Ten reasons why the Tory plan to limit visits to the GP is barmy and will cost lives


4:18 pm - May 29th 2013

by Kate Smurthwaite    


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Monty Python famously had a Ministry of Silly Walks. Sometimes it starts to look like David Cameron is running a Ministry for Silly, Stupid and Downright Dangerous Ideas. The latest of these to be floated* by the Conservative Policy Forum is to limit the number of GP visits individuals are entitled to on an annual basis.

Another way of phrasing this would be “penalise people who are sick a lot”.

Here are ten sets of circumstances in which this could lead to, well, death, among other issues.

1. Currently the people who make the most appointments are the elderly. If older people feel that they’re a burden, especially with long term conditions like high blood pressure, they won’t seek help. Thousands of elderly people, including my grandma, already fail to spot and report conditions like pneumonia and minor strokes.

2. People with long-term medical conditions that affect their immune system. AIDS is an obvious one, people taking immuno-suppressant medication after organ transplant is another. These people need to be vigilant in reporting any minor illness to their GP.

3. Patients with multiple interacting conditions. For example Crone’s Disease sufferers may not be able to readily absorb medicines given for other conditions so may need repeated visits to adjust the dosage.

4. People with minor symptoms of potentially serious conditions. Charities addressing conditions like bowel cancer are forever telling people to go to their GP if they spot blood in their stool or seem to be losing weight for no reason. Knowing there’s a limit on visits is surely going to encourage people to wait longer before raising these apparently small issues.

5. Similarly new parents with sickly kids may visit doctors multiple times over fairly small issues, it’s natural for new parents to be over-cautious. Discouraged from making frequent visits serious conditions like meningitis could be missed.

6. Those who suffer from mental health problems are also put at risk. This is another group of people who use more GP visits than average at present. Mental health conditions can’t be treated in a one-off way, they’re long-term and need monitoring and a variety of approaches tried to tackle them. Refusing to treat such patients would inevitably lead to deaths from anorexia and suicide.

7. People feeling unwell who have already “used up” their allocated number of visits may resort to borrowing a friend’s ID to speak to a doctor. Faced with the wrong set of medical records doctors may prescribe medicines that are dangerous for the patient.

8. People with sudden emergency medical problems – car crash victims, heart attacks, epilepsy sufferers, are placed at greater risk because Accident and Emergency rooms are suddenly clogged up with people who’ve run out of GP appointments to use.

9. Young people visiting their GP to discuss sexual health issues in confidence. What will happen when they are unwell and their parents or carers suggest they see their GP? How will they explain they have fewer appointments left to use? This breeches their right to confidentiality and risks encouraging them to lie and avoid medical attention.

10. People who are unhappy with the care they’ve received from their GP. Everyone’s entitled to seek a second opinion. A simple example would be a woman who’s doctor refuses to refer her for a termination. If you happen to live in an area where high numbers of doctors are unwilling to help women seeking abortion, you could end up using up all your remaining appointments without getting the referral you need. Or a victim of rape or assault who wants to try different professionals until they find one they are comfortable talking to.

But I guess what Cameron and his team are trying to build is a health service that works perfectly well for everyone except the old, children, the sick, parents, the poor, young people, people with mental health problems, people with sexual health problems, and victims of car crashes, cancer, meningitis, stroke, heart attack, epilepsy, AIDS, Crone’s Disease, crisis pregnancy, rape and assault.

In short there are millions of people who might need to see their GP more often than an arbitrary number of times in a given year. Actually I’m one of them. Sometimes I feel I should get reward points I’m there so often. Over the last couple of years I’ve found about six lumps in my breasts. Each time the doctor asks me to make a couple of repeat appointments so she can check if the lump is temporary or changing, each time I get referred to the local hospital for an MRI and sometimes a biopsy. So far the diagnosis is that I have “dense breast tissue”. This may explain why the published political opinions of The Sun’s page three models never seem all that insightful, but it’s nothing to worry about.

What my doctor has never told me is “hey, if you find another lump – just ignore it”.

There’s a petition you can sign online on this issue. https://secure.38degrees.org.uk/page/s/dont-cap-GP-visits

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About the author
This is a guest post. Kate is a stand-up comedian and is interested in secularism, feminism and stand-up comedy. Also at: Cruella-blog, Butcher's Writer's Group and Kate's Quite Sarcastic Almost Daily News Podcast
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Reader comments


1. Sam Barnett-Cormack

Sometimes I wonder if they think that those of us who have reason to see the doctor often enjoy it. I’d love to go a month or two between trips to my GP (or the practice’s NP, or nurse or HCA). Just doesn’t work like that.

As well as having complex and multiple health issues, I’m on immunosuppressants (for eczema of all things, which didn’t respond properly to other treatments). I’m supposed to see someone at fairly small provocation, and there’s always new things going wrong.

2. Paul Trembath

It seems to be literally true that they know the price of everything, and the value of nothing.

3. Natacha Kennedy

The Tories don’t care they just want you dead anyway if you can’t afford private health care.

It’s a barking idea, but it might be worth pointing out that this was a poll question on a party forum from a list of agree/disagree questions (like “we can’t afford out-of-hours service/visits”) and as such isn’t even remotely party policy.

Limiting visits to GPs is a rational policy.

Pensioners and the chronically sick are the most vunerable but their early demise will help to reduce the budget deficit by cutting NHS costs and reducing the payout of state pensions and disability benefits.

My first thought on hearing this was that it would have an impact, not just on frequent visitors, but also on anxious types who (even if they were in no danger of using up their allocation) would worry about the issue and avoid going to the doctor when genuinely ill.

7. Derek Hattons Tailor

I think it’s safe to assume that the restrictions would not apply to vulnerable groups viz the elderly, children and those with long term or chronic conditions.

This is clearly aimed at the “worried well”, generally healthy young people who bother their doctors on a regular basis with trivial issues which could easily be treated by a quick internet search and a trip to the chemists. Their numbers have grown massively under the onslaught of messages from the “health lobby”.

There are also a lot of people who make appointments and don’t turn up, without cancelling, costing NHS resources and meaning someone who does need attention has to wait.

8. Charlieman

Isn’t this just about the stupidity of targets?

Quantifiable targets encourage people to shoot for the measured goal. They don’t necessarily incite people to do what it best.


The OP and other commenters identify circumstances where a count of ten visits is daft. Owing to what crops up (or bursts and explodes), patients may seek more than 10 visits in a 12 month (calendar year?) interval.

On visit number 11, what is the GP expected to do? Banish the patient from the premises, or examine the patient to identify a problem which might be fixable enough to extend life?

9. Witchsmeller Pursuivant

Crone’s disease? Did your grandma have that too?
FFS. Can this website become any more tabloid ?

10. Derek Hattons Tailor

@ 8 A wild guess – they would be charged for visit 11.

11. Steve Howe

@7 You obviously have faith in the good intentions of this government yet all their actions so far have targeted the poor, the sick and the otherwise vulnerable. I haven’t seen anything to indicate that the plan is to target time wasters; it’s targeting those that visit the doctor more than most.
The plan does seem to be to hide the difficulty people already have trying to get an appointment, and is presumably to stop people blaming the government for cutting the health service and encouraging them to blame the sick instead. The usual tactic.

12. Chaise Guevara

“barmy”

I fucking hate this word. It’s only used by tabloids, lazy politicians trying to avoid discussing the issue, and Dennis the Menace.

That said, this plan is obviously terrible and thoughtless and you’re entirely right to challenge it. I’ll blame Sunny for the headline as per usual.

13. So Much For Subtlety

We provide a valuable service for free. Naturally people are going to use it when they shouldn’t.

In the old days people had still grown up with the values of the past and so rationed themselves. We no longer have those values. People are more selfish and will abuse the system if they can.

Thus we must ration in some way access to doctors. This is a stupid way. But if not this way, what? We can’t go on. We need some system to limit costs or the whole system will collapse and then everyone will have to pay. So over to you all.

14. General Jumbo

@12 I can’t remember Dennis the Menace EVER saying Barmy.
You rotter.

I’m sure Tory think tanks come up with this by holding focus groups in the Golf Clubs of Surrey.

15. margin4error

At face value it looks likea money saving effort by means of population control as bob describes.

In reality it is a transparent attempt to break down the initial barriers to charging for healthcare. Start with charges for the eleventh go visit, later make it sixth, then third, then for all visits but only if people are of working age, and so on. Nothing fills the hearts of certain people with more hatred and viciousness than the thought that we get our healthcare at their expence and still see it as a principle not a profit margin. This is their response.

A far better idea would be for an upfront charge of, say £20, for GP visits (higher at the weeekends or out of hours), that would be refundable by the NHS (or other state-run insurance provider) either in full or in part depending on the age and circumstances of the patient. Usual exemptions (elderly,infants etc) would apply.

This would mean there would be an end cost to visiting the GP, making it a service less likely to be abused (I have friends who are GPs, and they are visited for astonishingly trivial reasons) while at the same time not putting a barrier up to genuine need.

Far too sensible ever to work here, though an identical system works perfectly well in that hard-right dystopia that is France.

17. the a&e charge nurse

[16] French health services have ALWAYS cost more, significantly more in fact compared to the NHS – why is that?

The system you advocate is simply untenable in a climate of cost cutting, sorry, I meant efficiency savings.

Minister for Murdoch (Jeremy Hunt) was in bed with News International execs and the tories came very close to handing Roop a virtual monopoly of our media – at the 12th hour digger’s culture of systematic abuse and corruption was finally exposed so the bid failed.

So what does Cameron do – promote him, and then say, there you go Jeremy, have another go at enriching the corporate fatcats.

You are seriously deluded if you think any of this has got anything to do with improving our health services, or making us more like France.

18. David Moss

How is it that despite the fact that the NHS is constantly running health campaigns to *encourage* people to go to their GP and that men as a group have a lower life expectancy in part because of their blanked reluctance to visit their doctor, so many commenters here have decided, with unfailing confidence, that people are visiting their GP too often and need to be discouraged?

16 – charging for a GP visit would cost more than not charging for a GP visit?

Visits? Plural? Haha, don’t make me laugh. Chance would be a fine thing that I might get to see a GP even once when I’m ill, let alone multiple times.

The NHS spends over £100 a month on my behalf – somehow it doesn’t feel like the £100 a month service I get elsewhere. Funny.

21. the a&e charge nurse

[19] that’s far too simplistic.

At one level financial advantages (associated with a £20 charge) could easily be calculated but the indirect cost that might arise because of such a system might be less easy to measure.

It has been argued that one of the main reasons NHS cost are so much lower compared to the likes of France, Germany and Switzerland is because of the gate keeping role provided by GPs (who already provide 250 million consultations each year – the equivalent of 4 annual consultations for every single person in the UK).

If people are deterred from seeking medical attention because of upfront charges then the financial cost associated with avoidance might actually prove to be considerably greater in the long term.

22. the a&e charge nurse

[20] I blame the GPs, not the 250 million consultations that people seek each year.
Of course the various helplines, walk in centers and A&E departments hate dealing with patients as well – why can’t we all have a live in GP, eh?

Thanks all. Erm fairly obviously (1) I didn’t write the headline. I agree, it’s not really a “Tory plan” it’s an idea they’ve floated. The headline was written by editors here, not by me. and (2) yes a spell checker turned Crohn’s into Crone’s. Why not get angry about it?

So what does it cost to visit a doctor in those socialist welfare paradises that Liberal Conspiracy covets?

Charge to visit GP in France : €21 – €25

Charge to visit GP in Sweden : £8 – £12

Damn those Tories and their plans to continue free GP visits.

@23

Blaming spell checker reveals that you care so little for your audience and/or the art of writing, that you are too lazy to bother with a final read-through.

26. Derek Hattons Tailor

@ 18 But it’s precisely because of constant health campaigns that GPs are full of hypochondriacs. The multitude of health “charities” and lobbies bombarding us with constant messages about health causes people to worry about health, and visit the doctor more.


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