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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

NHS should charge people

222 replies

Brideandpredjudice · 27/08/2022 17:38

AIBU to think that people should be charged a fee for wasting the time and resources of the NHS and to think this might help with some of the current problems?

I was just reading a thread where someone had purposely done something that they shouldn't have done before their appointment, which meant it couldn't go ahead. Why do people think this is okay?

We can't continue to have a free health service if it's misused like this and perhaps the only way to deter people would be with a fine. No idea if or how this would work in actuality and how they would police genuine mistakes from accidents, but it's so infuriating. They should at least be pushed back to the bottom of the queue.

I recently had to pay for an appointment because the waiting list was over 12 months. I wonder how much shorter it would be without all the missed appointments etc.

OP posts:
ToppCat · 27/08/2022 19:07

I reckon it would cost more to administrate than they would get back in fines to charge people for missed appointments. They are hard pushed already.

cptartapp · 27/08/2022 19:07

My MIL like many women of her generation, gave up work mid 20's to raise and family and never returned. She's 82 now.

brightnesses · 27/08/2022 19:10

Purpleforthewin · 27/08/2022 17:47

Well they do charge at least some times. I get a text before every hospital or clinic appointment telling me how much I will be charged if I miss it.

@Purpleforthewin no they don’t?

You get a reminder text and it mentions something like ‘failing to show up to appointments cos the NHS £160’ etc. That’s not an amount that you’d be paying….

ElBandito · 27/08/2022 19:12

Ooo, that's a brilliant idea. Children have never paid NI so they shouldn't be treated at all should they?

Suzi888 · 27/08/2022 19:12

ghostyslovesheets · 27/08/2022 18:15

children don;t pay NI either - maybe they should save their pocket money?

most older people have worked and paid NI

I do understand the frustration OP - I have a friend who is a paramedic - the things people call an ambulance for makes my blood boil (including feigning illness to get an emergency ambulance so they can get a lift to hospital for an apt!)

Agree with this poster. ^

The problem is there are too many of us for one and for two there are alot of people that take the piss. See above posters third point.

ElBandito · 27/08/2022 19:13

Sorry, that was a reply to Bamabina

WhatIsThisPlease · 27/08/2022 19:14

I spent 4 hours in A&E a couple of weeks ago with DP who needed stitching up.

The amount of people in there who clearly didn't need to be was ridiculous. One bloke had turned up with his gf because he'd had s&d for a few hours!! Another man walked in and said he'd hurt his leg playing football a month ago and it was still hurting. Wtaf!!!

I think the triage nurse should be able to say "hello s&d/football injury man. We absolutely will treat you. You'll be waiting 5-6 hours and we'll charge you £100 as we don't believe you need to be in A&E.

Isaidnoalready · 27/08/2022 19:19

Really? Who is going to do that then hire more staff? Pay more money chasing pennies? Why not sort the shit storm out that we have now? Ds 1 supposedly referred in January its August no referral has gone through chased up multiple times and ignored or how about the "urgent" referral he had two and a half years ago 13 years old now still walking in pain still no appointment so how are we going to fix that issue? By hiring more fucking ADMIN?

ScaryFaces · 27/08/2022 19:20

swg1 · 27/08/2022 18:58

Two things to consider:

  1. People who are severely ill tend to have a lot of appointments going on. It's easy to think "How can you just forget to go to an appointment?" when you're generally healthy but when you've got a couple of appointments per week and you've unexpectedly been hospitalised for a night or two you can be genuinely shocked that oh, whoops today is Tuesday not Monday? Or you have appointments spanning over multiple NHS trusts and turn up at the wrong hospital (I have personally done this). Or you actually do know exactly when and where you're meant to be.. but you can't drive due to illness and your transport lets you down (an increasing issue in these days of high fuel prices as taxis get less reliable). Or you actually got hospitalised last night in Hospital A as an emergency, you're meant to be seeing your consultant in Hospital B tomorrow and whilst Hospital A promised you it was sorted the message didn't get through .
  2. A lot of serious illnesses involve brain fog. Tiredness, unclear thinking, and sometimes inability to recall a conversation. And the more appointments you have, the more likely it is that someone has called to give you some of them over the phone because you need to be seen soon which means you don't necessarily have everything in writing to check through if you forget. I've known people travel miles into London for an appointment that wasn't until a week later. In an ideal world we'd all have someone helping us track these things when we're not quite functioning mentally but a lot of people are limping through making mistakes.

At one point in my life I was under the care of the mental health crisis team, deeply suicidal and having a panic attack during the consultation. In this state of brain fog and confusion, I noted down the time of my next appointment - I wrote down 3.30 when I should have written 13.30. As a result, I missed my appointment. Any system of fines is inevitably going to hit vulnerable people like I was at this point.

So how would you administer a system of fines to ensure genuinely vulnerable and confused people aren't being penalised? Bearing in mind you'd have to actually make it someone's job to issue, chase and administer these fines, which would cost money in itself.

MugginsOverEre · 27/08/2022 19:24

cptartapp · 27/08/2022 19:04

Except they wouldn't charge 'everyone'. Children wouldn't pay, nor those on benefits, nor pensioners (despite ability of many to pay).
The same poor sods in the middle would be the only ones penalised.

Good point. It's us workers just about scraping by without any benefits would be the ones having to pay.

ScaryFaces · 27/08/2022 19:25

WhatIsThisPlease · 27/08/2022 19:14

I spent 4 hours in A&E a couple of weeks ago with DP who needed stitching up.

The amount of people in there who clearly didn't need to be was ridiculous. One bloke had turned up with his gf because he'd had s&d for a few hours!! Another man walked in and said he'd hurt his leg playing football a month ago and it was still hurting. Wtaf!!!

I think the triage nurse should be able to say "hello s&d/football injury man. We absolutely will treat you. You'll be waiting 5-6 hours and we'll charge you £100 as we don't believe you need to be in A&E.

Except it would be quicker and less costly overall for the nurse to say "Hello s&d/football injury man, we're not going to treat you as you're not urgent, please go and see your GP instead, bye now". Which is what they do currently. What you're advocating would actually cost more and waste more time, both in providing the unnecessary treatment and in administering the fine.

Sproglets · 27/08/2022 19:27

I had an appointment following up a fractured wrist recently. First thing I knew about it was when the clinic rang me asking where I was as I had missed my appointment. It isn't as easy as just giving people fines as there will be all sorts of reasons that it happened including not being told about the flipping thing in the first place!

bakewellbride · 27/08/2022 19:29

The trouble is there are lots of people out there who genuinely need medical assistance but fear they are going to 'waste everyone's time' and are convinced that their problem is nothing much. This would put those people (who typically are elderly) off seeking help even more.

RancidOldHag · 27/08/2022 19:33

I have only ever missed one appointment - it was a routine mammogram, my first so I didn't know to expect it, and the first I knew about it was when I got the 'naughty non-attender' letter.

Original appointment letter must have been eaten in the post.

Should I have been fined????

TheWayoftheLeaf · 27/08/2022 19:36

That opens it up to victimising people with mental health problems and poorer people not 'risking it' when they worry they or their child is I'll because they're afraid to be fined for seeking help

lunar1 · 27/08/2022 19:38

All charging would do would punish the most vulnerable.

People with complex needs, people suffering with their mental health and the people who just couldn't afford to get to their appointments.

Topseyt123 · 27/08/2022 19:39

Purpleforthewin · 27/08/2022 17:47

Well they do charge at least some times. I get a text before every hospital or clinic appointment telling me how much I will be charged if I miss it.

No. They inform you that each missed appointment costs the NHS £160. They are not charging you. They can't.

I've never (to my knowledge) missed an appointment. I have, however, also had a couple of "boot on the other foot" experiences. One was where I didn't receive the letter informing me of my hospital appointment until almost a week after it I should have been there. With the best will in the world, I cannot attend an appointment if I don't know about it. The same happened to my mother too. Both were put down as DNAs (did not attend) and we each had to argue hard to get that removed from our notes.

Georgeskitchen · 27/08/2022 19:40

BambinaJAS · 27/08/2022 17:58

No.

Over 65% of NHS spending is on the over 65s

They do not pay NI

Make them pay NI as they use the NHS but do not pay for it.

NHS problem solved.

But most of them will have paid NI for about 50 years.
How about targeting the loafers who have never had a job and never paid a penny.
Just think how much money that would save!!

Gingerkittykat · 27/08/2022 19:42

Purpleforthewin · 27/08/2022 17:47

Well they do charge at least some times. I get a text before every hospital or clinic appointment telling me how much I will be charged if I miss it.

They don't charge, they just tell you how much the missed appointment will cost the NHS.

NHS should charge people
AnguaResurgam · 27/08/2022 19:43

BaileySharp · 27/08/2022 18:53

I suspect charges for seeing GP will happen eventually. It is a bit of a worry though, as some people put off seeing a doctor at the best of times and are less likely to go if they have to pay. Might lead to missed diagnosis of serious conditions

I would hate to see this happen.

Free at point of use matters - as I would never want to return to the days when people put off seeing the doctor because of cost, and then were a whole heap harder to treat when they finally did present. I would like to see more preventative medicine, and deterring people from attending early would inhibit that.

Also, I assume that in England, those who have exemptions from charges (age, pregnancy, qualifying medical conditions, receiving qualifying benefits) wouldn't have to pay. So it'll just be another charge on those in the middle, bearing hardest on the low-paid.

youkiddingme · 27/08/2022 19:47

I have had those letters saying how much missed appointments cost the NHS. I have had to have a lot of appointments over the last few years and have never seen a situation where a doctor or nurse was sat twiddling their thumbs waiting for patients. For every appointment, I've been waiting beyond the appointment time. Sometimes by many hours. I've often been seen late in the day when the Drs are already working beyond the time they were due to leave.
I have never missed an appointment and certainly don't advocate anyone doing so but I'm a little sure about the accuracy of these missed appointment costs.

Misunderestimated · 27/08/2022 19:47

Okay, I'll bite. Virtually nobody who pays for the NHS studies the NHS.

In general, National Insurance is just an additional Income Tax - Rishi's decision to equalise the personal allowance for both IT and NI is the first step towards eliminating the the NI break given to those of state pension age.

www.england.nhs.uk/patient-safety/never-events-data/

Not for the faint-hearted, never Events are serious, largely preventable patient safety incidents that should not occur if healthcare providers have implemented existing national guidance or safety recommendations. 407 in 2021/22 - if you calculate the value of a ten minute appointment with a GP, what is the value of a faulty procedure?

Perhaps the NHS would do better with more money?

www.gov.uk/government/publications/dhsc-annual-report-and-accounts-2020-to-2021

Not the easiest to digest and delivered extremely late by DHSC. If you go to page number 170 (page 174 of the pdf), the second to last column shows an underspend of £20,555,846,000. Rather more than the money on the side of Boris' bus.

On the same page, an accounting sleight of hand, £22,823,176,000 of hypothecated National Insurance fully used, because otherwise Rishi's NI increase wouldn't stack up.

The NHS is an amazing asset for the UK, it can be a great force for good, but it is poorly served by civil servants and its managers.

giveovernate · 27/08/2022 19:49

djdkdkddkek · 27/08/2022 17:49

I think they should charge for people who have clearly attended services to try and force another services’ hand

What do you mean?

Starlightstarbright1 · 27/08/2022 19:56

I had an appointment for my DS a couple of months ago..Local hospital , parking is horrific.. We queued for the car park for an hour and was a couple of minutes late...

I asked about timings of appt for parking..Staff said sometimes it is horrific ..They said last week they had phonecalls from people who simply gave up.. How would you charge for that?

Tbh .. I think you don't realise how chaotic some peoples lives are...

mathanxiety · 27/08/2022 19:58

Everyone in the US gets the same standard of treatment - even the homeless and unemployed?

There is medicaid for people who are unemployed or paid a low wage. In addition, people facing bills for medical treatment whose private insurance has a high deductible can apply for a waiver of the charges, with proof of unemployment or low wage status. Interest free payment plans can also be arranged, or self pay reductions in charges.

The homeless tend not to engage with medical care but they are treated for free at county or public hospitals if they are admitted.

Same standard of treatment - yes.

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