How can it be “ethical” to charge patients?

Access to our service will, unlike the NHS, be limited by ability to pay. However, NHS GP is not without barriers, especially now, as it can be limited by the ability to pick up the phone or internet at the correct time, or to prioritise one’s own needs appropriately.

Pillars of medical ethics

We are aware of the risks of describing ourselves as “ethical”. It is common to consider questions of medical ethics under four “pillars”: autonomy, non-maleficence, beneficence and justice.


We believe it is for society rather than individual GPs to ensure justice of access to general practice, whether that be by ensuring that all patients have the means to pay for care, or whether that be by providing excellent NHS general practice.

A growing private GP sector will support just access to primary care by providing additional capacity (we will increase my working commitment significantly, for example), and perhaps also by helping to define expectations of NHS GP by providing a contrast.


What possibly sets us apart is our commitment to non-maleficence (“first do no harm“), perhaps not always a priority for private healthcare providers, for whom there can be a temptation to sell tests and treatments without certainty that they will not cause undue anxiety, or that any condition so found definitely merits the side effects and risks of treatment.

Safety and value for money

So yes, we have to charge our patients. But we will do our utmost to ensure that we do not charge patients for appointments, tests or treatments that are not completely necessary. That way, our patients get value for money whilst receiving medical care as safe and high quality as possible.

Do GPs work 7 days a week?

NHS General Practice is available 24/7, via GP Out of Hours services – both Heather and John have done GP Out of Hours work in the past (Heather during the second wave of the pandemic in 2020).

Most NHS GPs work incredibly hard – 10 to 12 hour working days are not uncommon, and many GPs do log on to their computer at the weekend to catch up on paperwork and filing results, even if they are not working in Out of Hours. The reason that many patients are struggling to access NHS General Practice are complex and are not due to GPs being lazy – rather, issues like funding, recruitment, and retention contribute.

Heather and John both work in the NHS too, and will mostly be working for Formby GP at times they would not otherwise be working. Furthermore, we plan to offer a 7 day advice service to subscribers.

One of the advantages for us in doing private work is that it gives us a high degree of control and flexibility about when we work, which is particularly important to us because we have a child with health needs which require us to be available a lot of the time. The alternative for us isn’t doing more NHS work.

On a personal note, we have recently had a very positive experience at Ormskirk Hospital when our child was unwell. We are grateful to everyone who works in the NHS for the incredible work that they do.

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