What a lump on my breast told me about the folly of charging to see a GP

Even though I may have been willing to pay, this is a dangerous idea that would surely break the NHS, not save it



One evening, a few weeks ago, I found a lump in my breast. After a fretful night’s sleep, I called my GP surgery the next morning to make an appointment.

Despite calling as soon as the lines opened, at 8am, I was kept on hold for 15 minutes. When I finally got through, and asked to see a female doctor, the receptionist told me there were no appointments left for the day.

“What about tomorrow,” I asked, my voice already quavering. The next appointment they offered was for three weeks’ time. “OK, what about a male doctor?” No, all those appointments had gone too.

I told the receptionist that I’d found a lump and three weeks wasn’t really good enough, for the NHS, in 2014. I got upset. “What if I have cancer? Do you think three weeks is OK to see a GP?” If I’d hoped the c-word would open a magical door in the NHS, I was wrong. The receptionist was apologetic, but it made no difference. At my surgery in south London, as at many across the country, this is the deal: you either queue for ages on the phone and are lucky enough to get a same-day appointment, as if this were trying to get tickets at Glastonbury rather than seeing a doctor, or you wait three weeks. There is no other choice.

In the end, I was offered an appointment with a “nurse practitioner”, who was excellent and caring. I was referred to my local hospital’s breast clinic. And in the end, thankfully, it was a benign lump that I had removed. But such was my state of anxiety on that morning that I would have done anything to see my GP – including paying money to jump the queue.

This willingness to throw money at a problem must be partly the reason why GPs are considering introducing charges to see a doctor of between £10 and £25. The British Medical Association will vote on the proposal later this month.

Those behind the motion say it aims to deter people who miss appointments, a problem which costs the NHS £162m a year. It is also an acknowledgement that the health service needs more funding, from somewhere. Presumably its backers also know, however, that there are enough people like me, who could afford the fee if desperate enough to see a doctor.

Yet even though I may have been willing to pay, this is a dangerous idea that would surely break the NHS, not save it.

Dr Mike Smith, chairman of the Patients Association, says those who could not afford it would be forced instead to go to A&E, where the system is already at breaking point. And so, the NHS would become a two-tier system: GP waiting rooms would become like first-class train carriages, used by middle-class people who could afford the £25 a time. Hospital A&Es would be NHS standard class, packed with people waiting hours on end to see a doctor. It is a disturbing vision.

Nevertheless, there’s no avoiding the fact that something needs to change in the NHS. With the Government putting the brakes on health spending, money to cope with demand must come from somewhere. Labour MP, Frank Field, has proposed an increase in national insurance contributions, ring-fenced to fund the NHS. At least this would be fairer, because higher earners would pay more, than a regressive charge for all GP appointments.

Another Labour MP, Ian Austin, has suggested giving real choice to patients: if their own GP has no appointments, they can choose another one. GPs would be encouraged to offer more out-of-hours appointments, while patients would also be incentivised to turn up, if they had this choice and control. All of these are radical ideas that need to be looked at urgently by the Government. If GPs vote this month for charges, ministers must veto such a dangerously divisive measure.

Come on, Chelsea – judge the Titch

Would anyone pay £575 for a black market ticket for the Chelsea Flower Show later this month? After the second-fastest sellout in the history of the RHS flagship show, touts are charging this extortionate amount.

I have paid the official £68 day rate for Chelsea, and smarted at that price. The reason for the demand, it is thought, is Alan Titchmarsh’s first garden design at Chelsea since 1985. Britain’s best-known gardener is a huge draw to Chelsea regulars.

But, what’s this? Having won a gold medal in 1985, the Titch, as he is known, isn’t going to be judged on this year’s garden, entitled “From the Moors to the Sea”. Instead the RHS is calling it a “garden feature”, and the famously tough judges are going to put away their clipboards as they walk past it.

What a shame. Surely Chelsea is all about the medals, and the huff of those designers who only get a Silver Gilt?

Twitter: @janemerrick

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