Why do GPs charge fees? Your questions answered
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. Sometimes the charge is made to cover some of the cost of treatment, for example dental fees. In other cases. In other cases it is because the service isn’t covered by the NHS, for example, medical reports for insurance companies, claims on private health insurance and other letters and forms which require the doctor to review the patient’s medical records.
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 pays the doctor for specific NHS work, but for non-NHS work the fee has to cover the doctor’s costs.
What is covered by the NHS and what is not?
What is covered by the NHS and what is not?
The government’s contract with GPs covers medical services to NHS patients. 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 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.
Examples of non-NHS services for which GPs can charge their patients
- Certain travel vaccinations
- Private medical insurance reports
- Holiday cancellation forms
- Referral for private care forms / letters
- Letters requested by or on behalf of, the patient
- In certain instances fitness to work forms
Examples of non-NHS services for which GPs can charge other institutions
- Medical reports for an insurance company
- Some reports for the DSS/Benefits agency
- Examinations of local authority employees
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. Most GPs have a very heavy workload- the majority of our GPs work up to 60 hours a week and paperwork takes up an increasing amount of their time. In addition non-NHS work must be undertaken outside of NHS contracted time.
We aim to complete private requests within 14 calendar days, but this is dependent on NHS requirements which take priority.
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.
Why do some letters cost £25 and others £50 or more?
Each request is very different and some requests can be completed very quickly as the medical history of the patient is very small and known to the GP. However, where a GP has to review a large medical history to ensure accuracy of any comment they make in a letter; or the content of the letter is extensive we must consider how much time it has taken to complete this work. Your cost includes the time the GP takes to review the request, review your medical record, to dictate a letter and the time for the admin team to type up the letter where necessary and printing/postage costs where necessary.
Why am I being charged for a private referral letter when I am saving the NHS money in going private?
Where a private referral request is treated in the same timescales as an NHS referral we do not charge a fee i.e. 7-14 working days. Where a patient requires the letter quicker than this timescale we apply a charge for providing the letter more quickly than would be available if it was an NHS referral. This is because the request is requiring additional medical secretary time to provide it without detriment to the existing NHS referral workload.
Why won’t you refund me if I don’t need a private letter any more?
We require payment in advance of any private work commencing. Clinicians and medical admin have to take time away from NHS work to complete private work. If you change your mind after the work has been completed, we still have to fund the time that was taken to do it. Therefore, we will not refund any monies where the work has already been commenced.
I have had a request for a letter declined – why is that?
All private requests are at the absolute discretion of the GP and they reserve the right to decline a request.
There are also several letter types we do not provide as they are not effective use of GP time and/or they are not necessary.
These include but are not limited to:
- Letters to schools and colleges regarding absence
- Letters regarding sickness absence during the period of self certification
- Letters to schools/nurseries regarding non prescribed medications.
- Please note that where a medication has been prescribed, a copy of the prescription and the medication with the administering instructions is sufficient for a school/nursery and they should not require an additional letter.
We do hope you understand that with so much pressure on NHS financial resources that we cannot provide private work without charge.