I thank Azita Ahmadi for their response to my article. I agree with them that patients will struggle to separate “appropriate reasons to attend” from “inappropriate reasons to attend” for primary medical care if user fees are introduced for NHS care. Charges may also disadvantage people from more marginalised groups such as the poor, those with limited English language skills and people who are less well-educated. It’s important that NHS care remains services remain accessible, providing both first contact care and guiding patients through the other parts of the health system.
1. Majeed A. Let’s look dispassionately at the arguments for and against user fees for NHS primary care in England BMJ 2023; 380 :p303 doi:10.1136/bmj.p303