GPs could charge for appointments to tackle NHS crisis, says top economist

Health Secretary Sajid Javid (right) meeting Dr Ali al-Bassam, during a visit to the Vale Medical Centre in Forest Hill, south east London, following the announcement of the blueprint for improving access to GP appointments and supporting GPs and their teams. Picture date: Thursday October 14, 2021.
Health secretary Sajid Javid has insisted hikes in National Insurance contributions are necessary to fund the crisis in health and social care. (PA Images)

GPs could start charging for appointments to ease pressure on NHS, a top economist has said.

Chief economist at the Institute for Government, Gemma Tetlow, said it is "really unusual" that the UK does not charge to see the the GP.

Her comments come as the NHS faces record-breaking pressures and an ever growing backlog which was exacerbated by the pandemic, which saw many elective surgeries and hospital appointments postponed.

The government announced last year that they intend to hike National Insurance contributions to tackle the crisis in health and social care in the UK.

However, the move has been fiercely controversial both in and outside of the Conservative party, with repeated calls from senior Tory MPs - such as David Davis, who called it "completely unnecessary" - calling for the rise to be scrapped.

Read more: Revealed: The region where you have to wait longest for an ambulance in an emergency

Experts have warned the tax rise, which will begin in April, will deepen the cost of living crisis with energy bills set to soar in the same month.

Tetlow addressed the issue at a Resolution Foundation event titled "Why the state is getting bigger and what we do about it".

On the topic of alleviating some of the pressures on public health care services without additional taxation, she suggested one approach could be charging for some healthcare provision, like GP appointments.

Read more: NHS COVID backlog will keep getting worse 'for a while'

“On health care, I think there are ways that you could [absorb some financial pressures]," she said.

“The UK is really unusual in not charging for GP appointments. And I know it's kind of utterly beyond the pale to suggest that here, but it's extraordinarily common [elsewhere].

“And if you think about the incentives for utilisation of health care, having some kind of like private cost so that someone [thinks] ‘do I actually really need to go and see the GP?’ could have lots of benefits.

“So I think we should put these things on the table."

Gemma Tetlow, chief economist at the Institute for Government, said charging for GP appointments could be a way of avoiding hiking taxes to fund the NHS. (Resolution Foundation)
Gemma Tetlow, chief economist at the Institute for Government, said charging for GP appointments could be a way of avoiding hiking taxes to fund the NHS. (Resolution Foundation)

People in England already have to pay for dentistry, which is subsidised in some areas, as well as prescriptions, which are free in Scotland.

European countries that charge for GP appointments include Sweden, Belgium, and France. In Sweden, GP appointments are around £12, and capped at £70 a year.

Some 6.1 million Brits were waiting to start treatment at the end of December, compared to 4.4 million in February 2020 before the pandemic began. Estimates suggest the waiting list could go up at least 50%, or almost double, before it starts to fall.

The number of people having to wait more than 52 weeks to start treatment stood at 310,813 in December, and a record 16,558 people had to wait more than 12 hours in A&E departments in England in January.

Read more: Hospital sends patients to stay in hotel to relieve pressure on wards

The health secretary conceded in parliament on Wednesday that NHS waiting lists will not begin to drop for more than two years.

Read more: People not going to hospital during COVID behind huge NHS waiting list, says UK minister

“Assuming half of the missing demand from the pandemic returns over the next three years, the NHS expects waiting lists to be reducing by March 2024," he told MPs in the House of Common, setting out the government's NHS backlog strategy.

“Addressing long waits is critical to the recovery of elective care and we will be actively offering longer-waiting patients greater choice about their care to help bring these numbers down.”

Watch: 1 in 9 people in England on NHS waiting lists as government lays out plan to deal with COVID backlog