Should the NHS start charging patients to use A&E?

The A&E department at the Norfolk and Norwich University Hospital. Picture: Denise Bradley The A&E department at the Norfolk and Norwich University Hospital. Picture: Denise Bradley

Friday, January 10, 2014
11:59 AM

Opinion: The NHS was built on a founding cornerstone that it should provide free healthcare at the point of use.

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So it was surprising to see that a third of doctors would like to see a charge introduced for patients accessing accident and emergency departments to stop inappropriate use.

The pressures facing A&E departments and front-line staff have been well documented over the last 18 months. But introducing a £5 or £10 charge is the completely wrong solution.

This week we also heard that nearly 12,000 patients across the UK used their local A&E more than 10 times last year and a small number – just over 150 – attended casualty departments more than 50 times in 2012/13.

A poll last week by Doctors.net.uk revealed that 32pc of the 800 GPs surveyed across England believed that introducing patient fees for some visits would be the most cost effective way of cutting unnecessary A&E attendance.

The survey suggested that A&E 
charges could be refunded if their attendance was found to be justified. It is 
shocking that such a high proportion of family doctors think charging for A&E is an acceptable thing to do when a lot of people go to their local hospital because they have to wait weeks for a GP appointment.

A charge to use A&E would hit the most vulnerable members of society the hardest – people with complex health needs, homeless people, and those with drug and alcohol problems, who might not necessarily seek help from a GP or 111 non-emergency healthline.

The number of people that visit casualty departments on multiple occasions in the space of a year is a small percentage of the more than 21 million visits a year in the UK.

It is no surprise that people flock to A&E when they know they should be seen by a doctor within four hours.

Rather than introducing a financial penalty for using services, NHS bosses need to look at improving out-of-hours access to GP surgeries and walk-in centres to help reduce the strain on busy A&E departments.

11 comments

  • Pay to use A&E yeah right, if you are drunk or drugged up yes they should be charged. but otherwise no, personally I won't be visiting A&E at the N&N again. I was taken their by ambulance at the end of last year and laid in A&E for 3 hours asking for a glass of water, I asked 4 nurses and 2 doctors and still no water, it wasn't until my wife turned up that she got me a glass of water, no one was telling me anything so I discharged myself although the doctors were not happy.. I had no trust in them so I certainly would not pay for the privilege.

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    Footyboy16

    Friday, January 10, 2014

  • After visiting our local A & E department at the weekend with my son I can see why Doctors are wanting patients to pay, as the A & E was busy and some were minor ailments. I also think the whole NHS needs revisiting starting from the GP surgeries. It's almost impossible to get an appointment at the surgery unless it's an emergency and the follow up appointments just don't exists at our surgery. When someone gets ill and in pain so bad that they are throwing up because the pain is so severe they need the hospital. Unfortunately some people wouldn't be able to afford to pay for emergency treatment , so what would happen to them? I am aware that compared to other countries our NHS service is amazing and our doctors do the best they can with limited funding but something definitely needs to be done. I'm not sure what though.

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    Jillyd

    Friday, January 10, 2014

  • This is just the start of the NHS being privatised. So unless people get off their backside at the next election and vote anything other than Conservatives, then it's R.I.P. NHS.

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    dark1988

    Friday, January 10, 2014

  • Footyboy16, sorry to be picky but surely if you were able to simply discharge yourself because you felt you'd been waiting too long then doesnt that tell us that perhaps you werent actually that ill and shouldnt have been in A&E? Perhaps its these kind of people who litter A&Es waiting rooms to avoid GP queues that should be invoiced? Insofar as not choosing to attend the N&N A&E again then again I think you might have it wrong. Nobody elects an A&E. If you're that poorly that you need to attent A&E then Id guess anyone will be fine. A&E - ACCIDENT & EMERGENCY. Clues in the title......

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    Tootyfrooty

    Monday, January 13, 2014

  • Yes, I can see a charge ought to be made but only for the drunks and drug addicts, there are other places for them and if they can afford either of these then they can afford to pay for the after effects. The problem is that they have closed all the smaller hospitals where you could go for minor injuries etc. My elderly dad keeps collapsing and inspite of many tests etc .they cannot find the cause, trouble is if this happens when he is out someone ends up calling an ambulance and he gets taken to A&E where they cannot do anything, the last time someone kindly took him to the GP's surgery as he asked them not to take him to hospital, however, the Dr was very irate and said it was not a walk in centre, so, my question is, what should he do? In the case of elderly people ending up in A&E I don't think they should have to pay as it is not their fault they are elderly and keep becoming unwell, there is no other facility for them. I too am concerned if they start charging for one thing we will soon be paying for all medical care which will hit those of us less well off and take us back to the dark ages.

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    Lynda

    Saturday, January 11, 2014

  • Of course the system should remain free to those who are ILL. But I see no reason why charges should not be levied on drunks, drug abusers and time wasters, of which there are plenty. The system is for accidents and emergencies,not stupidity & self abuse, or a cut finger. If these were eliminated, there would be plenty of capacity for the real emergencies. People who have spent a lot of money getting trashed, either with drink or drugs, can obviously afford to pay for their own treatment. Why should any taxpayer, or N.I contributor keep subsidising treatment for such people? Would you give money to a drunk on the street so that heshe could buy paracetamol to treat his her hangover? I doubt it. This has nothing to do with politics, efficiency or morals and everything to do with the logistics and how much we can afford to keep paying. We already pay plenty and I see no reason to waste that money on expanding the system to treat ever more 'avoidable' admissions to A&E.

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    Labratone

    Sunday, January 12, 2014

  • It would cut down on the regular time wasters, perhaps the ambulance service should do the same, I am sure the money raised could be used to put extra resource on the road.

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    Wife

    Saturday, January 11, 2014

  • Charges should be made in certain circumstances, the drunks on a weekend, or any other time, should be subjected to a charge, and why not? They can afford to spend a fortune getting "paraletic" and think the A&E should sort them out, well charge them, they are taking up valuable space and a charge may also reduce alcohol charged assaults against hospital staff. I also think that if you are in Hospital you should pay for your food, after all, you would be paying for it if you were at home. The NHS is a great service which is just being abused and those who really need it are being denied the treatment they need because staff are tied up dealing with drunken louts. May make them think twice if a visit to A&E or an ambulance ride set them back a few hundred pounds.

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    Mr T

    Friday, January 10, 2014

  • The fact that this question is being asked is further evidence of the Tory party's determination to further and completely privatize our National Health Service. Wake up Britain or we will have an American style health service where being Il is made worse by the constant worry of having to pay for treatment.

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    Yorky

    Friday, January 10, 2014

  • Base it on National Insurance Contributions, if you have a full NI contribution history then it is free. If not, then it's not.

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    Bruce87

    Friday, January 10, 2014

  • Any charge imposed should be paid by the GP practice that too often makes it almost impossible to get an appointment. Even getting through on the telephone to try to get an appointment is really difficult and can take over an hour. The GPs benefited from a massive hike in their pay and promptly cut down on their willingness to see patients. That is where the real problem lies.

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    andy

    Friday, January 10, 2014

The views expressed in the above comments do not necessarily reflect the views of this site

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