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Why do GPs charge fees? FAQs

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 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, stationery) in the same way as any small business.

The NHS pays the doctor for specific NHS work, but for non- NHS work the fee charged has to cover the doctor’s costs.

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 requested by, or on behalf of, the patient
Examples of non-NHS services for which GPs can charge other institutions are:
  • Medical reports for an insurance company
  • Some reports for the 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 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.

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(the doctors' regulatory body) or even the Police

What will I be charged?

The BMA recommends that GPs tell patients in advance if they will be charged, and what the fee will be. It is up to individual doctors to decide how much they will charge, but the BMA produces lists of suggested fees which many doctors use. 

What can I do to help?

  • Not all documents need a signature by a doctor, for example passport applications. You can ask another person in a position of trust to sign such documents free of charge
  • If you have several forms requiring completion, present them all at once and ask your GP if he or she is prepared to complete them at the same time to speed up the process.
  • Do not expect your GP to process forms overnight: urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this will cost more.