Leading nurses have shot down the prospect of charging patients for GP services, saying that the most vulnerable people would suffer if such an initiative was rolled out.

The Royal College of Nursing's (RCN) annual conference in Liverpool debated whether or not patients should be charged for seeing their family doctors.

Traditionally, the RCN has stood behind the belief that the NHS should be free at the point of delivery, but nurses put forward the motion, saying NHS finances were "not infinite".

More than nine in 10 delegates voted against the motion, which called for a fixed fee for GP appointments.

Presenting the motion, Andy McGovern, from the RCN's north-east London branch, said: "As the NHS faces one of the most significant financial challenges in its history, this is a debate that we have to have.

"At some point in the future, regardless of which UK country we live in, there will have to be a choice between increased taxation or paying for public services like health that we have hitherto expected by right.

"Consequently the debate for charges for NHS services like GP appointments has reignited.

"The NHS needs more resources and the question has to be asked, where will these resources come from?

"Whilst paying for NHS services is a difficult, and for many a taboo subject to debate, we really do have to think about how we move things forward."

Speaking against the motion, Dave Dawes from the Manchester central branch of the RCN said: "We don't need to imagine some hypothetical world where people look in their pockets, see how much money they have got and decide whether or not they can see their GP.

"We used to live in that country. We decided we didn't want to live there any more so we invented the NHS – free at the point of delivery."

Lisa Reith, from the south-west London outer branch, added: "When we already pay for this service through general taxation it seems unreasonably unjust."

Heather Henry, also from the Manchester central branch, said she was "shaking with horror" at the thought of the resolution.

"It would be the worst thing for health inequalities that we could possibly propose. The vulnerable would suffer. What would happen with screening and immunisations? Our most vulnerable patients would be presenting later, sicker, or worse and A&E attendances will rocket."

Dr Peter Carter, RCN's chief executive and general secretary, said: "Charging patients for GP visits is a controversial issue – one that goes to the heart of what the NHS is and should be.

"Today, nurses and healthcare assistants have reaffirmed their passionate belief that the NHS should be free at the point of delivery.

"The future funding of the NHS is shrouded in uncertainty and we need clear direction from our politicians about the way ahead so that clinicians and commissioners can plan for the future.

"As the general election approaches, the public need to know where the parties stand on this vital issue.

"Nurses are passionate about protecting the health service and its founding principles, but they know that it faces challenges, that its finances are finite and so they will continue to address the difficult questions."

Recently, doctors debated the same issue. Making certain patients pay a fee for some services would "emphasise the value" of GPs, the British Medical Association's (BMA) local medical committees conference was told in May.

But the proposal was dismissed by a number of leading medics including the former chairman of the BMA's GP committee Dr Laurence Buckman, who said it would lead to "survival of the richest, not treatment of the sickest".

Commenting on the RCN's debate, a BMA spokesman said: "Charging patients for GP appointments is not the way to solve challenges facing our health service.

"Not only would a charging system be complicated and expensive to set up, it would also place a restrictive financial barrier to care in front of some of the most vulnerable members of our society.

"A patient's access to healthcare should be based on their clinical need, not the size of their bank balance."

A Department of Health spokesman said: "We are absolutely clear that the NHS should be free at the point of use, and we will not charge for GP appointments.

"We know GPs are under pressure, which is why we're cutting GP targets by more than a third to free up more time with patients, and are increasing trainees so that GP numbers continue to grow faster than the population."

