A group of Welsh Conservatives has come out in favour of fining NHS patients who miss doctor's appointments. They have said that if the Conservatives win power at next year's Welsh Assembly elections, they will introduce the policy.
The idea is based on the fact that missed appointments cost the NHS almost £1 billion a year. The hope is that by charging people £10 for missing appointments, it would give them an added incentive to show up.
Darren Millar MP said: "While some people who miss appointments do so through no fault of their own, the reality is that many do not. Missing an appointment doesn't just waste the time of doctors and nurses and have potentially harmful outcomes for those who fail to turn up, it also deprives other patients of an opportunity to get their appointment, wastes taxpayers' money and keeps waiting lists longer than they should be."
Jeremy Hunt raised the issue on BBC Question Time last week. He said: "We are very stretched for resources." "If we are going to square the circle and have a fantastic NHS, despite all those pressures, then we have to take personal responsibility for the way that we use NHS resources. I don't actually have a problem in principle with the idea of charging people for missed appointments. I think in practical terms it could be difficult to do. But I have taken a step towards that this week by announcing that when people do miss an appointment they will be told how much that has cost the NHS as a first step."
However, there are a number of problems with fines. Many GPs are against it on ideological grounds: they believe that healthcare must be free at the point of need, and that there should be no exceptions. They also warn fining people could damage the relationships between patients and their doctor, which is vital to maintain if people are to feel confident and comfortable talking to their doctor.
There's also the risk that introducing the fee could actually end up costing the NHS more overall. It could put people off making GP appointments, and they could choose to go to A&E instead. A&E visits cost the NHS far more than a GP visit, plus there's the risk that the system is overloaded with people who should be seeing their GP, increasing the dangers for those who need emergency help.
Any system of fines will also end up punishing people who miss appointments through no fault of their own. Those who are working several jobs to make ends meet - and have to use public transport to get to the surgery - are particularly likely to struggle to get to the doctor for an appointment. Fining them would simply be adding insult to injury.
Instead, the NHS has been using technology to combat missed appointments. Email and text reminders are becoming commonplace, which is helping reduce the number of missed appointments A number of NHS Trusts are also rolling out systems to enable patients to book their own outpatient appointments at times that suit them - rather than imposing a time that patients are likely to miss.
But what do you think? Should people who miss appointments be fined? Let us know in the comments.
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