NHS should charge people

[Brideandpredjudice]

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.

They should at least be pushed back to the bottom of the queue

NHS care should be prioritised on clinical need, nothing else.

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

I wouldn’t object to paying for missed appointments myself but the NHS would have to seriously get its processes in order first. I and DDs had three consecutive appointments with an asthma nurse (half hour each) a while back, but we had to extend the period we were abroad and couldn’t make it. So I used the text message system for cancellation they sent me to cancel all three, and got three acknowledgements. When I got back and called up to rebook I was rebuked for wasting an hour and a half of their time. I was so pissed off I took my phone in to show them the cancellation text msgs - they couldn’t explain what had gone wrong, but it was their systems fault, not mine.
Before he passed away my DF had multiple appointments at various locations, different consultants etc. One particular procedure was booked, and carried out, but he kept getting letters from a different hospital (completely different Trust), with his name and address but an incorrect NHS number. Three times I called to say, nope no idea what this is but it’s not definitely not him - and he’s already been seen. Kept getting letters to remind us, each time I called I was told they couldn’t cancel the appointments as they didn’t exist. However, after the date of the appointment we got a letter, again rebuking him for not turning up to an appointment that wasn’t for him, he didn’t need and I had tried to cancel three times only to be told it didn’t exist! God only knows what happened there.

To @Jux and @Firstbornunicorn , if you are fully diagnosed with MS or any similar degenerative condition, then I would hope you'd be rapidly classified as disabled and treated gently. But if you are pratting around drunk after a heavy Saturday night, then I think you need to take a ticket in the carpark, bring your driving license and generally prove your entitlement to care. Likewise the BH weekend DIY bodger who falls off his ladder. I can invent 1001 nights of medical events, but 900 probably don't need A&E. Save A&E and the dedicated staff for the life threatening conditions that need urgent intervention. Go to the GU unit on a Tuesday morning if you have an abcess on your bottom. Forget Be Kind... Be Sensible.

if you are fully diagnosed with MS or any similar degenerative condition, then I would hope you'd be rapidly classified as disabled and treated gently.

Nope. It's entirely possible that someone with primary progressive MS can have their DLA/PIP rejected despite all symptoms worsening over time.

The fact you can't apply for PIP online should tell you all you need to know even if you refuse to believe the governments stated aim of reducing claims over time.

(This is something I know a lot about, having assisted countless people in navigating the system).

I didn't know that, and am suitably chastened.

Most people with degenerative conditions don't qualify.
Most people who miss appointments are not "pratting around drunk"

You haven't addressed the issue of the insane and non communicative appointment systems. Fix those, then we can talk about charging people as "no shows". As it stands those "no shows" include appointments they didn't want, didn't know about or were not able to cancel or had cancelled and the fabulous appointment system just kept them in there. Sorting out botched business systems would genuinely save the NHS fiefdoms money - of course you have to convince them change is needed first.

Re. missed appointments - telephone based appointments and video calls improved these quite a lot, as did text reminders.

For people with good communication skills, access to the technology, privacy to take a call and the confidence to represent themselves effectively and not needing the appointment for a routine procedure then yes, they can be an improvement.

That is just one subset of patients.

I still do not understand why every other professional (including the same doctors when seen privately) I deal with can give me a specific time or at least a reliable window of an hour or so for a phone/video call but from the health services it tends to be "at some point on day X" and if you are on the loo when the call comes then tough - you lose your spot. So someone on a zero hours contract is expected to take a days unpaid leave knowing that the call may not even happen. Some doctors do manage to give a window - eg late morning, between 3-5 in the afternoon - why can't more do it?

There is huge systemic discrimination against the less able and less well off in our system and yet we pretend its equal access for everyone.

Oh and also most medics are not trained to use calls/video comms with patients. It was screamingly apparent during the pandemic that they should have access to training to manage appointments using modern telecoms.

I do pay, in the form of expensive NI

Some have, some havn't yet are still eligible. I.e. those who worked part time, cleverly working just below the NIC threshold, so they get "credits" for state benefits but don't pay NIC. Or those living on "unearned income" such as dividends, property letting income, investment portfolios, foreign income, etc. Or those who are on certain benefits which grant "credits" where no NIC is paid. But even those who have been "workers" and have paid NIC will have paid a lot less than current working generations because whilst income tax has remained unchanged for decades, the NIC rates have doubled since the 70s and increased twice under Blair/Brown and also increased under the Tories.

So, no plenty of people havn't paid NICs and most paid at lower rates than today.

Aside from the moral and ethical arguments, it would probably be a disaster. Usual story. Outsourced to some outfit with dubious relationships to senior ministers. Massive IT system commissioned which would arrive 3 years late, billions over budget and wouldn't work. Once eventually up and running it would transpire that running the system actually costs more than the revenue collected.

the NIC rates have doubled since the 70s and increased twice under Blair/Brown and also increased under the Tories

So, no plenty of people havn't paid NICs and most paid at lower rates than today.

That’s completely illogical. It only works if you assume current pensioners haven’t worked for the last 40 odd years. Most of us paid NIC at current rates. I was a higher rate tax payer and, trust me, I paid a lot of NIC over 46 years. Enough to make up for one or two lower paid people not doing so.

But monies paid in the past have long been spent. Tax/NIC isn't a personal savings account. We need more tax revenue TODAY, so everyone needs to pay more tax/nic TODAY to pay for today's needs. In the interests of fairness and to spread the burden as wide as possible, that means EVERYONE needs to pay a bit more tax/nic.

It's completely illogical that a pensioner with a £50k income pays just income tax, when a worker earning £50k also pays NIC, student loan repayments, workplace pensions etc etc. The burden needs to spread wider.

It's completely illogical that a pensioner with a £50k income pays just income tax, when a worker earning £50k also pays NIC, student loan repayments, workplace pensions etc etc.

Pah ! Get away with your "logic".

The burden needs to spread wider.

You know where the ballot box is

Unless they forget because they are so ill it's difficult to remember what day it is any more. Or they got given an appointment over the phone and wrote it down wrong without knowing. Or they got a second letter changing the appointment date but missed that one. Or already got hospitalised and are in no state to remember their consultant appointment is tomorrow.

I can invent 1001 nights of medical events, but 900 probably don't need A&E.

That’s fine if you’re qualified to know what doesn’t need A&E, but most people aren’t. I took my DD to A&E this morning, now I know what was wrong it probably could have been dealt with by the GP but at 6.00am faced with a very sore, angry looking injury I didn’t think it could wait until the GP opened, arranged a phone consult and then gave a face to face appointment (which she needed because she needed to be examined). She was seen by a paediatrician at children’s A&E and home again before the GPs surgery was even open.

People are often making judgement calls when they or someone they love are in pain, distressed and in need of care, knowing they’ll wait for a GP even to call them back. I think A&E is a precious resource but one there to be used when an individuals judgement deems it necessary.

I was asked multiple times, very sternly, on one A&E visit if I had been drinking as I was very wobbly and couldn't walk straight. I had been brought in by ambulance after several hours of d&s and so much pain I was convinced I was dying. They had given me paracetomal IV which can apparently make some people a bit drifty. I was not capable of staying coherent enough to explain this so was clearly a drunk time waster.

(24 hours later they admitted me for three days)

They could save money with better admin - trouble is, they have had to get rid of too many admin staff over the years, which is a false economy. I've had letters turn up for hospital appointments with really short notice, or letters saying I've missed an appointment I hadn't even been informed about. Everyone getting a text reminder about an appointment would help also- this is done by the dentist but not the GP surgery or hospital yet.

Oh lord the joy of "that referral isn't through". Last time I had that they finally resent it. Two months later dutifully attending an appointment sent through with no explanation (We get lots of those) it emerges the Dr sent it to the wrong hospital trust so my son was temporarily under two different consultants.

Charging for a GP doesn't have to mean people won't go. Some GPs may chose to charge a lot but there could be cheaper/subsidised appointments/practices.

I think one of the biggest issues in the UK is the lack of preventative medicine. We need to go back to people being responsible for themselves and we need to be honest. I was surprised the other day to see a post where posters were amazed the OP had reversed her type 2 diabetes. Why don't people know that being overweight and eating crap is the main cause - ie things that's people are responsible for.

My OH (cancer) got an appointment to see a specialist bone marrow transplant consultant at a different hospital in the next county 90 minutes drive away. Appointment letter was for 9.30 on Wednesday.

We turned up, checked in, and waited, and waited. At 11.00 he went to the desk to ask how long it would be and was told "not much longer". At 12.00 he went back, told again "you need to be patient". At 1.00 the place was literally deserted. No staff around, no patients, just a different receptionist. He went to ask her and was told "I wondered what you were here for". The day's consultations have all finished and the consultants have gone. When she looked to see who he was booked in to see, she rolled her eyes and told him that Mr X didn't work on Wednesdays and then sort of laughed and said the appointments office keep making that mistake!

Needless to say were were pretty angry at wasting so much time, petrol money, days of work for each of us, and more so that none of the morning staff bothered to tell us!

@viques my bet is you would be shocked to see how much a 30yo on an average salary pays in NI and Tax nowadays compared to the measly % you paid for 40 years….

@CaptainFlubby well that’s because they chose not to work and not to pay anything into the system

@cptartapp so she paid nothing in why should she get everything for free now?

Not really in my experience. Yes, if I go on to my records, it'll give me a time but I'm rarely called on time. Was once called almost 2 hours early and another time, an hour late. Would I have been fined if I didn't turn up for either? My previous GP didn't give a time. If I wasn't in, would I then be fined for not turning up?