If your financial disincentives were in place I'd have paid a lot of money last year for my partner to be misdiagnosed by medical people before finally getting the hospitalisation she needed a week later. We saw ambos, A&E nurses, A&E doc, an incompetant and rude GP before finally getting walkin centre nurses to consider that her breathing problems and severe pain weren't just "backpain" or "a panic attack". They got her seen by their doc who diagnosed liver failure and had her admitted immediately. The rude and incompetant GP told us that he wouldn't see my partner for at least a week after he didn't even ask her any questions or examine her - it took us 4 days to dare go to the walkin centre nevermind anything else. My partner was left in pain for 4 more days that she needed to have been because this GP couldn't be bothered to look past the "timewaster" label that she'd been stuck with. If people are misusing the services, a lot of that will be because they are uninformed and scared. This blog has taught me a lot about when and when not to dial those three 9s. I know when I should have used them, and perhaps should not have used them. Charging me 28 quid to see a GP would screw me over big time as I have a number of medical conditions which means I sometimes need to see a doc before they get serious or nasty. As a student, I sometimes didn't have money for a prescription nevermind the cost of an appointment. I'm still with the university medical practice and my GP says she gets relatively few time wasters, most of whom are scared either by other people, or by things which they don't understand. Increasing nurse-led services, alternative prescribing options for people on longterm/lifelong medications and keeping people informed about stuff would go a long way. I for one often don't need to see a GP, but can't get the services (prescriptions, or referrals, or sicknotes) sorted by a nurse at present. Maybe there could be coordination with taxi companies to prioritise calls from people wanting to go to hospitals, and more encouragement for people to use walkin centres and GP services for serious but not immediate problems. My experience of taxis isn't great, as they can take 20-30 mins to come, if they come at all. Before we make a richer/poorer divide we should break down the information divide. The NHS direct website is very good, even if the phone service is mixed. We're never going to solve all of the problems all of the time, but I think we could do a bit more with what we have without making it about money. There will always be drunks/homeless people in the streets, and people getting scared.