Senior doctors have rejected new survey findings which show that 32% of GPs regard charging patients as the “most cost-effective” way of reducing pressure on hospital A&E departments. 

The survey of around 800 GPs was conducted by, whose chief executive, Dr Tim Ringrose, said the findings were not surprising.

“It may be a clear departure from the traditional NHS vision, but many doctors are now saying that radical action has to be taken to reverse the ‘free at the point of abuse’ culture that is a key contributor to the current emergency care crisis in some areas,” he said.

However, the British Medical Association (BMA) pointed out that two-thirds of the GPs surveyed had said they were against levying patients for using A&E services.

“Introducing charging for NHS services runs the risk of deterring vulnerable patients who genuinely need help from seeking treatment at a time when many people, from all backgrounds, are struggling financially,” said Dr Mark Porter, chair of BMA Council, while Dr Chaand Nagpaul, chair of the Association’s GP committee, called for a coordinated response across the NHS to reducing pressure on A&E.

This should include acknowlegement of the need for more resources, improvements in the quality of NHS 111 and better integration between community services, social care, GP and hospital services, he said.

“We will not solve the problem by penalising less well-off patients by erecting financial barriers within the health service,” said Dr Nagpaul, and he warned that doing so could prove counterproductive, as patients who are deterred from seeking medical attention at A&E may end up becoming more ill, requiring greater hospital care later on.

“Patients could also inappropriately seek treatment at their GP practice, even if they genuinely need hospital care. This could act as a perverse incentive that sends patients in the wrong direction for their care,” he warned.

And the Royal College of General Practitioners (RCGP) cautioned that charging patients for A&E treatment “would put us on the slippery slope towards the Americanisation of healthcare – where only those who can afford it get the care and attention they need.”

Patients usually attend A&E because “they don’t know where else to turn,” and the solution to the crisis is through the provision of adequate funding for general practice, said College spokesperson Dr Helen Stokes-Lampard, a GP in Lichfield.

“GPs conduct 90% of the NHS contacts for just 8.39% of the NHS budget. If general practice was better funded, many people who are seen in emergency departments could be seen by a local GP,” she said.