Views & Reviews From the Frontline

Charging patients fees is bad medicine

BMJ 2013; 347 doi: (Published 12 August 2013) Cite this as: BMJ 2013;347:f5007
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

A poll of general practitioners, recently splashed all over the newspapers, had most supporting charging patients up to £25 (€29; $39) a visit.1 The rationale runs like this. When something is free it isn’t valued. So patients don’t value doctors or our advice. Fees would stop the so called time wasters who abuse the system, reduce workload, free up time for deserving sick people, and, in the process, raise much needed income. A win-win, backslapping, punch-the-air and kiss-the-person-beside-you sort of good idea, isn’t it?

Not really. Collecting money is expensive. In …

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