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My 2016 prediction: Everyone will be charged £60 for each missed appointment

Dr Matt Piccaver

The powers that be will conclude that this is the only way. The number of missed appointments is getting silly, with dozens of wasted slots each month. While I don’t know a doctor who doesn’t use the time to catch up – or who just breathes a sigh of relief – it costs the NHS money. So we will ask for it back.

The decision to charge £60 for DNAs will be made jointly by LMCs, the CCG and even local patient organisations. The money will be paid directly back into the local NHS, rather than into the income of the practice – a bit like the plastic bag tax. Or the lottery. Or a library fine.

The NHS will hire muscle to extract fines from the sick

Every patient that DNAs, regardless of reason, will have to pay up. No exceptions. Car crash? Pay the price. Frail elderly? Cough up. Dementia? Hand it over. Admitted to hospital as an emergency? No excuse, you still have to pay. Died? That’ll be 60 quid I’m afraid.

As a result, the poorest, sickest and most vulnerable, those I’d sworn to look after, will stop coming. That said, it will be easier to get an appointment, and those that can afford it won’t care about the fine.

Revenue-protection officers will be employed, like those scary people who patrol trains. The NHS will hire muscle to extract fines from the sick and there’ll even be talk of stopping patients getting any care until they pay up. Ambulances equipped with credit card readers could join in by charging if they feel you aren’t sick enough to need their services.

Another step on the slippery slope to privatisation? Nah, just healthy market competition, we will be told.

Dr Matt Piccaver is a GP in Glemsford, Suffolk

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Readers' comments (13)

  • Nope, we'll end up charging that per appointment - far more effective.

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  • No, I have drilled down our DNA figures (8% total) and that breaks down into 73% mental health patients, 9% communication issues at the reception end, 8% of worsening and going hospital plus 10% who couldn't be arsed.

    That 10% splits roughly 50/50 into patients booking appointments for themselves and carers for kids or vulnerable patients.

    Taking all of this into account, - penalising patients for missing the appointments is not feasible.

    Also it helps our GPs to run on time.

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  • Missed appointments don't always 'waste' money as GPs run over anyway, and DNAs are a welcome mental 'bonus' to help one draw breath.
    Charging for ALL appointments would be far more effective.

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  • I almost cry when ALL my patients show up. Help, I say with whimper. Please next patient be stuck in traffic.

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  • 5p/plastic bag and they become obsolete. What would £5/appointment do to demand?

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  • Who cares about DNAs. get over it. They don't cost anyone anything cos were all seeing too many patients anyway. It costs us our mental health if they all turn up. The only reason to charge for DNAs is if youre charging for patients who do come so youre actually losing money if they don't.

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  • Idiotic, let's charge Dr Piccaver for every minute he runs late.....oohps, perhaps he does not see patients!

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  • DNAs are the only breaks i get.

    give the Doc a break - I think he is being T.I.C

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  • When everyone turns up I run even later - because we're seeing too many people in the first place in insufficient time.

    Apart from that trying to get money out of the kind of folk who who couldn't be arsed or who weren't able to get to the appointment (through air-headed vacancy or severe illness) is almost the definition of an impossible task.

    Even if they did pay would the occasional £60 help? It'd cost three times as much trying to get the money out of them in the first place and the end result would be a let of agro and even more exhausted Drs. It'd have no impact on funding, and a negative impact on work load.

    General practice isn't under strain because of people missing their appointments. General practice is under strain because demand is going exponential at a time when funding is in decline. That's what needs to be fixed.

    The country's limited health budget is being sold to the public by politicians as if it were limitless, have anything you want any time you want it for free. There will never be enough GP appointments to satisfy this kind of service. We need to be doing something to manage demand, not mucking around chasing people for money when they don't turn up. Charge them when they do...£5 a time. That might make some kind of difference.

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  • Charge everyone for an appointment - with the BMA and RCGP doing promotional adverts about the benefit of paying to see a highly trained healthcare professional.

    Something like "I pay to see my GP... because I'm worth it' with a camera panning out to a patient with flowing locks thrush in the air with a clearly satisfied side glance!!

    Disgruntled GP Partner (3yrs)

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