Sunak’s £10 NHS fine proposal ‘will not solve the problem’

THE NHS would spend more money chasing patients for £10 fines for missing appointments than it would receive under the proposed scheme, healthcare leaders have warned.

Rishi Sunak, the Conservative leadership hopeful, said he would introduce a £10 fine for missed GP and hospital appointments, in an effort to stop people wasting NHS resources.

In an interview with The Sunday Telegraph, the former chancellor said the scheme would be temporary and only kept in place as the NHS tries to clear the record backlog of 6.6 million patients waiting to start treatment.

More than 15million GP appointments are wasted every year after patients fail to attend, according to NHS England. Each appointment costs an average of £30, meaning the total cost to the NHS is more than £216million a year. But health bosses say Mr Sunak’s scheme will incur more administrative costs for the NHS than would recoup through the fines.

Dr Layla Mccay, director of policy at the NHS Confederation, said the reasons why patients don’t attend appointments is “complex”.

“Penalising them unfairly will not solve the problem and working with it local communities to address the root causes is essential,” she said.

“The administrative burden this would place on the NHS risks being considerable and could well far outweigh the money brought in by the fines. This proposal will also not solve the fundamental and long-term issues the NHS is currently grappling with.”

The Royal College of GPS (RCGP) said such a proposal would add more bureaucracy for family doctors who are “already drowning in red tape”.

Dr Gary Howsam, the vice chair of RCGP, said: “When patients miss appointments, it’s frustrating as these are appointments that could have been used for other patients. But charging... is not the answer.

“It would fundamentally change the principle that the NHS is free at the point of need and would likely impact on our most vulnerable patients most – and it would add another layer of bureaucracy to a GP service already drowning in red tape.”

Mr Sunak said: “I’m all for a healthcare system that’s free at the point of use, but not one that’s free at the point of misuse.” He added: “Yes, it means we have to do something brave and something different, but that’s what I’m about doing. I want to be a transformational prime minister.”

SIR – Rishi Sunak plans to fine patients £10 for each missed NHS appointment (report, July 31). Will he also fine those patients who never received the letter confirming their appointment, or those whose letter cancelling it was sent out in error? Will persistent “offenders” get black-listed by the NHS and die untreated?

He seems to have no idea what most of us have to put up with. I despair. Michael Round London SW19

SIR – As a GP whose surgery is always overbooked with extra patients needing to be seen urgently, I am quite relieved if the occasional booked patient doesn’t turn up as it is the only way I can even vaguely keep up. This is usually because the patient’s problem has resolved, and the non-attendance allows a slot for an emergency. The time is never wasted.

I would much rather Mr Sunak focused on recovering the money owed by overseas’ visitors, who are not entitled to NHS care but receive it for free nevertheless because no one bothers to chase it.

Dr Fiona Underhill

Woodford Green, Essex

SIR – It’s good to hear that Rishi Sunak is promoting a £10 charge if patients miss NHS appointments without a valid reason. This is long overdue: we cannot have NHS patients treating the system with contempt. But why has no politician raised the matter of a charge for hospital food? Those on universal or pension credit could be exempt, but others could well afford a charge.

The NHS does not just need more money, it needs a radical rethink. Geoff Neale

Cheltenham, Gloucestershire

SIR – How will Rishi Sunak’s planned fine be collected? Past experience shows that the cost of gathering the money would far exceed the amount collected.

Before the NHS there was a charge for visiting the GP, which not everyone could pay all at once. My GP father then had to employ a debt collector to retrieve the outstanding amounts – five shillings, or 25p, a lot of money in those days. That is why people only went to the doctor if they were ill. Gillian Lurie

Westgate-on-sea, Kent

SIR – Mr Sunak’s idea to charge £10 for an NHS appointment no-show is not the answer. Much better to charge £10 upfront when booking the appointment, which would then be refundable to people such as those on low incomes, the elderly and disabled, as long as they show up.

Chris Thomas

Reading, Berkshire

SIR – In the interests of fairness and transparency, will Mr Sunak introduce a similar fine for every appointment cancelled by a GP or NHS hospital? Over a period of time, it would be interesting to know which group was in credit – the patients or the NHS. David S Ainsworth

Denton, Lancashire

SIR – Most NHS outpatient appointments cost about £150. A £10 fine for missing an appointment for no good reason is far too cheap. A £50 fine would be more realistic.

Yvonne Kirk

Great Sutton, Cheshire

SIR – The concept of paying a fine for a “no-show” GP or hospital appointment is ill-conceived. The response should be to find out why it was missed. Was it because the patient could not make contact by phone to cancel or explain the reason? Was the patient too ill to travel, or had no way to travel to keep the appointment?

More admin would be required to collect fines, and more money wasted. Dr Rhoda Pippen

Cardiff

SIR – Never mind fines for no-shows at GP appointments, I’d be quite happy to pay £10 just to be able to secure an appointment in the first place.

Peter Harper Lover, Wiltshire