The Plastic Bag Prescription

My daughter rarely finds her dads jokes funny (hard to believe, I know) but she had to laugh about a year ago when we were out doing a bit of shopping and got to the checkout with  about nine items including some loose bananas, a large pot of yoghurt and some quiche.
“Would you like a bag for that?” asked the shop assistant,

“No it’s alright,” I said, “I thought I’d just juggle the buggers across the car park.”

It seemed such a daft question at the time, but that was before last October when all large retailers were forced to start charging 5p for a plastic carrier bag. Now they always ask the question, and most of us seem to be saying no.

Since the plastic carrier bag charge came into force, it’s estimated that uptake in affected retailers has fallen by about 80% in England. And this estimate roughly mirrors the effect in Scotland, Wales and Ireland where similar policies have been in place for much longer. I’ll come back to this – and what I think is a far more interesting and wider implication in a moment – but first I want to look at the real effect of the levy.

On the face of it, it looks like an open and shut case. Plastic bags can take 1,000 years to degrade and so they create a litter issue. And then there’s the ecological impact. When seabirds, sea mammals or fish ingest plastic particles it can result in serious illness or death. But when you look a bit closer, things get a whole lot hazier.

Plastic bags are not a large component of the overall rubbish problem. It’s estimated that they account for less than 1% of all items of litter. So reducing usage by 80% (whilst welcome from a litter reduction perspective) isn’t going to have a perceivable effect on the overall problem. And while it’s obviously ‘better’ for sea life if it isn’t exposed to discarded plastic bags, the effect is impossible to quantify or calculate.

And there are several other sides to this coin.

Shoppers haven’t taken to juggling lessons; they’ve taken to using alternative methods of carrying their shopping instead. Re-useable cotton bags  would need to be used 131 times compared to a regular plastic bag before they are better in terms of limiting global warming,  according to the Environment Agency. That figure goes up to 173 times for the 40% of people who use their plastic bags as bin liners.

I know they’re called ‘bags for life’ but 173 uses is pushing it a bit, wouldn’t you agree? And if you do try to make the thing live up to its name, you’re going to want to keep it clean. Re-useable bags are a breeding ground for all manner of bacteria that can cause pretty unpleasant illnesses. Researchers in California found harmful bacteria in over half the bags tested and E Coli in 12%.

So it’s going to need cleaning. And that needs hot water and detergent, stuff that causes a greater use of resources and potential environmental damage than the plastic bags the cotton bags replace.

Maybe paper bags are the answer? Well not according to studies in the USA where they are more prevalent than the UK. A study in San Francisco found that using paper bags  led to “greater landfill waste than plastic bags”, and a similar study in Austin Texas found that following a ban on plastic bags, shoppers started to throw out many more heavy duty reusable bags, resulting in increased landfill.

So the impact of charging for plastic bags is already looking questionable, and that’s before we’ve even considered the economic effects. In February 2016, Nelson Packaging in Lancashire announced that they would be closing with the loss of 40 jobs, citing the carrier bag charge as the chief cause. I doubt they will be the last firm to go under, or the last jobs to be lost, because of this. There’s even some evidence that shoppers are shifting away from retailers affected by the levy (those with over 250 employees) to online alternatives, with inevitable employment implications to follow.

The tax on plastic carrier bags seems to be a perfect policy for the government, but not particularly advantageous for the rest of us. While it gives the impression of  doing something positive, the end result can be argued to be neutral at best.

But here’s what’s really interesting to me…

It’s been phenomenally ‘successful’ in the sense that imposing a 5p charge on something that was previously free has resulted in an 80% fall in demand. Just read that again, and digest it…charging a piddling 5p for something that was previously free has caused eight out of ten people who previously ‘bought’ to decide not to do so.

Now you might argue that these people are really responding to the environmental message rather than the economic cost, but I’m not sure that’s valid. We’ve been told for years that plastic bags were doing environmental damage and yet we continued to take them. It was only when we were told there was a charge, that we gave any thought to whether we really needed them or not.

Surely this is powerful information we can use to much greater effect than reducing the use of  plastic carrier bags, which as we’ve already seen,  is of questionable value anyway. Which brings me round to the NHS. I know – you didn’t see that coming!

Have you attempted to get an appointment with your GP lately? It can be very difficult in many practices, with non-urgent cases being offered appointments two and three weeks in advance. I don’t know about you, but I don’t ring a doctor for fun; I want to see a doctor now – not in 10 days time when I’ll have either got considerably better or worryingly worse. Complain and the receptionist will shrug her shoulders and blame the huge demand on the service. She has a point, but does it really have to be like this?

I fully appreciate you can’t tell everything (or indeed very much) just by looking at the people sitting in a doctors waiting room, but would you at least accept, based on your own experience, that there are some people who really don’t need to be there?  They’ve turned up unnecessarily  with very minor ailments, and they’ve turned up because it’s ‘free’.

It isn’t free of course. I read yesterday that the average cost of a GP’s appointment to the taxpayer is £57. Think about that for a moment. Demand is so high that you struggle to get an appointment, and every one of those people is costing the taxpayer £57.  Now let me ask you this…

How much shorter do you think the queue would be if there was a small charge applied for each appointment, in the same way that there’s a small charge for a plastic carrier bag? If a 5p charge for something that was previously free causes 80% of people to question whether they really need it, what impact would a small charge have on the demand for doctors appointments? I’d be shocked if the immediate impact wasn’t at least a 15%-20% fall in demand for appointment – it could be a lot more –  and that would surely free up the service for the people who really need it.

Such a policy would be a nightmare politically for anyone brave enough to give it a try, and there are any number of issues to iron out – the size of the charge and a system for ensuring that the genuinely ill aren’t discouraged from seeking help, for example. But in principle, I’m  convinced it would work. And if it worked in the NHS, what about other psychologically free, but over-stretched resources? Which brings me to toll roads…well maybe another day.

For now, I’ll go and get my tin hat!

(As an aside, what you have  here is a nice explanation of why many information based internet sites struggle to make money using a traditional business model.  They started out offering their services for free, and once people have had something for free, they’re extremely reluctant to pay even a small amount of money for it.)

27 thoughts on “The Plastic Bag Prescription

  1. barry charman

    John In France you pay when you see the Doctor -and in due course the State gives you back about 75% of that money.
    Doctors aren’t the wealthy much loved invididuals they often are over here – may be because they get real money out of your pocket.
    But that doesnt stop the French being a nation of hypochondriacs – even more than us!
    so nice idea but I will give you a better one
    Instead of giving out FREE aids -like crutches or wheelchairs- which some people can’t be bothered to return -charge them a fee or deposit.
    But as a business the NHS is a disaster -stopping HealthTourists by putting a MONEY COLLECTOR in each hospital – on commission -would rake in MILLIONS!

    1. Roy Hesketh

      It’s not that people can’t be bothered to return items such as zimmer frames, crutches, wheelchairs etc. I asked this question at a hospital that I attended. Their answer was that they do not accept them back as the cost of checking and maintenance of such items outweighs the cost of replacing them. What maintenance is required on a zimmer frame, or crutches? Apart from renewing the rubber ground pads, it costs nothing. Wheelchairs do require repairs and maintenance.
      A series of collection points could be set up countrywide which would also be a maintenance point and a distribution point. Hire them out for a fee, 80% of which is returned on the return of the item. The outstanding 20% would go towards the cost of repairable items and the wages of the staff etc. the fees of those that were not returned and there would be some, would be plowed back into the collection/supply/repair centre.

  2. Steve Newton

    Good points. If being green was really what the Govt wanted, they’d have done far more if they targeted the excess packaging waste that supermarkets and their suppliers produce … and they should standardise the 100’s of types of plastic so that more are recyclable easily – far too may are “not acceptable” by the waste processors.
    Agree about charging for GP visits (or fines for non attendance!) … and why not charge for hospital food for inpatients (if they improved the quality! – good incentive to do this if they were able to charge) – everyone has to eat and it costs, so why get it free in hospital? …..And ensure outpatients are given free parking at hospitals when going for treatment/consultations ……why penalise someone further if they have to have chemo etc for their cancer?

  3. Mike Price


    I live in Jersey, Channel Islands (and no, I’m not rich) where we have to pay to see the doctor, It’s not cheap at £35 a go and there is a small Government subsidy of about £20, but I can get an appointment within 24 hours and usually with a choice of times. Nobody here goes to their GP unless they really need to. There is a reduction for children, otherwise the fee is payable by everyone including pensioners.

    1. admin Post author

      That’s interesting. Thirty five pounds sounds rather a lot for most people. I’d be interested to know what the average number of appointments made per head of population is, compared to England.

      Just did a little reading up on this and a couple of problems seem to emerge from the way they do it in Jersey…

      1. Over-prescription of things like antibiotics to avoid people having to come back and pay for another appointment.

      2. Extra strain on A&E at hospital because treatment there is free.

      My thought (perhaps wrong) is that a nominal charge of around £5 would dissuade the time wasters from making an appointment, while not being a disincentive for those genuinely in need.

      1. M. Pennington

        I agree £5 would put off many time wasters. People who are ill because they over partake of drink, drugs and food should have to pay if taken into hospital for treatment and people from other countries should have the bill sent to their governments if they fail to pay within a month.

  4. Francis

    “Instead of giving out FREE aids -like crutches or wheelchairs- which some people can’t be bothered to return -charge them a fee or deposit”. On three occasions during the last 10 years I have returned crutches used by my family, but not me (!) and each time the Receptionist has looked surprised saying that these items and many others are seldom returned, but they see them on Ebay! Is money no object? 18 months ago they lost my Xrays for 3 months and asked me to locate them at the local hospital as I would probably get results. I did but then most of the PC’s couldn’t read the Xrays from the same Health Authority, but none of the staff seemed too concerned? So wasting time and money appears to be continuing wholesale, so what is management really doing?

    1. louise stevenson

      I have just been in hospital, it was an eye opener. The doctors and nurses are wonderful and very hard working but the right hand doesn’t know what the left hand is doing. they are so disorganised.

    2. M. Pennington

      I have seen many aids thrown out on skips when people have died perfectly usable. When I needed to borrow a frame after breaking my ankle the hospital collected it a few days after I rang
      I have taken aids back to the Red Cross for other people and was amazed to see all those that were scrapped because of a slight chip in the paint or a hand grip missing. Some of those given community service could help out with bring these aids back into use.

  5. patricia buckeridge

    I heartily agree with you, John. I’ve been saying this for years. I could CONTRIBUTE to all NHS. procedures but couldn’t afford the whole costs. I’m a very old , widowed pensioner.

  6. June

    Interesting blog, John, as ever. Things are not always what they seem apparently with plastic bags – you’ve opened my eyes as I felt quite smug having cut down on mine by using my own re-useable bags. However, at the check-out, my regular chap insists on giving me a FREE carrier for my meat and ANOTHER one if I get fish! He insists it’s common sense so who am I to argue?

    As for making charges for the NHS, I entirely agree, especially for missed appointments. I would pay to see the Dr which might also mean less missed appointments. It might cut out malingerers, too. Before the NHS I remember Mum taking me to see the Dr and it was 2/6d (15p in today’s money) plus another 2/6d for a bottle of medicine which he himself made up. Doesn’t sound much now but it would be quite an item then if you were only earning a few pounds per week – but he’d always plenty of patients and he was popular.

  7. Paul

    Hi John,
    Food for thought, no pun intended!!
    The doctors and A&E issue would easily be solved with the charging of a nominal fee which needs to be high enough to dissuade people from making unnecessary appts/visits, £10 in my view. This charge would be off set by no prescription charge if in the opinion of the Dr the visit was valid, if a return visit is required then the fee is waived. It would be a easy one to administer in my humble opinion.
    Let’s face facts, the NHS has and always will be a money pit of list cash as it’s a constant political hot potato that any solution put forward attracts unpopular attention from one sector or another of society, that no current politician has the balls to deal with.

  8. Marina Marler

    Absolutely pay to see the G.P The system we have at present is definitely not one to be proud of. I’m currently laid up reading your blog nursing a nasty chest infection but have not so much as tried to get a G.P appointment. The reason being is because I know I would be wasting my time and energy. Time I have plenty of but energy I do not and what little I do have is being saved to get through the day , not wasted on debating the NHS with the receptionist at the surgery. The GP situation is a national scandal along with social care ( which incidentally we do pay for). I could go on forever but one very important point to make is that I am very aware that both the NHS and the social care departments in the UK aremaybe not so much set up now days for the patient but more so for the Hugh and well paid work forces that in my opinion can be very very badly managed and do not represent good value for money.
    As for 5 p for a carrier bag. Have to admit I’ve become that juggler you initially mentioned.

  9. Wojtek Gaworzewski

    The problem with carrying your own bag for shopping is that jute , cotton etc. bags are too big to carry with you comfortably in a pocket or a handbag.

    In Eastern Europe, under communism, when the only things on shop shelves were jars of beetroots and vinegar, everyone always had a bag with them just in case they spotted something to buy.

    These bags, called net-bags, were made of a material which looked like a hairnet, the individual strings were elastic and the bag was very expandable. Unexpanded it was the size of a small mobile phone, expanded it could carry a heavy load of shopping. Unlike just about everything else under communism it was of good quality and the net did not break under the shopping load.

    When the 5p charge was initiated I got onto the internet to get myself one – no joy.

    I figure there’s a fortune in finding a manufacturer and marketing such a bag in the right way.

  10. Ian L

    Charging for GP appointments would not be as radical as all that, if one considers that we already pay subsidised fees for NHS dentists and opticians, not to mention prescription charges. I do agree however that all our politicians are too chicken to do anything about introducing such a charge (even with exemptions for pensioners, the unemployed etc), although I’ll bet that, despite their protestations to the contrary, they would dearly love to do this and have probably discussed this at high levels of government.

  11. Malcolm

    John, congrats on a well written article, which brings up a number of valid points, some of which have been addressed by the comments made. I lived in Germany for around 20 years, and recycling awareness was years, if not decades in advance of that in the UK. One of my good friends there is a director of a major environmental impact testing agency, and I can remember the debates around re-using glass bottles v plastic or cartons. Turns out that there is minimal environmental difference between the different ways, when one considers re-washing/sterilising etc rather than single-use. I stopped using cloth bags soon after.
    As regards doctor’s appointments, a great idea, and £10/visit sounds about right. How about a charge for using the Ambulance, Fire and Police services – all waived if the call-out is a genuine one? As regards hospital charges, as a resident of an EU country I am entitled to free medical/emergency care in any EU country, however maybe a charge or non-EU residents? Pay for hospital food and get better quality- again, a great idea in theory, but I seem to remember Jamie Oliver struggling to change attitudes towards hospital food standards. A reasonable (£6-9) daily rate though seems sensible, if this brought about healthy, nourishing choices! Thanks for the blog, always interesting. Regards, Malcolm

  12. Mark Leman-Lawrie

    Always good to read the thoughts of others, still undecided about the GP charges, it would possibly solve one problem, but create others we have not foreseen, a.k.a. plastic bags.
    This lead to a thought from an 80% reduction in plastic bag use, and your shopping trip, are a percentage of people now buying less items in supermarkets when they visit, because of the bag charge?
    Are there any charts that you could say, look there, that’s around the time a charge was introduced and sales started a slow decline.
    From Warren Buffett to plastic bags and GP’s in five minutes, and why not?

    1. John Harrison

      Yes, there are always unexpected and unintended consequences to things like this. It’s never simple.

  13. Malcolm

    I take the point about the bags John but not so sure about the view on a charge for Appointments with the doctor. I’m 64 ears old and take my health and fitness very seriously. I suffer from one or two minor health problems one of which is the skin condition psoriasis. I can usually sort out health issues with a call back from the doctor and can usually accept the wait if I need an appointment to see a doctor. However, on one occasion I visited the doctor because I had a swollen finger. This could be regarded as trivial and pathetic (I had no pain) but I knew that it shouldn’t be like that. Long story short I had started with early symptoms of Psoriatic Arthritus and was referred to a specialist. I was given suitable medication to alleviate this condition and four years later I am still working and living an active life and I am still swimming, running and weight training. Had I not taken early action I could well have become incapacitated, (arthritic damage is irreversible as far as I am aware), which would have cost the state much more money. How many stoic people might be put of from receiving an early diagnosis of life threatening illnesses by this kind of charge being levied? Maybe we should charge for more health services thus allowing less affluent people to die younger and saving the state a great deal of money.

    Regards Malcolm

    1. John Harrison

      That’s a good point. From a purely economic angle though, I wonder how many ‘trivial’ appointments there are which are a waste of time, for every one that turns out to be important like yours? If we take the figure of £57 per appointment, I think (but don’t know) that the overall cost of these outweighs any long term savings.

      The other side of this coin is that there a lot of people who SHOULD visit a doctor, but are put off trying because of the difficulty in getting an appointment. It’s an equally valid arguement that imposing a charge would free up appointments and encourage these people to seek early help, therby making the type of long term savings you describe.

  14. Roy

    Nice post John. The last ‘aside’ paragraph rang a bell with me. I have a popular online newsletter which I wrote weekly for 18 months and gave it away free. I gained a few hundred subscribers and then decided that I would change it to a monthly issue and charge £3.50 a month for it.
    The upshot was that I lost more than half of the readers overnight. However, the ones that remained and new subscribers that join now are people that I know actually want to read my stuff.

  15. John T

    Sensible idea to pay to see a doctor – possibly with re-imbursement if you turn up, on time, with something actually needing seen to.

    More generally the NHS – excellent in concept – is run entirely as a bureaucracy and needs some consideration of its business aspects in order to deliver service more effectively. Huge attitude change!

  16. Martin white

    I couldn’t agree more. Like so many aspects of our social system it is no longer fit for purpose and able to meet the demands of today’s society. But then it was never intended to extend to over dependence or abuse. As any government knows that such proposals to change it would be political suecide as the electorate have become used to taking the benefits system for granted.

    A prime example of this is following the announcement in yesterday’s budget to reduce the amount of money paid out in disability benefit has caused a major rift within the government. Now I am not suggesting that there are not many who are deserved however there are many who are not. All the goverment are trying to achieve is to ensure that only the truly deserving benefit whilst reducing the abuse, hence reducing the budget deficit.

    You would think that most people would see this as a great proposal, clearly not from what I’m hearing. How incredibly ignorant society can be.

    Great article.



  17. John Parr

    I agree with the principle recommended. The NHS can get clogged up with trivial and unnecessary demands.
    What adds to this and annoys me even more is people who make appointments and do not bother to turn up.
    What if a charge of £10 is made for every appointment, but refunded at the consultation.
    I believe the number of appointments might drop and the NHS would receive some income for missed appointments; this could provide two benefits and yet medical treatment would still be completely free.
    It might encourage some people to act more responsibily whilst still receiving “free -, courtesy of the tax payer” treatment.

  18. Richard

    Dear All,

    I some times wish that I could find a magic lamp as in Aladdin, and have 3 wishes to help the world!!

    And there are many options to consider, like Stopping all diseases, poverty, water for all, every one equal, no wars or racism, the list can be endless, but if any of us had the power to do this, what would we choose? If one was to end all diseases, then would we need doctors or hospitals! If we were all equal, who would run the world!

    So every coin has at least 2 sides to it and some where in the middle when stood on end and there becomes no right or wrong side or solution! In today’s world why is it not possible to make all packaging either recyclable or biodegradable! Like many others, I don’t use bags if I can help it and it amazes me that people walk out of a grocery store with a trolley full of shopping with out a bag in sight. At one time the poor security guard stood by the doors, would stop you and question why your shopping was not in any bags, all he can do now is stand and smile at you if you are lucky. So the stores are now having to buy less bags, well 80 % less, but how much more are they loosing as a result of this! This in turn will put the cost of our shopping higher as to compensate for this increased loss! So is the 5p charge really helping any of us? Also. if the revenue of the total sales go down as a result of having to buy bags as well, this will have a knock on effect of job losses if not stores!!

    As for charging for doctors, that’s another issue, how many times have you tried to get an dentist appointment the same day, unless you say you are in serious pain and can’t wait!! Many appointments for the doctors are routine, like a review of your meds etc so therefore you have to attend, be it you are sick or not and not all doctors surgery’s work the same way! Maybe a charge of some sort may help, I don’t know and how would this affect people out of work and or on benefits? But again that is another issue that needs to be resolved! (the benefit system I am referring to here)

    So if we all had just 3 wishes, how could we best use them! and would the end result be what we intended!!!

  19. Roy Hesketh

    At a photography meeting the other night, there was a new member who worked in the NHS, something to do with the theatre. He reckoned that the NHS is slowly being privatised. All of the admin buildings are half owned by Richard Branson. New hospitals that are being built around the country are funded by private bankers.It has to go private if the NHS is to be saved from being swamped by migrant attendences.


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