Boots health checks – are you happy to pay?

This will create a two tier health service. – yet another indication of gradual privatisation of the NHS.

If health checks are carried out at Boots by qualified practitioners who are able to prescribe antibiotics for example for minor problems that you would hesitate to contact your GP and wait up to 3 weeks for an appointment, then I would willingly pay a small amount. I would hesitate to use this service for a potentially more serious problem such as skin cancer when you would need a specialists referral.

I always see a different Doctor when I visit my local practice anyway so it wouldn’t make much difference to me, as long as I knew he/she was sufficiently qualified to practice.

Ian says:

And privatisation creeps furtively into the Health Service. I have a problem with this in many ways, but one is very simple: if GPs will be ‘free’ to do private visits, how come NHS patients have to wait?

I’d be fascinated to see the justification behind the idea. Boots wants to make money, of course – pure and simple – but GPs are already being paid by the NHS. If the argument is that it will reduce stress on the service, then bring in fines for those who make completely unnecessary calls, but don’t make people pay up front.

Beryl says:

Where I live you would be extremely lucky to get a GP out from my local practice to visit. If you are still able to drive, they expect you to get up from your sick bed with a high temperature and breathing difficulties and visit the practice. The only time I have received a visit from a GP in the 26 years I have lived here has been from the out of hours service.

malcolm r says:

There seems to have been a mix of private and NHS for years. Doctors all charge for some services – for the information required to retain certain driving permissions over 70, for some vaccinations, and consultants mix private and NHS.

We do abuse the NHS. A friend recently went to an eye clinic. 24 appointments had been made. At least 10 had not shown up for theirs when he was seen. Perhaps we should pay a deposit when we are given an appointment and get it refunded when we attend – or lose it unless you have a good reason and generally cancelled it in advance.

Mike S says:

Many appointments are missed when the car park is full making it impossible to attend. This is particularly true in rural areas where there is no bus alternative.

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Ian says:

To be fair, Wales isn’t allowing it, either.

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John Ward says:

How can Scotland or Wales stop what Boots are proposing to do? If the service is what people want then they will use it and consider it good value for money.

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John Ward says:

I expect Boots will take those points on board as they plan their roll-out Duncan.

Seeing how people will drive thirty miles and back to go to the Hospital A&E department rather than go to the GP’s surgery, nothing would surprise me now.

John Ward says:

One of the NHS’s big problems is that there are just not enough doctors to meet the needs that are presenting in ever-rising numbers. It’s no good building more hospitals or installing more beds and day treatment facilities if there will not be enough staff to cover them. So anything that abstracts doctors from the National Health Service is a bad move. Hospitals and Primary Care Practices are in a staffing merry-go-round and relying on temps, locums and overtime to cover the service. And yet we have a booming parallel private health system offering all manner of complex procedures of an elective nature leaving those with serious clinical conditions and injuries to be dealt with by a struggling service which, ironically, is actually so good that it is generating more demand than it can cope with. If every physician tied-up doing what I consider to be non-urgent vanity operations [and I know the counter arguments about confidence and self-esteem] were deployed into the NHS that would help. People wanting such procedures would then have to go abroad for them, but such interference in the freedom of surgeons to practice wherever they choose would not be tolerated by the profession and could also be counter-productive.

I have just one objection to the existence of privately funded hospitals carrying out treatments and procedures that would otherwise block up the NHS, and that is that they enable people to jump the queue; but I think that is an inescapable quid pro quo for which there is no satisfactory alternative; we should bear in mind also that such facilities provide valuable overspill bed-space for the NHS during peak admission periods. This is a free country and if people want quicker and more convenient treatment in a place that is more like a hotel than a laboratory they do have the right to pay for it. A lot of the consultants who serve in such establishments do also do work for the NHS [even if for no other reason than that it gives them valuable experience].

Getting back to Boots and the provision of drop-in health checks, examinations, minor treatments, and procedures of the kind that GP practices are supposed to be able to do virtually on demand, I think a lot of people will avail themselves notwithstanding the costs. They will not be wondering where the additional GP contact time is coming from and whether the NHS will suffer as a result [as it probably will]. So many people such as me have no alternative to having private dental treatment and have been paying for spectacles most of our lives. So a few pounds a year extra for dealing with a minor problem without bothering your GP will appeal to many. I sometimes ask for advice from the pharmacist on ailments, irritations and temporary skin complaints so it is really just an extension of that [except for the payment]. An increasingly affluent and time-sensitive population will welcome this service.

I am less happy about the flying doctor service projected through private home visits by established GP’s as this will deplete the resource available at the surgeries to deal with patients who will not be able to afford such a service. More driving time equals less patient contact time. The present out-of-hours NHS service is bad enough already without weakening it further by attracting doctors to a premium payment service. The doctors providing this service will either be doing it to the detriment of their contracted hours for their existing clinics and surgeries, or will be doing it in their own time to the detriment of their own health & safety and possibly that of their patients if there is no restriction on the hours they serve. There is a lack of information on this aspect of the Conversation so my comments could just be speculation.

alfa says:

We had company private healthcare for a few years, and all the doctors we saw also worked in the NHS. You could see a doctor privately within a week, even the next day, but have to wait months to see that same doctor on the NHS.

I would like to know how doctors are employed in the NHS. My impression is that doctors who also work privately, have a lot of free slots. Even our GPs do private work away from the local surgery and we might have to wait a month to see our GP of choice.

It seems to me, there could be enough doctors if they spent more of their time in the NHS and less time in the private sector.

I also think newly qualified doctors should have to work in the NHS for a certain number of years to pay for their training and maybe get a bonus after 10 years for staying.

Pharmacists have long been useful for enquiring about minor ailments. If Boots start charging, does that mean you can’t ask which cream to get for a rash without paying first?

John Ward says:

As an aside, some of us who live out in the country do know a little bit about the Uber cab service but such references confirm Which?’s pervasive metro-centric stance and failure to be inclusive. Even many Londoners are entirely untouched by Uber although most will probably know about it. The further you go away from the capital the less relevance it has. It is also an unfortunate analogy in the context of this Conversation since one of the reasons that Uber has become notorious in London is due to allegations of sharp practice, untested and unvetted drivers, and improper personal conduct and behaviour. To associate this, even indirectly, with GP’s providing a private home visit service is a step too far in my opinion.

dieseltaylor says:

All very good points JW. I think we all need to be very very concerned over the steering of the NHS to an American model.

It is incontrovertible that the US pays the most for an ineffective health system for the majority. Anything coming from the US needs serious consideration given that costs seem a major problem. Paying 4 times as much of GDP as the UK on health and they are bottom of 20 countries and we are top … something to bear in mind.

For those that like the base information is was research by AFAIR the US based Commonwealth Fund
http://www.commonwealthfund.org

Ian says:

There are really two strands to this debate. Boots and the NHS, which are different entities in all the ways that matter. But overall the thrust of this topic is to discover whether we – in the main – support the creeping privatisation of the Health Service.

It’s a massive topic, not least because it affects every single person, and I admit to being both surprised and delighted that Which? is willing to dip its institutional toe into this particular quagmire of political intrigue.

I suspect we will need several offshoot topics to cover all the possibilities, but off the top of my head I can think of several aspects that need considering.

Abuse: should there be a penalty for NHS abuse? If so, how should that penalty be enforced?

What will define abuse? From stupid 999 calls to those who injure themselves while blind drunk or those who consistently overeat junk food – it’s a huge category.

Training of Doctors: JW notes we’re short of Doctors, and one reason for that has been a drop in applicants for Medical courses. Why?

Facilities: we need more and better triage centres to ease the pressure on the ambulance service. When I was taken in as an emergency in early January I only had to wait until one ambulance had cleared the bay, so it wasn’t too bad. At other hospitals some patients were waiting for hours. In the ER ward there were 8 beds and the patient distribution that I saw was 1 x deliberate overdose, 1 x man with sore leg, 1 x clearly inebriated individual, 1 x indigestion sufferer who thought she was having a heart attack and myself.

This is a colossal topic and I have to say well done to Which? for stepping into this one.

Beryl says:

It’s really a question of affordability, whether you are considered ‘at risk’, for example, over 65, the very young, or people with a chronic disability.

If you normally enjoy reasonably good health and can afford to pay for a quick trip to Boots (and I would hazard a guess that Lloyds Pharmacy will also follow suit) for a speedy diagnosis and treatment for a minor complaint, then why not? This would save you a long wait for an appointment with your GP and would free up more of their time, enabling them to attend to the ‘at risk’ patients who either can’t afford to pay, or are unable to access Boots for whatever reason, or have no means of travelling to their local GP practice either. Many elderly have had to give up driving through ill health and problems with their vision.

The NHS is overstretched, one of the reasons being that it is “free at the point of access”, which in turn renders it liable to abuse and that “access” is becoming more and more difficult to obtain. The taxpayer is already funding NHS treatment in privately run independent hospitals where a large percentage of that funding is being paid to their top executives and shareholders. And then there’s also the PFI’s!!!

I am also fortunate enough still to be able to afford to pay for private dental treatment and new specs and don’t mind doing so, but I still maintain a need for private charges to be regulated.

If we continue along the present lines however, with people continuing to smoke, drink to excess and feed on junk food, often as a result of stresses in their lives, and that includes some medical practitioners, sustainability will eventually break down and compromises will have to be made (which I believe is already happening) resulting in a two tier system where those who can afford to pay will probably receive faster and better treatment and those who can’t are left at the back of the queue, waiting and wondering if and when they will receive the care they need.

nick davies says:

I won’t give Boots a penny until they treat their staff properly and desist from treating the NHS as a cash-flow generator.
http://www.theguardian.com/news/2016/apr/13/how-boots-went-rogue

dieseltaylor says:

Thanks for the link Nick. I will also be boycotting Boots.

A very depressing tale of corporate raiders funded by the Banks loading Boots with debt and then hiving it off-shore to some opaque tax beneficial land.

The idea that we. the British public. should be supporting a secretive foreign company beggars belief. The answer to stop this corporate raiding is for the public to boycott the bought business. This means that the corporate raiders are left with non-functioning assets but with stacks of borrowing to service – it may lead them and their supporters to major losses.

alfa says:

Thanks for the link Nick. That is some eye-opener.

It is such a shame yet another of our great British companies is treated with such contempt by foreigners who only see it as a cash machine with no regard to its employees or healthcare.

When are governments going to start protecting our companies and employees from these vultures? How can it be legal to load them with debt while the vultures get richer?

The problem with boycotting Boots is they have already taken over most of the small independents.

wavechange says:

The Conversations about Optical Express provide a warning about poorly regulated healthcare. I’m concerned that Boots could be allowed to do checks for skin cancer and suggest that they stick to selling sun protection cream, preferably not the products that are revealed as sub-standard in the Which? tests.

Years ago we learned that privatisation of cleaning services resulted in unhygienic and sometimes filthy hospital wards and toilets. That was just the start. We need to campaign to stop healthcare services becoming a way of generating money.

Many have found private dentistry is so expensive that they cannot afford to have their teeth looked after properly. Carry on with privatisation of the NHS and some people will not receive the care that need because they will not be able to afford it. I have used private healthcare for around 25 years and it’s fast becoming prohibitively expensive, and I have not yet reached retirement age.

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malcolm r says:

We already have a private health care system that many pay into for convenience. I have no problem with this as it relieves pressure on the NHS. As for “private clinics” such as Pharmacies might offer, again I have no problem with people being given this choice, especially if it helps them to nip problems in the bud.

However, I would want those dispensing this sort of health care to meet the same standards, and be assessed and qualified, just as the staff at your surgery. Bear in mind you may well see a practice nurse and not a doctor anyway at youtr surgery for some complaints.

I doubt that Boots will take “skin cancer” too far, I’m not sure why you would take a worry of this kind to them but if you do I’d expect exactly what your doctor would do – if there is any doubt refer you. to the specialist at your hospital. Doctors grade the referral to the specialist at your hospital according to their judgement of the stage of the possible lesion – from a week onwards. If Boots or Lloyds work in the same way then i’d expect them to refer you to your doctor. If it helps putting your mind at rest, or gets things moving quicker, then it is not a bad thing.

I remember when our surgery had doctors on call through the night. With the number of doctors at our health centre I don’t know why this cannot be resurrected.

wavechange says:

Malcolm – What sort of training do Boots staff have to recognise malignant melanoma, an aggressive cancer that needs prompt identification? GPs have years of training to do their job and still sometimes get things wrong.

malcolm r says:

wavechange, Doctors refer to specialists at hospital in my experience for diagnosis – so whilst they may themselves not be experts in skin cancer they know when to take the next step. I’d expect anyone else to be suitably qualified to be able to do the same – in the case of Boots, say, that would be to refer you to your GP.

Presumably most people will not think “I might have skin cancer” in the first place, but it may be a sore patch, a spot or something else that they could ask about. They may, for a variety of reasons, not choose to “bother” their doctor with something “trivial”, but might ask at the chemist. If they have the ability to spot a possible problem and then refer them to their GP, so much the better.

Anthony William Mitchell says:

It has been going on in the US for years with many pharmacies having a doctor attached, I can see the efficiency in it and for routine problems it could be very useful but should be funded by the NHS.

dieseltaylor says:

19 May 2016

Just a reference to the US and health care
” The American Association of Retired Persons released a report in February showing that the cost of a year’s worth of prescription drugs had doubled, on average, from 2006 to 2013, with price hikes hitting senior citizens the hardest because Social Security benefits are not keeping up.
The average annual cost of prescription drugs widely used by the elderly increased from $5,571 in 2006 to $11,341 in 2013, according to study. That accounts for about three-quarters of average Social Security benefits and 48 percent of the median income for people receiving Medicare benefits, according to the Kaiser Family Foundation.”

It is just a warning perhaps that the US system has a lot of problems and very profitable pharmacies may be part of the problem.

MUMSHOTEL says:

I most certainly not be prepared to pay ” AGAIN” to this Rip off chemist chain. They are quick to jump onto the bandwagon and I know of several cases of misdiagnosis with their staff already including giving my husband and I the wrong anti malaria pills a few years ago for a visit to South America. We will take our chances with our GP thank you.

Ian says:

It’s sad, but Boots has become a monopoly in many places, now, as independent pharmacies shut their doors. During the past 20 years we’ve seen seven independent pharmacies shut down, leaving only Boots and a single Superdrug.

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Beryl says:

Lloyds Pharmacy have been carrying out health checks for a small fee for some time. Cholesterol and Heart Checks are available for a £15 fee. They also carry out blood sugar checks for suspected diabetes. No appointment is necessary except in busy times. They have a team of qualified clinicians who are regulated by the CQC.

See more @. lloydspharmacy.com – Health Checks and Advice.

Llewelyn Mwnt says:

This is not unexpected following the Boots take over by the American Drug Store giant Walgreens – just think back to how Cadburys’ chocolate has been changed following Kraft takeover and the many other examples of USA-based conglomerates “milking” British consumers

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