Ten pound "Did Not Attend" fine proposal

[Spartacus]

One of the candidates for PM is proposing a £10 fine for not attending hospital or doctor appointments

Avoiding missed appointments where doctors are left with empty slots is an obvious way to ensure some efficiency in the NHS, but there are also obvious issues with such a scheme.

1. How will it be enforced, will receptionists sit there with a card machine next time you go in demanding payment? Or will it be a letter and how will it be followed up if you refuse to pay ?

2. I've often had appointment letters either not arrive or arrive after the event, what then? Would I be fined for not attending an appointment I didn't know about ?

3. What about the times I've arrived at an appointment to be told the doctor is absent or overbooked and I've got to rebook? Should I then be paid for them missing my appointment?

4. What about patients using hospital transport that fails to turn up or gets them there too late for their appointment? Who pays the £10,then?

So many concerns and also feels like the slippery slope to privatisation.

[malumbu]

Oohh I bet some of the receptionists would love this

Some of the things the coalition did were reasonable including the nudge. Most of us attending hospital appointments will have had texts and even calls giving remainders, often mentioning the cost of failing to attend to the NHS

If it wasn't for unecessary austerity and the Brexit referendum we may even have fond memories of Nick and Dave.

[womanofdulwich]

In all the time I have used the NHS, not once has anyone said, the dr is free now, you can go in early because there have been some no shows. I cant help but think that they already factor in no shows.?

[OutOfFocus]

I discussed this sort of thing with my GP. She said she regularly gets discharges from hospitals due to misunderstandings. In my case they offered me an appt on one date but asked for a change so my partner could come.. didn't put in dairy meanwhile the unconfirmed appt passed..

I suspect some clinics practice "airline overbooking" on assumption there will be DNAs. But don't want people to asume that.

On tangent - I have once got early and left BEFORE published start time

[KidKruger]

I'm reading all this as total bluster from the PM candidate(s).

They have to say something in the pointless 'leadership' race, this is just another BS proposal - it hasn't been enacted, probably never will be (eminently unworkable, no?), distracts the public nicely and (they hope) makes it seem like the candidate has things to say.

'Tax the Rich' would work for me, but they'll never propose that.

[diable rouge]

I agree with KK that most of these 'proposals' are all bluster, red meat to a miniscule section of the public that live in a parallel universe to everyone else, but it's telling nonetheless.

Which is to deflect from 12 years of Tory rule and underfunding of the NHS and all that entails, and instead point the finger of suspicion as to why 'some people' can't get an appointment because 'some people' don't turn up for appointments...

[OutOfFocus]

I had an appointment i wish i had cancelled. A therapist that was deficient in listening skills.

With hindsight i should have paid £10 fine

Have also been late due to diverted buses. To an ADHD clinic, would have been quicker to walk.

Seriously- it is a lot to poor people, not much to rich and PITA for staff to collect.

[OutOfFocus]

It might increase the problem. A friend of mines son thought it cheaper to pay penalty charges than buy tickets (until they take you to court).

[Lebanums]

One of my friends' parents was visiting from Argentina. She fell & broke her ankle. She was in A&E & then sent to the hospital. She tried to show her insurance documents and pay, but they refused to accept payment.

I don't see how they will collect for no shows with no payment details if they can't collect for visitors when they are willing to pay. The whole system needs an overhaul.

[Pugwash]

NHS is free for those who find themselves in the situation as previous entry also strokes/heart attacks etc.

Cost occur when admitted and also if rehabilitation required for those who do not qualify for free care. Many years ago I worked on a stroke ward, the initial treatment was free but post stroke care which could be several weeks involving physio/speech therapy/dietitian etc was chargeable. At that time, cost of a bed was £160 per day. There is usually a section within the hospital which deals with patients etc from abroad.

I remember someone from Nigeria who had a stroke, the hospital found a stroke unit near where she lived in Nigeria and paid for the air fare to return her home as this worked out cheaper than treating her in GB.

Whilst we were in the EU we could receive emergency care abroad, now after Brexit we need to have full medical insurances. Not sure what the situation is now for those EU members visiting GB.

The hospital I worked in had 2 million pounds owing to it from 'health tourists'.

[Spartacus]

Lebanhams, you make an interesting point as Dr's and nurses are there to treat people, not act as administrators.

I guess there would have to be tenpound administrators employed to collect the missed fees, and if the number of did not attend appointments was below a threshold then that persons role would end up costing the hospital.

The age old issue of medical tourism is one that possibly does need looking at but from what I witnessed once a patient is admitted and treatment starts, it's only when they are well enough to respond that they are asked if they should pay and if not can they prove not. That process can take days during which time they still receive treatment and potentially can discharge themselves without any follow up. Again Dr's and Nurses are there to treat people not be hospital accountants.

Lol maybe we all need our NHS number Barcoded on our wrists to identify if we should pay or not (whilst I joke, I bet someone in power has or will suggest it)

What's the answer? Employ more admin staff ? Yet we are already top heavy with not enough practitioners !

There's no easy solution and with the size of the NHS a full reorganisation is highly complex and potentially doomed to fail as all large government projects seem to from experience.

[Moovart]

Charging for DNAs pops up every few years and is always dismissed as a bad idea. Better ways to ensure people attend are the text reminders and appointment confirmations etc that now exist.

I don't actually see any problem with ensuring patients are entitled to NHS care via, for example, an NHS card. It is supposed to be for those paying appropriate tax, those in receipt of benefits or those from overseas who have registered to pay for their care. It's simple finance to check entitlement to care and could be done in advance of care via a patient's NHS number. But for some reason people see it as xenophobic even though the same people expect to pay for care or to pay for insurance when they travel abroad. They also fear any type of card which could be seen as data collecting despite many people leaving a very thorough ID and data trail with every social media post they make

Certain emergency care is free to anyone and everyone anyway but for example, cancer care can cost hundreds of thousands of pounds. We could say that anyone that comes here can have free care which is often what happens here by default as no administrator checks. Or we could say that those contributing or on benefits, are entitled to care and others are welcome but have to pay.

Since most people here are entitled, it's more of a political and society mind shift than an administrative difficulty. It could be done but at the moment it is left to receptionists and other staff to randomly identify those who might need to talk to the appropriate administrator to assess entitlement or need for payment.

We have to get beyond the idea that limiting entitlement to tax funded services to those appropriately contributing (or on benefits) is inherently xenophobic. If it makes financial sense then why not do what most other countries do and collect funds appropriately.

[Nigello]

We still get free healthcare in EU countries and certain others. The name of the card/system has changed but it’s almost identical to the previous format. Always take out insurance, though!

[Moovart]

We still get free healthcare in EU countries and certain others. The name of the card/system has changed but it’s almost identical to the previous format. Always take out insurance, though!

 

We get certain things free in the EU but it depends on what is provided by the government in the country you are in. Usually it's not the comprehensive, free at the point of delivery, care you get in the UK.

I have had free care for a minor injury in a state hospital in France using an EH1C but received a bill for x-rays taken at the time with the bill sent to my home address in London a couple of months later.

So as you say, still worth having insurance.