Third of GPs back charging £10 to keep timewasters away from A&E units

Doctors want to end the ‘free at the point of abuse culture’

One in three family doctors supports charging patients £5 to £10 every time they visit A&E and only refunding them if the trip is found to be necessary, a survey has found.

The controversial proposal would be a “cost-effective” way to cut unnecessary A&E attendances and release pressure on stretched emergency departments, according to 32 per cent of a sample of more than 800 GPs in England.

To discourage patients attending A&E for minor ailments and injuries, the fees could be charged on arrival, but reimbursed if the patient was in genuine need of emergency care, the doctors said.

While acknowledging that charging at A&E was “a clear departure from the traditional NHS vision”, Dr Tim Ringrose, chief executive of the online forum Doctors.net.uk, said that many doctors were backing “radical action” to counter “the ‘free at the point of abuse culture’ that is a key contributor to the current emergency care crisis in some areas.”

However, the Royal College of General Practitioners (RCGP) said that the “vast majority” of doctors still believed that healthcare should be provided free at the point of need, and warned that credit card machines in emergency departments would be the beginning of “a slippery slope towards the Americanisation of healthcare”.

The survey, carried out by the Press Association, also revealed widespread scepticism about the Government’s plans to alleviate the A&E crisis by expanding the role of GPs. Three-quarters of family doctors disagreed that giving elderly people a named GP responsible for their care would cut numbers attending A&E.

The plan is a key pillar of the new GP contract, hailed by the Health Secretary Jeremy Hunt as the return of “proper family doctors”. Mr Hunt has previously blamed an increase in attendances at A&E wards since 2004 on changes to the GP contract introduced by Labour, which allowed family doctors to opt out of providing an out-of-hours care service.

GP leaders have furiously denied the claim, pointing out that pressures have increased across the system, with many family doctors seeing as many 60 patients in a single day.

A Department of Health spokesperson said there were “no plans to introduce fees” at A&E departments – as it would “go against the founding principles of the NHS”.

Dr Chaand Nagpaul, chair of the British Medical Association’s GP committee, said that pressures on the NHS would not be solved by “penalising less well-off patients by erecting financial barriers within the health service”.

“It could be counterproductive as patients who are deterred from seeking medical attention at A&E, may end up becoming more ill, requiring greater hospital care later on,” he said. “Patients could also inappropriately seek treatment at their GP practice, even if they genuinely need hospital care. This could act as a perverse incentive that sends patients in the wrong direction for their care.”

Dr Helen Stokes-Lampard, a GP in Lichfield and spokesperson for the RCGP, said: “Doctors have a duty to provide healthcare to patients regardless of their ability to pay. Patients seek healthcare when they are at their most vulnerable and if they attend A&E, it is usually because they don’t know where else to turn. Emergency departments are really struggling but the way to solve the crisis is to adequately fund general practice, so that family doctors can provide more care for patients…”

Attendances at A&E wards have increased from 18 million in 2004-05 to 22 million in 2012-13. There were a record 105,800 emergency hospital admissions in the first week of December 2013. A&E wards missed a government target to see 95 per cent of patients in less than four hours for two weeks running at the beginning of December, with data for the Christmas period due next week. Last winter, 6 per cent of patients waited longer than four hours in A&E departments – a nine-year high.

The College of Emergency Medicine has said the problems is rooted in a staffing  crisis, warning that the  country has a shortage of 375  emergency doctors.

Suggested Topics
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
News
The comedian, 42, made the controversial comment following the athlete’s sentencing to five years for the culpable homicide of Reeva Steenkamp on Tuesday
peopleComedian's quip about Reeva Steenkamp was less than well received at music magazine awards
News
Cumberbatch spectacularly photobombs U2 at the Oscars
news
Life and Style
Could you tell the difference between this and an organic alternative?
food + drink

Culinary experts in The Netherlands thought it was 'fresh' and 'tasty'

News
Will menus with calorie counts really deter junk-food addicts from eating junk?
i100
Sport
Today's Liverpool Echo back page
football
Life and Style
Six of the 76 Goats' cheese samples contained a significant amount of sheep's cheese
food + drink
News
i100
News
Russell Brand arriving for the book launch in East London
peopleRussell Brand cancels his book launch debate due to concerns about the make-up of the panel
Arts and Entertainment
JK Rowling will not be releasing a 'romance' novel anytime soon
books
Life and Style
tech

Of all the computers Apple has ever made there’s only one that Steve Jobs had to sell his car to finance

Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    2nd Line server support - Microsoft certified

    £25000 - £30000 Per Annum: Clearwater People Solutions Ltd: Our large organisa...

    Reception Teacher required in Cardiff

    £100 - £105 per day + plus free travel scheme: Randstad Education Cardiff: The...

    Marketing Manager - Leicestershire - £35,000

    £30000 - £35000 per annum: Ashdown Group: Marketing Manager (CIM, B2B, Adobe, ...

    Systems Tester - Functional/Non-Functional/Full Life Cycle

    £20000 - £22000 per annum: Ashdown Group: Systems Tester - Functional/Non-Func...

    Day In a Page

    How could three tourists have been battered within an inch of their lives by a burglar in a plush London hotel?

    A crime that reveals London's dark heart

    How could three tourists have been battered within an inch of their lives by a burglar in a plush London hotel?
    Meet 'Porridge' and 'Vampire': Chinese state TV is offering advice for citizens picking a Western moniker

    Lost in translation: Western monikers

    Chinese state TV is offering advice for citizens picking a Western moniker. Simon Usborne, who met a 'Porridge' and a 'Vampire' while in China, can see the problem
    Handy hacks that make life easier: New book reveals how to rid your inbox of spam, protect your passwords and amplify your iPhone

    Handy hacks that make life easier

    New book reveals how to rid your email inbox of spam, protect your passwords and amplify your iPhone with a loo-roll
    KidZania lets children try their hands at being a firefighter, doctor or factory worker for the day

    KidZania: It's a small world

    The new 'educational entertainment experience' in London's Shepherd's Bush will allow children to try out the jobs that are usually undertaken by adults, including firefighter, doctor or factory worker
    Renée Zellweger's real crime has been to age in an industry that prizes women's youth over humanity

    'Renée Zellweger's real crime was to age'

    The actress's altered appearance raised eyebrows at Elle's Women in Hollywood awards on Monday
    From Cinderella to The Jungle Book, Disney plans live-action remakes of animated classics

    Disney plans live-action remakes of animated classics

    From Cinderella to The Jungle Book, Patrick Grafton-Green wonders if they can ever recapture the old magic
    Thousands of teenagers to visit battlefields of the First World War in new Government scheme

    Pupils to visit First World War battlefields

    A new Government scheme aims to bring the the horrors of the conflict to life over the next five years
    The 10 best smartphone accessories

    Make the most of your mobile: 10 best smartphone accessories

    Try these add-ons for everything from secret charging to making sure you never lose your keys again
    Mario Balotelli substituted at half-time against Real Madrid: Was this shirt swapping the real reason?

    Liverpool v Real Madrid

    Mario Balotelli substituted at half-time. Was shirt swapping the real reason?
    West Indies tour of India: Hurricane set to sweep Windies into the shadows

    Hurricane set to sweep Windies into the shadows

    Decision to pull out of India tour leaves the WICB fighting for its existence with an off-field storm building
    Indiana serial killer? Man arrested for murdering teenage prostitute confesses to six other murders - and police fear there could be many more

    A new American serial killer?

    Police fear man arrested for murder of teen prostitute could be responsible for killing spree dating back 20 years
    Sweetie, the fake 10-year-old girl designed to catch online predators, claims her first scalp

    Sting to trap paedophiles may not carry weight in UK courts

    Computer image of ‘Sweetie’ represented entrapment, experts say
    Fukushima nuclear crisis: Evacuees still stuck in cramped emergency housing three years on - and may never return home

    Return to Fukushima – a land they will never call home again

    Evacuees still stuck in cramped emergency housing three years on from nuclear disaster
    Wildlife Photographer of the Year: Intimate image of resting lions claims top prize

    Wildlife Photographer of the Year

    Intimate image of resting lions claims top prize
    Online petitions: Sign here to change the world

    Want to change the world? Just sign here

    The proliferation of online petitions allows us to register our protests at the touch of a button. But do they change anything?