Would charging for NHS appointments really cut demand?

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By Beth Roberts

Former Health Secretary Sajid Javid has resurrected a policy idea that refuses to die: paying a fee to see your GP to lower demand for over-stretched services. Is there any evidence it would work?

When spearheading the foundation of the National Health Service in 1948, Aneurin Bevan, the Labour Minister of Health, promised that healthcare would be “available to the whole population freely”.¹ But since then that hasn’t always been the case.

Charges for dentistry, ocular health and prescriptions were introduced over the years. Some procedures deemed cosmetic require patients to seek private, paid treatment. Some find themselves having to pay for interventions such as IVF due to postcode lotteries.

And now primary care should join that list – at least, according to the former Health Secretary.

Writing in The Times, the Bromsgrove MP suggested the 75-year-old NHS model was “unsustainable” and called for “radical reform”. One of his key proposals for tackling “excess demand” was to introduce a fee to see your GP, which would encourage “people [to] take active steps to assess whether their demand for frontline services is required”.²