Patients across England could be asked to pay means-tested ‘Netflix-style’ monthly subscription fees to see their GP as part of a controversial new ‘alternative strategy’.
Family doctors in England will vote on proposals that could allow them to introduce subscription-based services, offering additional services to patients willing to pay.
The move would mark a dramatic shift away from the founding principle of the NHS – that care is free at the point of use – and risks creating a two-tier system.
It comes as GP partners – who are self-employed – earn an average of £159,000 before tax, with increasing numbers also taking on private work.
Under the suggested model, patients could pay a regular fee to access services outside the standard NHS offer, in a system similar to NHS dentistry, where some treatments cost up to £319.
The British Medical Association’s GP committee confirmed it will ballot doctors on what it has described as a ‘plan B’ or ‘alternative strategy’ for general practice.
The proposals follow a vote by GP leaders earlier this month to draw up plans for ‘exiting’ NHS contracts and exploring options for working outside the health service.
Some leaders suggested that quitting the NHS could be used as leverage in the ongoing dispute between doctors and the government.
The move would mark a shift away from the founding principle of the NHS – that care is free at the point of use
Dr Katie Bramall, chairman of the BMA’s GP committee, said doctors were ‘deeply frustrated’ and had ‘no other choice but to explore alternatives’.
She warned that confidence in the future of general practice within the NHS was now ‘at an all-time low’.
‘This didn’t happen overnight,’ she told Pulse. ‘It has been a slow and gradual deterioration of morale within the profession.
‘We risk losing NHS general practice entirely if urgent action is not taken.’
Dr Bramall said years of under-investment, rising workloads and staff shortages had left many GPs struggling to provide safe care.
She added that current contract arrangements limit doctors’ ability to meet patient demand, restricting what services they can offer.
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Critics say the move towards subscription or means-tested models could entrench inequality, allowing those who can afford to pay to access quicker or better care.
The Department of Health and Social Care said it opposed any shift towards paid-for GP services.
A spokesman told The Telegraph: ‘Moving towards a model of private, means-tested or subscription-based GP services is not in the interests of patients or the NHS.
‘A two-tier health system would only serve to deepen the health inequalities that already exist.
‘The founding principle of the health service – that care is free at the point of use -must be protected and we will do so.’
GP leaders have previously discussed drastic measures, including mass resignation from NHS contracts, to force improvements to funding and working conditions.
Last year, local medical committees authorised the BMA to use the threat of GPs ‘walking away’ from the NHS to strengthen its negotiating position.
Separately, previous protest actions have included proposals to cap the number of patients doctors see each day.
At the same time, a growing number of GPs are supplementing their income by working in private healthcare or for online medical services.
