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At the heart of general practice since 1960

GP finds A&E drive 'has the opposite effect'

Patients should be charged for missing appointments and removed from practice lists if they make it a habit, two-thirds of GPs believe.

Research into DNAs show-ed patients missed more than 10 million GP appointments last year, a rise of more than a million over 2003.

The survey of 683 practices carried out by Developing

Patient Partnerships and the Institute of Healthcare Management also found a further five million practice nurse slots were missed.

More than four practices in five (84 per cent) said missed appointments were a problem, up from 68 per cent last year.

Dr Terry John, spokesman for Developing Patient Partnerships and a GP in London, said missed appointments wasted time and made them miss Government targets.

'These results are disappointing, especially if we consider that each GP appointment costs £18,' he said.

But he added that charging patients would present a 'hellishly difficult administration problem'.

Of the 66 per cent of GPs who supported charging patients, 48 per cent said fines should be under £10 with 17 per cent recommending more than £10.

Dr John said the threat of penalties for missing appointments could dissuade people with genuine problems from making appointments and threaten the doctor-patient

relationship.

Some 71 per cent of GPs said they should be able to strike offenders from their list.

But Dr Hugh Stewart, legal adviser at the Medical Defence Union, warned practices against following this course of action. He said removing non-attenders often led to complaints against doctors.

He said: 'There may be a misunderstanding on the patient's part about how the appointment system works or there may be health or social problems that are not immediately apparent.'

Some 69 per cent of GPs said they believed patients simply forgot to attend and 22 per cent said they thought patients most often felt better and chose not to attend without alerting the surgery.

By Daile Pepper

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