Charging for GP services leads to sub-optimal prescribing that’s bad for health

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I have little doubt that the Tories will eventually lead this country towards a charged-for NHS. Discussion of GP charging is already commonplace, not least amongst GPs, as a way to ration services. In that context it's easy to compare the UK with Jersey, a place that is the same as the UK in all but dubious constitutional status. As the Jersey Evening Post has reported today:

The use of antibiotics in Jersey is falling, with prescriptions down 10% in the past five years to 0.82 per person per year.However, the fall in the UK has been much greater – 60% – to an average of 0.52 prescriptions per person per year.

Dr Philip Terry, chairman of Jersey Doctors on Call, said the cost of GP fees was one contributing factor to higher prescription rates, as patients want to ‘get something for their £40’.

It is widely known that excessive antibiotic prescribing is bad for patients, for populations and long term drug resistance that undermines public health. And yet it is prevalent in Jersey where the only really likely factor to explain the difference in prescribing is charging (and I have noted the other arguments in the article and think they are extraordinarily unlikely to be relevant across the population as a whole, to which this data relates).

Giving people a prescription to justify their fee is bad medicine, but all too easy to succumb to. Charging leads to bad medicine. It's an easy, and in this case, very obviously correct conclusion.

But it keeps drug companies happy.