On Wed 18 Sep, Dr David J Plews wrote:
> At 16:57 18/09/1996 GMT, Adrian M wrote:
>
> > What advice should the incoming government be given to assist them
> > in producing a sensible and effective system of charges - or
> > should it be removed altogether?
>
> Two suggestions:-
>
> [snip]
>
> 2. Scrap prescription charges, but everybody (and I mean everybody)
> has to pay to see the doctor/nurse/A&E.
Local GPs met Peter Garland (deputy director of Finance & Performance,
NHSE) on Tuesday, and put this very point to him in discussing how we
might modify patient demand in the current consumerist climate. The
point was made that introducing charges for eye tests certainly had
an impact on service utilisation.
"Politically unacceptable at the present time" is a fair precis of
his reply.
Nevertheless, if we were to charge how would we go about it? Very low
(one pound?) flat fee? Lowish (five pound) fee, with exemptions?
Frequent attenders discount/surcharge? Night visit supplement?
And how would exemptions work? A means tested "Benefits Card"? Pay up
front and collect reimbursement from the Post Office?
Would the bureaucracy involved in collecting such sums be justified
by the outcome? Would surgeries become crime targets? (Five pounds
x 100 patients on a Monday morning = 500 quid).
Quite apart from the politics it gets complicated when you sit down
and try to work out the details. (Hotch's "Total utter complete
fundholding system" has similar complications).
Trims.
______________________________________________________________________
Dr Ian Trimble email: [log in to unmask]
Sherwood Health Centre
Elmswood Gardens Tel: +44 115 962 4516
Nottingham NG5 4AD Fax: +44 115 985 7899
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