It has been suggested this morning (Telegraph) that NHS “no-show” patients should be charged a fee – basically a fine by another name.
Norman Lamb, a key adviser to Deputy Prime Minister Nick Clegg, told the Sunday Express: “We should consider introducing a charge for missed appointments.
“People have to understand when there is only a limited amount of money available it means cuts on care that could go on other patients.”
I’m surprised this has been suggested and I am most definitely against it, for two reasons.
Firstly is having heard stories about the historical (thankfully!) practice of Charing Cross Gender Identity Clinic to discharge patients who failed to show up for two appointments. However – and this is the reason I’ve said “so-called” no-show patients – stories of appointment letters turning up after the appointment and people being discharged as a result were common. In some cases, letters simply did not turn up at all.
Some bits of the NHS have very good administration but in any organisation of this size, there will be areas where the paperwork is not of the same standard. It is dangerous to make a universal assumption that the NHS is functioning correctly and fine patients, probably already suffering from appointment confusion, if it is not.
Secondly, what should the fine be? £100? That’s an awful lot of money to someone on benefits who really needs the NHS and does not have the mental energy to spare appealing fines if the administration is messed up. It’s not a great deal of money to someone who is earning a decent wage and thus is not so dependent on the NHS. £20? That’s still a big blow to someone on the poverty line but just a meal out for the middle-classes.
What has also been suggested are SMS reminders for those patients who supply a mobile phone number, something that both my hairdresser and my dentist (And I suspect many other similar organisations) use. I would prefer rolling out this more positive, cooperative approach across the NHS first before we even consider the authoritarian penalty approach.