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 - Credit: Archant 2013

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

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.


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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.

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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.

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