The introduction of increase in user charges is often suggested as a means of restraining the demands on the health care system. Patient charges have been used in the U.K. National Health Service since 1951 in the provision of prescribed drugs, dental treatment and spectacles. Recently, these charges have been extended to eyesight examinations and dental check-ups, while the levels of charges have increased far in excess of the rate of inflation. In this paper the implications of the extended use of patient charges are considered from the perspective of patients, the health care system and the Government, using available evidence on the effects of charges on consumer behaviour.