A pharmacist has issued a stark warning to UK residents about the possibility of having to pay for NHS GP appointments in the near future. Nadia Malik explained that the British Medical Association (BMA) will ballot GPs before June 2027 over 'Plan B' — an alternative to the current GP contract. This could allow GPs to carry out more private work and introduce a means-tested subscription service similar to dental care.
What Plan B Could Mean for Patients
"It's a little bit controversial because although GPs are independent businesses, they have a contract with the government to carry out NHS services," Nadia said in a TikTok video. "So for patients, care should be free at point of access." However, if the ballot favours Plan B, this could change. "Patients that see GPs the most are ones with chronic, long-term conditions and often multiple ones, and it's those people that would be disproportionately affected," she added. "We know the NHS has already got massive health inequalities, and is this just going to make it worse?"
GPs Forced to Seek Alternatives
Nadia pointed out that GPs have not asked for this change; rather, it stems from government restrictions that have forced them to look for alternatives. She highlighted that GPs say the current climate "isn't financially sustainable," especially with an ageing population demanding more care. "We don't have the workforce to deal with it, we have a shortage of staff, and as the workload has increased, the funding hasn't increased to reflect that," she noted.
The Department of Health and Social Care reportedly expressed displeasure about GPs pursuing this route, prompting the BMA to urge engagement over contract concerns. "Maybe this is a scare tactic, or maybe it is a genuine contingency plan," Nadia pondered. "I guess we will have to watch this space."
Government Response
A Department of Health and Social Care spokesperson said: "We do not believe that moving towards a model of private, means-tested or subscription-based GP services is in the interests of patients or the NHS, and a two-tier health system would only serve to deepen the health inequalities that already exist. The founding principle of the health service — that care is free at the point of use — must be protected. We want to work with GPs to build a sustainable future for primary care as the front door of the NHS. We have already hired thousands more doctors, provided record funding for General Practice, and introduced online booking to increase access to GPs across the country."
BMA's Stance
Earlier this week, BMA GPs committee chair Dr Katie Bramall said of the ballot: "The committee's confidence in the future viability of their livelihoods, and of the profession itself within the NHS, is at an all-time low. Warnings have been repeatedly ignored by politicians that long-term under-investment in general practice, coupled with rising workloads, increasingly complex patient need, workforce attrition, and contractual arrangements that leave practices vulnerable, will lead to GPs and practices being unable to deliver safe and sustainable care to their NHS patients."
Dr Bramall also told the BMA's website: "Under current contractual arrangements, GPs are prevented from meeting patient demand for some services. These obstacles limit our ability to deliver the care patients ask for or deserve, restricting clinical flexibility. This exploration of an alternative model is a consequence of long-term political and systemic failure to protect NHS general practice and has left the profession deeply frustrated, with no other choice but to explore alternatives. This didn't happen overnight; it has been a slow and gradual deterioration of morale within the profession. The need for this ballot can be prevented, but the Government must urgently engage with the very real concerns GPs have around their core contract, as well as their wellbeing and livelihoods, or we risk losing NHS general practice entirely. The latest contract imposition and the Government's demand for GPs to provide unlimited access is the final straw for many."
Public Reaction
Writing in response, one TikTok user fumed: "As someone with complex and rare health conditions, unfortunately I need a bit of healthcare. It's difficult enough getting a GP appointment. There's no way I can afford to pay, I can't afford to go to the dentist never mind this." A second added: "This is just going to lead to more people misusing A&E and making it more overworked when they can't get to a GP or they can't afford it so wait until it's an emergency." Meanwhile, a third person said: "I work in GP and I was horrified the BMA did this. This is exactly what successive governments have been hoping for: privatise the front door and the rest will fall. The BMA have failed at negotiating GP contracts for years, and I suppose they want to position themselves to negotiate a private contract."
