Payment for visit to GP at £75 an appointment
Questions are being asked about the future of the NHS in Northern Ireland after a GP surgery began accepting private patients at £75 an appointment due to financial pressures on the practice, with some describing the decision as “the beginning of the end of the NHS as we know it”.
The independently funded Think Tank, The Nuffield Trust spoke with the doctor in the surgery concerned:
"Dr Tom Black, the chair of the BMA’s Northern Ireland branch and a prominent figure for many years. He said he was left with “zero choice in the matter”. He argues that the practice had been losing money for 15 months and faced bankruptcy in six. Under this arrangement private patients, drawn from people outside the practice’s NHS list, are charged at £75 per appointment. The intention is to use that to subsidise the care of NHS patients.
Significantly, this hybrid arrangement is entirely dependent on the goodwill and voluntary effort of the four other partners in the practice. They have agreed to see the private patients without getting any extra payments themselves, so that the extra money can prop up the bottom line of the NHS practice. The partners have guaranteed the same number of appointments will be available for the NHS patients."
The Nuffield Trust news item went further in reporting on the issue:
"The beginning of 2024 marked a watershed moment in the history of the NHS in Northern Ireland, with the opening of the first hybrid public-private GP surgery. Abbey Medical Practice, located in an inner-city area of high deprivation in Derry, began accepting private patients in a bid to stay afloat.
This move has caused quite a stir. Dr Alan Stout, chair of the BMA GP Committee for Northern Ireland, commented that “this is the beginning of the end of the NHS as we know it”. While some reactions applaud an innovative response to getting more money for the NHS, others raise the fear that this move is the beginning of a slippery slope to something like the model for dentistry in the NHS, where staff and patients alike are squeezed into paying for care as the state system withers."
The Trust makes this final comment following the re-instatement of local shared government for Northern Ireland at Stormont:
"Northern Ireland’s newly reformed government faces plenty of urgent problems in its health service. The decision at the Abbey Medical Practice highlights that letting them sit may result in further losing the capacity to deliver the care people need. And for other health services across the UK, it is a more visible manifestation of the problem they all face in keeping workers inside the strained systems they rely on to deliver care to everyone who needs it, free at the point of use."
Click the image above right to read the original article.
Source: Heenan D and Dayan M (2024) “Privatisation by the front door: what does a new public-private GP model mean?”, Nuffield Trust blog