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Should we tell patients how much NHS services and medicines really cost?

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If patients knew how much their medicines had cost the NHS, would they be more or less likely to take them? If they knew how much a visit to the A&E cost, would they be more or less likely to go?

As one delegate at the self care conference last week (12 November 2013) pointed out, the NHS is one of the only services that the public regularly accesses while having no idea of the cost. If patients knew that an 11-minute GP appointment for their cold costs the taxpayer £43, they might be more likely to try to treat it themselves, thus freeing GP time to see patients with more complex problems. Similarly, if the cost of a medicine was printed on the label, it might encourage patients to take it properly and reduce the likelihood that they would waste it.

However, there are concerns that if patients know these costs it may deter them from accessing the services and medicines that they do need. It is feared that elderly people in particular may feel guilty about the cost to society and therefore stop visiting their GP or collecting their medicines.

Rob Darracott, chief executive of Pharmacy Voice, said that one way to address this problem was to make people aware of how much services and medicines cost at a population or local population level, so that patients would not worry about how much their individual treatment costs. This seems like a sensible approach, but dilutes the effect — it removes the onus on the individual to consider the necessity of their GP appointment carefully.

Another delegate suggested charging people a small fee, similar to a prescription charge, for visiting the GP or A&E. However, this seems to create more problems than it solves. First, it would further deter people who need to access services from doing so. Many of those who do not pay tax are unlikely to be able to afford the fee. Secondly, patients who do pay tax would feel that they are being charged twice. There would also be logistical problems, and the NHS would no longer be free at the point of access.

Publicising the cost of NHS appointments raises another issue in that some patients feel entitled to “get their money’s worth” from the NHS, as a GP present at the conference explained.  John Chisholm, chairman of the Men’s Health Foundation, acknowledged the problem but emphasised that the NHS is not an entitlement and that everyone should get from it what they need, not what they put in.

This is noble and accurate, but would not necessarily console a healthy taxpayer with a cold who is encouraged to visit a pharmacy while paying for other people to visit a GP. Therefore, it is important to emphasise why looking after yourself or visiting a pharmacist for support is not only a benefit to the NHS, but also why it is a benefit to the individual.

The self care message clearly needs to be delivered sensitively and thoughtfully. A robust national campaign would be ideal, but it is difficult for the Department of Health to make a commitment in austere times.

However, many projects presented at the conference suggested that patients do have a strong appetite for self care — people want to be able to look after themselves. Waiting for a GP appointment is tedious and pharmacies are convenient. European Antibiotics Awareness Day is today, and the “Treat yourself better without antibiotics” campaign is freshly launched. Let us capitalise on all this.

Spread the word: common conditions can be treated more effectively and conveniently by patients and pharmacists than in GP clinics or the A&E. Doing so could save time, money and, ultimately, the NHS.

See also:

Education on self care

Winter campaign encourages the public to seek pharmacy advice


Emma Page is editorial assistant at The Pharmaceutical Journal



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