Well, I think I'm about right in saying the NHS costs something in the region of �300,000,000 a day to run, can we say, roughly �12,000,000 for an hour's worth of care, kit, caboodle sweat, tears and some of LaLite's famous 'coasting'. So, if you had a spare �76m you might be able to run the NHS for about six and half hours.

Are you with me so far? Good, thank you. Because I am trying to understand the reasons for one of the daftest ideas I think I have ever read. Mike Farrar's Confed' seem to have taken leave of their senses.

They announced to an unsuspecting world that they think patients using out-of-hours GPs should be charged �8.50 a-go. An NHS boffin (Thanks R) tells me there are about 9m GP home visits in England in a year. Hence, multiply eight and a half quid by nine million and you get �76.5m. About enough for one quarter of one day's operating, sewing-up, diagnosing, feeding, washing, prescribing and keeping the lights on.

Let's think for a moment. Would Farrar's Fee encourage more people to use out-of-hours services and relive the pressure on A&E, or not? Well, this requires some serious consideration; A&E for free or  GP for a fee? �8.50 or nothing. Free or eight and a half? No brainer.....

What about a scenario, something like: I feel really rough, I have a pay-day loan; �8.50 and not pay the loan or pay the loan and try and make it through the night; see the GP in the morning. In the small hours something bursts, stops or drops off. Ring 999 and have a free ambulance ride to A&E at a cost of about �300++.

I can only think Farrar's Fee is the product of a kids club of middle-class people who have no idea what it's like to be poor, old, frightened and sick.

Let's think for a minute; What about the OOH GP who has been working all night in a down-town part of a run-down inner-city; coming to the end of his shift he's collected about ninety pounds. It's in cash. The hoodie, racked with an addiction, he meets in the alley (the one where the street lamp has been out since Christmas), knows the Doc will have a few quid. Punches him in the teeth, breaks his nose and makes-off with the night's takings.

Let's think for a minute; only take credit cards? What percentage of single Mums, pensioners and unemployed will have a Visa card? I doubt there is anyone working on Farrar's Fee who does not have a credit card.

Let's think about collecting Farrar's Fee: commissions to credit card companies, paying-in cash, accounting, audit, banking, bureaucracy and fiddling about.

And then let's think about not collecting Farrar's Fee.   Refuse to visit? Someone dies and the OOH Doc is hauled in front of the GMC and the OOH NHS contracting company is all over the front page of the Sun.

Let's think about collecting bounced cheques and fraudulent payments: a debt collecting agency would be an idea. I can see the headlines now; NHS debt collector frightens widow into suicide. Let's think about the cost of collection, appearances in the small claims court, the impact on the NHS brand and political fall-out.

Let's think who we might exempt from Farrar's Fee: people on benefits, pensioners, family credits, long-term sick, nursing Mums, Cancer sufferers, home dialysis patients. If Farrar's Fee works, like the rules on prescribing, about 80% of patients would not have to pay and he'd be left with enough money to run the NHS for about the time it's taken you to read this.

Let's think about this. Is Farrar's Fee worth all the admin, bureaucracy, palaver, risk, redirection of patient flows, political disapprobation, patient anxiety and cost; to run the NHS for six hours?

Think about it.... is anyone at the Confed thinking.