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In his latest BMJ column, Des Spence writes about charging patients to sign letters and documents:
“I don’t charge for simple certificates, passports, referrals, housing letters, and the like. With medicals it would depend on whether or not patients were paying for themselves, and if so I would charge only a token fee. I do not take cremation fees. Now this might seem nauseatingly pious, just Champagne socialist posturing. But I think that we are already extraordinarily well paid and many of the people we charge are those who can least afford it. And my approach makes it easier to square the uncomfortable circle that is our high pay.” http://www.bmj.com/content/345/bmj.e7078
GPs are private companies and the NHS does not cover the cost of signing and processing these letters. The BMA has guidelines for what fees to set – but the majority of these fees are only guidelines and this means there is practice to practice variation. Is that fair? http://bma.org.uk/practical-support-at-work/pay-fees-allowances/fees/why-gps-sometimes-charge-fees
In addition, Spence also makes the point that if you charge for certain administrative services this erodes the reputation and goodwill associated with the practice. The profits gained from this sideline are “negligible compared to overall practice income, which is mainly based on NHS capitation: the number of patients that we have.” If patients get the hump from having to pay extortionate fees then they might not recommend the practice to friends and this could have a knock-on effect in terms of attracting new patients, the overall reputation of the practice, and future funding.
Should the fees be capped, means tested or even scrapped altogether?