Goldsmith, a former GP and now an adviser to the Conservative Party, who controversially suggested in 2001 that anyone earning more than £35,000 a year should pay for some of their NHS treatment, predicted private general practice funded by prescription would become increasingly popular.

David Green, the director of Civitas, the Right-of-centre think tank, said, "In my opinion, the GP service is the worst part of the NHS. At the moment they don't have the motivation to provide a very good service unless they happen to be very nice, very motivated people." Dr Eileen Daly, a GP at Bedford Park Surgery where all three doctors see both NHS and private patients, said, "Going private allows patients early morning appointments, late evening appointments and longer appointments. An NHS appointment is 10 minutes at our surgery, whereas a private one is 20 minutes. As a result, around 10% of our visits, about 350 patients, are private. Considering all the benefits, £255 a year is good value." (Source: Daily Telegraph)

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