Patients should pay for elective procedures, say public health doctors

The Association of Directors of Public Health (ADPH) have said that patients who ‘want' a procedure should pay for it, whereas patients who ‘need' treatment should get it for free and advise scrapping most prescription charges in England.

Dr Tim Crayford, President of the ADPH said that there should be a clinical price tag associated with those procedures which do not have a proven clinical benefit.

The ADPH has identified the following ‘over-used' procedures, which have doubtful clinical effectiveness:

  • Surgery on minor skin lesions.
  • Tonsillectomy and adenoidectomy.
  • Varicose vein surgery.
  • Carpal tunnel syndrome.
  • Hysterectomy for heavy menstrual bleeding.
  • Homeopathy.

Inconsistencies

Dr Crayford said: ‘Eighty-nine per cent of prescriptions are free as it is, and there's no logic on health grounds to charge people for the remaining 11 per cent, except for everyday medicines like aspirin and paracetamol, where charges should remain. It seems unfair to charge for highly effective drugs like statins to lower cholesterol and prevent heart attacks, whilst not charging for some treatments that offer much smaller benefits to people.

‘If people had to contribute to the cost of these things, they would think twice before going ahead. There's often an alternative, which is much less costly.


‘There's no consistent approach to this across the country. Every primary care trust makes its own decisions. Let's have a public debate about what should be charged for and then apply a common framework across all 150 PCTs.

‘The savings to the NHS by charging for doubtful procedures could easily compensate for the revenue lost by making most prescriptions free.'

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