List cleansing is bean counting
Stringent list cleansing appears to be inspired by bean counters who have no knowledge of GP practice or the differing attendance rates of individuals of different demographic ranges.
For example, it is accepted many young-to-middle age males have a very low attendance rate since they are healthy and have a less critical sense of their health, soldiering on with self-resolving minor illnesses. To wipe these individuals off practice lists appears monstrous.
Conversely, weeding lists of those who have moved from the area or have died is a necessary task which should be carried out routinely. Practices that do not do so should be penalised for claiming money they are not entitled to.
From Dr John Carne