Why do GPs sometimes charge fees?

The National Health Service provides most healthcare 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 is not covered by the NHS, for example,  providing copies of health records or producing medical reports for insurance companies.

It is important to understand that many GPs are not employed by the NHS; they are self-employed and they have to cover their costs - staff, buildings, heating, lighting, etc - in the same way as any small  business. The NHS covers these costs for NHS work, but for non-NHS work, the fees charged by GPs contribute towards their costs.

The Government’s contract with GPs covers medical services to NHS patients, including the provision of ongoing medical treatment. In recent years, however, 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 ensure that information provided to them is true and accurate.

Read more about why GPs sometimes charge fees

Examples of non-NHS services for which GPs can charge their own NHS patients are:

• Accident/sickness insurance certificates
• Some Travel Vaccination
• Private medical insurance reports

Examples of non-NHS services for which GPs can charge other institutions are:

• Medical report for an insurance company
• Report for the DSS/Benefits Agency
• Examination of local authority employee

BMA suggest fees for non-NHS work which is not covered under GP’s NHS contract, to help GPs set their own professional fees. However, the fees are guidelines only, not recommendations, and a doctor  is not obliged to charge the rates suggested. The BMA recommends that GPs tell patients in advance if they will be charged, and how much. It is up the individual doctor to decide how much to charge. Surgeries should have lists of fees available for patients.

Please note:

• 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.
• For Passport and naturalization applications a GP has to have known the patient or in the case of child the parents for a certain period of time. The GP has the right to refuse if he/she has not known the patient for the defined period of time or if he/she feels they would not be able to recognize the child from the photograph.
• Do not expect your GP to process forms overnight: urgent requests may mean that a doctor has to make special arrangement to process the form quickly, and this will cost more. Please be aware that  some reports may take more time, as the doctor might have to check the patient’s entire medical records. Carelessness or an inaccurate report can have serious consequences for the doctor with the General Medical Council (GMC) or even the police.