Intended for healthcare professionals

Head To Head

Should patients pay to see the GP?

BMJ 2016; 352 doi: (Published 06 January 2016) Cite this as: BMJ 2016;352:h6800
  1. David Jones, foundation year 2 doctor, diabetes and endocrinology, Worthing Hospital, Worthing BN11 2DH, UK,
  2. Nancy Loader, GP partner, Beccles, Suffolk NR34 9NX, UK
  1. Correspondence to: D Jones david.jones2{at}, N Loader nancyloader{at}

Copayments could raise much needed funds for the health system, thinks David Jones, but Nancy Loader worries about increased overall cost and harms to patients

Yes—David Jones

Various calls have been made in recent years to charge patients for general practice consultations in the United Kingdom.1 2 In 2014 motions in favour of copayments were defeated at meetings of the BMA’s local medical committees3 and the Royal College of Nursing.4 In Australia, however, patients pay the doctor at the end of general practice consultations. No one sees this as unethical—it is the norm. The amount depends on the duration and complexity of the consultation and on the clinician but is typically about £10 (€14; $15) for a standard consultation, with the remainder of the costs paid by the government.5

The NHS prides itself on free healthcare at the point of service, but with ever increasing demands, and its inflation adjusted annual budget rising over sevenfold from £15bn to £115bn in its 67 year history,6 we need fundamental change to ensure its prosperity and longevity.

Drug prescriptions and dentistry

People in the UK already pay towards drug prescriptions and dentistry, which were free at the NHS’s inception,7 showing that the public accepts that an entirely free healthcare model is not sustainable today. Prescriptions, despite 90% of items being exempt from charges, generate in excess of £400m gross income a year.8

We should follow many other developed countries and also pay a fee when we see our GP. …

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