Should Patients Pay to See a Doctor?

Should Patients Pay to See a Doctor?

Some years ago, seeing a doctor even in private clinic is absolutely free! I would conclude that maybe the fee had been built into the drugs prescription. A case of malaria for instance, then the common drug was chloroquine! We all remember those days right? Those drugs were as good as free! I concluded doctors weren’t making money so I would not be a doctor. How would they survive if they aren’t paid for a service they rendered? But those days are gone now. Just like a mechanical engineer who services your car bill you, doctors too has a consultation fee which the patients pay even for taking 2 minutes of their time.

Emobileclinic reporter went round the hospitals and the least she saw in private hospital was N5, 000 ($18) to see a GP. While seeing a consultant cost between N35, 000 ($129) to N40, 000 ($166). (We only have consultants on this site! lol) Specialists or GP consultation in government’s hospital is still free!

Two doctors debated this same issue in BMJ some days ago. One of them was of the opinion that ‘Charging patients for GP consultations could raise much needed funds for the health system argued David Jones, a foundation year 2 doctor at Worthing Hospital. In this context he is talking about doctors in government sector. The UK NHS prides itself on the mantra of free healthcare at the point of service, but with ever increasing costs and demands “we need fundamental change to ensure its prosperity and longevity,” said another. In Australia, a standard consultation is typically about £10, which is partly subsidized by the government. “No one sees this as unethical – it is the norm,” says David. But he adds that charges may offer other benefits, such as a reduction in missed doctor’s appointments, patients taking more personal responsibility, leading to fewer visits with conditions that they could manage themselves, greater service availability, and shorter waiting times says .

‘The argument that charges would deter the sick from seeking help doesn’t stand up’, he said. He compared UK with Australia and concludes that ‘Australia annual doctor attendances per person are comparable to those in the UK where free consultation is practiced. “Copayments would not be a vote winning strategy for politicians, (who had promised free health) but to maintain the highest possible standards for all patients, amid ever increasing healthcare costs, we need radical measures to ensure the continued success of the NHS,” he concludes.

But Nancy Loader, a GP partner in Suffolk shared another view about this. She worries about increased overall cost and harms to patients. She is of the opinion that ‘evidence shows that strong primary care led health systems, free at the point of access, are associated with improved health outcomes, increased quality of care, decreased health inequalities, and lower overall healthcare costs’ And she explains that in countries that have introduced copayments, governments “end up reimbursing, capping, and waiving the copayment to reduce health disparities.” For example, New Zealand and the Irish Republic, where patients have always made a copayment to GPs, “it has interfered with initial access to care and deterred preventive care measures, resulting in greater health spending in secondary care,” she writes. Charges can also deter patients from seeing the GP as advised after medical or surgical discharge from hospital, she adds. They can encourage patients to collect multiple problems to discuss in a single consultation and pressure doctors to deal with them all at once. And they can encourage unnecessary prescribing or referral.

And she points out that patients who cannot afford to see a GP simply attend free emergency departments instead. “Keep the NHS free for all at the point of access, not for sentimental or historical reasons, but because it makes good economic sense, is better for healthcare outcomes, reduces bureaucracy, and allows for innovative ways to match supply and demand in general practice,” she concludes

What do you think about Nancy and David’s opinion? Fee or no fee? Kindly comment.


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