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It’s in their DNA

It’s in their DNA

How enthused are we all about the leadership contenders for the Conservative Party?! Hello? Anyone?

In their attempts to outdo each other’s insane and reactionary policies, Liz Truss has distanced herself completely from the Boris Johnson regime. Unfortunately, it wasn’t by denouncing the lockdown parties, or reversing the Rwanda policy – instead, she decided the ‘levelling up’ policy was the most egregious element of the Johnson government, so she has committed to ‘level down’ public sector pay (we were only joking when we suggested this Liz).

For his part, Rishi Sunak has proposed a £10 charge for GP appointment ‘did not attends’ (DNAs). It might be that this is a policy that has been formulated over months, modelled with a full impact assessment and has been agreed with GP groups and patient groups. I strongly suspect, however, that this was a case of 2 + 2 equals £10.

There is so much wrong with this. First, the assumption that DNAs are a bad thing in the first place. Some GPs might say so, but for others they are time to catch up and ensure that following appointments are less rushed and waiting times are shortened.

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Second, this will more likely affect those with mental health problems – who have good reasons for missing appointments and feel unable to inform their practices – than those who simply can’t be bothered turn up.

Finally, and most importantly, this will not reduce waiting lists and will probably even lengthen them. By putting this fee in place, it reduces the guilt aspect of failing to turn up to an appointment and it is not enough to provide a financial dent to most patients, apart from those who are already deprived. I suspect more people will decide they feel more ok with missing an appointment with that fine assuaging any guilt.

And more importantly, according to Sunak’s supporter Greg Hands MP, GPs would be administering this, and would be using their own discretion. This could be disastrous for the GP-patient relationship, but that is of minor importance compared with the workload it would add to practices. Which would, in turn, increase waiting lists.

But I’m sure Sunak’s team have considered all this. Right?

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash  or email him at



Please note, only GPs are permitted to add comments to articles

Simon Gilbert 3 August, 2022 3:44 pm

I used to work with a Urology consultant who, at the end of every clinic, picked up the pile of DNA records and announced “DNAs, God bless every one!”.

David Banner 5 August, 2022 1:50 am

All hail DNAs, the unsung heroes of the NHS. How it lifts your soul when that 5pm Friday heartsink you were dreading all afternoon fails to show up. Glorious.

But how we despise the dreaded soul-crushing pseudo-DNA, who teases you by not showing on time, but then rocks up 9 minutes late blaming, y’know, “traffic”, then eats up 20 more minutes with multiple agendas, cos, y’know, “I can never get an appointment”.

Dylan Summers 6 August, 2022 12:38 pm

Well said David Banner.

Possibly even worse is the self-inflicted pseudo-DNA when reception forgot to book in the patient and you didn’t think of looking in the waiting room. Suddenly they’ve been waiting 45 minutes and it’s your fault.

I recently phoned a patient who had failed to attend. No answer on home or mobile. Only later did it become clear that there was no answer because they were sitting 20 feet from where I was phoning from.

David OHagan 8 August, 2022 5:31 pm

Did they say it is the patient who pays, or is this a charge on GPs for having DNAs?
(just in case we aren’t leaving fast enough)

Kevlar Cardie 9 August, 2022 9:32 am

Two cheeks on the same pair of buttocks.

Christopher Ho 9 August, 2022 11:31 am

“it reduces the guilt aspect of failing to turn up to an appointment” – GUILT??? What world are you living in, Jaimie?
If you’re so concerned about the reduction of guilt, what say you about “entitlement” then? That pretty much removes any guilt pangs coming off my demographic… if there was any to begin with.