British General Practitioners - the gateway to the services of the National Health Service - get paid through capitation fees. An amount per person who is on their patients list.

More than a third of GPs refused to offer routine appointments during the last year, a poll has revealed.

Covid absences, unprecedented demand from patients and staff shortages have created significant pressures in primary care, GPs said.

More than 800 family doctors were surveyed by Pulse and 35 per cent reported that they had stopped taking bookings for routine appointments at some point in the last 12 months.

One GP in Liverpool, who asked to remain anonymous, said his practice had switched off the online booking system overnight and at weekends due to the overwhelming demand.

He told the magazine the workload level would be “unsafe” to operate and the practice still sometimes turns off the booking system during the day.

The incentive therefore is not to actually see - or treat, heavens above no - patients. It is to have a list of patients who may or may not get seen - or treated.

As we’ve been known to point out the first of the two things that everyone should know about economics is that incentives matter. It’s possible to muse that incentives are misaligned here.

Possible even to go further and suggest that the incentives be realigned. Pay GPs for actually seeing patients - or even, wonders, treating them - and marvel as behaviour changes to match the new incentives.

After all, none of us has great problems in getting in to see a lawyer, who are indeed paid by the time they spend actually dealing with us. So, yes, why not pay doctors as we do lawyers, they both claim to be professionals, why not pay them the same way?

GPs are currently paid not to see patients. Is it really any wonder that it’s difficult for a patient to see a GP?