Sir, – Following up on the discussion between Dr Reggie Spelman (November 20th) and Sean Fox (November 21st), and having until recently worked as a GP in the UK, may I make the observation that the optimum situation probably lies between both camps.
The waiting time to see a GP in the UK has built up because of continuous disinvestment in a doctor-led service in favour of multi-tiered access involving variously pharmacists, NHS 111, urgent care centres and paramedic assessment all of which leave much to be desired, increasing the time it takes a patient to see someone who is able to make a proper assessment of their clinical problem.
All of this is “free at the point of care” but ultimately most people pay though taxation and national insurance contributions.
The UK department of health instituted these multiple points of access in order to save money and increase access but in fact have made access more difficult at increased cost and poorer quality.
The advantage of having to pay at the point of care is that you would have rapid access from an independent practitioner who is less bound by system regulations and pathways which are counterproductive, with the downside of paying a fee on the spot. – Yours etc
DERMOT RYAN FRCGP,
Leicestershire, UK.