Why do GPs charge fees?
The National Health Service provides most health care to most people free of charge but there are exceptions. Prescription charges have existed since 1951 and there are a number of other services for which fees are charged.
The NHS pays the doctor for specific NHS work, but for non NHS the fee has to cover the doctor’s costs. It is important to understand that GPs are not employed by the NHS, they are self-employed and they have to cover their costs which include staff, buildings, heating, lighting etc. in the same way as any small business.
Sometimes the charges exist because the service is not covered by the NHS, for example, providing medical reports for insurance companies or employers, claims on private health insurance and other letters and forms which require the doctor to review the patient’s medical records.
What is covered by the NHS and what is not?
The Government’s contract with GPs covers medical services to NHS patients however in recent years more and more organisations have been involving doctors in a wide range of non-medical work. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community or because an insurance company, employer or public body wants to ensure that the information provided to them is true and accurate.
Examples of non-NHS services for which GPs can charge their own NHS patients
- Accident/sickness certificates for insurance purposes
- School fee and holiday insurance certificates
- Reports for Health clubs to certify that patients are fit to exercise
- Private prescriptions for travel purposes
Examples of non-NHS services for which GPs can charge other institutions
- Life assurance and Income protection reports for insurance companies
- Reports for the Department for Work and Pensions (DWP) in connection with disability living allowance and Attendance allowance
- Medical reports for local authorities in connection with adoption and fostering
Surely the Doctor is being paid anyway?
It is important to understand that GPs are not employed by the NHS, they are self-employed and they have to cover their costs – staff, buildings, heating, lighting, etc – in the same way as any small business. The NHS covers these costs for NHS work, but for non-NHS work the fee has to cover the Doctor’s costs.
In recent years, more and more organisations have been involving Doctors in a whole range of non-medical work. Sometimes the only reason that GPs are asked to do non-medical work is because they are in a position of trust in the community, or because an insurance company or employer wants to be sure that information provided is true and accurate.
Why does it sometimes take my GP a long time to complete my form?
Time spent completing forms and preparing reports takes the GP away from the medical care of his/her patients. The surgery will always prioritise the care of patients. As a result, non-NHS work may take longer to complete.
Some reports and correspondence may also be complex and requires information to be gathered from a number of different sources. Other reports may require a medical examination. These factors also influence the time taken to complete reports.
Non-NHS work must be undertaken outside of NHS contracted time. We will aim to complete all private work within 15 working days.
I only need the doctor’s signature, what is the problem?
When a doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true. Therefore, in order to complete even the simplest of forms, the doctor needs to check the patient’s entire record. Carelessness or an inaccurate report can have serious consequences for the doctor, with the General Medical Council or even the Police.
How are charges decided?
The British Medical Association (BMA) recommends that GPs tell patients in advance if they will be charged. It is up to the individual practice to decide how much to charge. The BMA has in the past provided guidance for GPs in setting their fees.
This is less common now and GPs are able to set their own fees to ensure that their costs in delivering the services are covered. Time spent completing private reports and undertaking private medical examinations are generally done outside of normal working hours as an extra commitment to a GPs workload. Hindon Surgery carries out periodic reviews of charges at other surgeries both locally and nationally and endeavours to follow a fair charging policy.
The services shown are not provided under the National Health Service (NHS) contract and the following fees will be charged. If you have any questions relating to these fees, please address them to your Doctor or the Practice Manager before requesting the service.
What will I be charged?
It is recommended that GPs tell patients in advance if they will be charged, and what the fee will be. The surgery has a list of fees which is available at Reception and on our website.
Payment Of Fees
In the past we have completed reports and forms before payment has been made, but have sadly found there to be too many occasions when the doctor has given up the time to do the work, but the fee has not been paid.
Therefore, the fee must be paid in advance at the time the request for the letter or form to be completed is made or when the appointment for a medical is booked. Due to
administrative time taken to complete the letters/medicals, fees are non-refundable.
What can I do to help?
- Not all documents need a signature by a doctor, for example passport applications. You can ask another person in a position of trust to sign such documents free of charge. Please read the information that comes with such forms carefully. Following advice received previously, Doctors at the surgery do not countersign passport applications.
- Think ahead wherever possible –bring forms to us as early as possible and give us plenty of time to complete the work you need doing.
- If you have several forms requiring completion, present them to the surgery at the same time for completion.
- Do not make an appointment with a GP for reports, form completion or letter requests. These must be paid for in advance and the administrative team will be able to help you.
- Forms may take up to 3 weeks to complete. Urgent requests may require special arrangements to be made which may add to the cost. Our priority will always be NHS patient care over non-NHS work.
Private patients
We have no private patients and apart from the services mentioned previously do not provide any private medical services to patients registered with the practice.