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.

And you would probably be shocked at what a teachers salary, a nurses salary or a police officers salary was 40 years ago.

Yes. Paying for a GP visit for example, is as reasonable as paying for food and rent, and it's absurd we've created an environment were so many people expect others to pay for them.

Too many NHS staff have the arrogant attitude that patients should accept what they're given because it's free, along with the "if you want an appointment" you'll make the effort to change your schedule to be available for it" - again, an arrogance from the "it's free so put up with it" attitude.

One of the better lessons I got in life was decades ago from a boss who noted that people confuse "free" with "of no value". And in the intervening years, that has been shown to be 100% correct.

In that context, it was annoyance with sales people who made part of the companies offerings "free" on invoices. As they said "once it's free, you can't bargain with it".

The answer was to put down "Item ..... £1,000" and then below it "Introductory discount - £1,000". The overall effect is the same (customer pays nothing). But now you have "given" them £1,000 which can become useful in further negotiations.

Maybe a solution here is to send everyone who uses an NHS service a "bill" for their treatment, and at the bottom cancel it off with "NHS service discount" ? At least it would teach the unthick that it's not "free".

Good post SerendipityJane. Salient points made.

"Free at the point of use" is a euphemism for "massively overpriced at the point of payment". As we've learned from the NHS.

It's high time it was scrapped and replaced with a continental-style insurance based system that will actually deliver.

I can’t believe people still object to things like GP appointments being charged for. It’s been mentioned above, but people don’t value free things. A dentist friend did some pro bono work once, thinking it would be a nice thing to do. It was a complete fiasco of unreasonable demands, missed appointments, zero gratitude. She gave up disillusioned.

It's high time it was scrapped and replaced with a continental-style insurance based system that will actually deliver.

Be careful what you wish for. Joni Mitchell was spot on when she said you don’t know what you’ve got til it’s gone.

We did

Its not viable. Most users of the NHS would probably find grounds to appeal the fine due to extenuating circumstances, being elderly, ill (obviously!) or low income so would cause undue hardship. Others would simply not pay. The money it would cost to administer the appeals and take court action for non payment would mean it would cost more than it gained. Not to mention the reputational damage of dragging elderly or ill people through the courts for 90 quid.
The type of person who could afford, and would happily cough up, to pay a fine without causing more work than it's worth is probably not your target demographic.

What exactly have we got? Or to be exact what have I got? An incompetent GP [who I can't even get to see]. Jam packed hospitals that can't improve cancer survival rates and nurses that I've seen with my own eyes mucking about spending their time laminating signs which declared there was no time to serve customers because of "government cuts"? You think I'd miss that?

The money I pay through tax for the NHS would get me spectacular coverage on the continent where I've experienced far superior healthcare to the crap the NHS "gives" me.

If only it was gone!

Call your retirement population Segment A

Call all current workers payin NI B

Present Value of ALL your payments over your entire working lifetime (aggregated for Segment A) is LESS THAN the amounts you will be extracting from the working population (that pays NI)

And,

Ratio of B to A is only 6:1 now

Used to be 10:1 (40 years ago)

Why do you think NICs have been steadily increasing over the last 40 years?

Because we now have to fund a retired segment of the population that is far larger (historically) than the working population. We are also dealing with a population that is far sicker and less productive.

This is completely unsustainable. Working folks are tapped out and it is impacting productivity as too much tax gets re-directed to the retired folks now.

That is what is also slowly suffocating the country from an economic standpoint.

Its going to ge even worse as the retired folks now want us working folks to pay for their social care while subsidising their assets (house).

At this point, the whole thing has become a political farce.

Very soon you will see the pitchforks come out for the entitled older folks. Working folks have absolutely reached their limits. The cost of living crisis has pushed many over the edge.

I don't think charging people is necessarily the answer, but I do sometimes think showing the general public how much things cost isn't a bad idea.

Especially those who say "I've paid my taxes all my life" - because I think a lot of people believe they have paid more than they've got out. When in fact if you look at the cost of an ambulance, a&e, social care, a hip replacement / heart bypass graft / even free prescriptions - I think many people would be surprised by how much those things actually cost.

Look at those who request a paracetamol prescription from the GP - you can get them much cheaper in the pharmacy or supermarket, but because they've "paid in all their lives" they think they should be entitled to it.

My own mum has said it about her and my dad - I point out that they are probably net - takers since they've had several children go through the education system, including fee-free university as well as all the healthcare we had.

My mum had an appointment Tuesday last week the appointment letter arrived Thursday last week. Luckily the GP confirmed everything and sent her an email with everything. When the letter came through it stated a missed appointment was a fine of £164.

OK if it works the other way and the NHS "wastes" a patient's time, phone and travel costs!

My OH had a blood test Monday morning. Got a phone call Tuesday morning saying the nurse hadn't put labels on the bottles so the blood was useless and told him to get another test done. So, he phoned the surgery to make a new appt, none this week at all. That's no good as he needs the blood test for oncology to issue his chemo prescription to start his next course of treatment on Friday. They just suggested he call back oncology, which he did - they suggested he drive to the oncology dept and they'd do it there, but that's a 45 mile drive each way which would take a full half day! Just for a blood test.

If the NHS didn't make so many mistakes and were so inefficient, they'd have plenty of money for proper treatment and wouldn't be trying to blame patients all the time!

I worked in the NHS for many years and a lot of time was wasted through missed appointments. It badly affected other people who were waiting for appointments.
Surprisingly parents of quite unwell children failed to bring them to appointments to the point of neglect.
On the other hand mistakes were made at the NHS's end, sending out appointments with too little notice, to incorrect addresses etc. There was an attitude that patients had nothing else to do and should be grateful for what they were given. I do think a system of text reminders would help.
Regarding the comments about pensioners. Pensioners do pay tax. I think NI will probably get absorbed into general taxation eventually. It originally covered unemployment benefit, Statutory sick pay and the state pension, the NHS was funded through taxation.

Of course, everything has changed now and benefits have changed, but originally pensioners were already claiming their pension and no longer had need of the other benefits of the NI scheme.
It's a shame that there is all this intergenerational division. There are very few pensioners on 50K (which someone referred to). The average income of a retired person is around £18,000. but 20% are on pension credit with an income of £9464pa. After housing costs are accounted for, the average pensioner and the average worker are at a similar level. Of course, young families with childcare costs are quite badly off. Childcare costs in the UK are high compared with many other countries.
Pensioners over 75 and single pensioners are considerably worse off than newly retired pensioner couples.
Needing long term care is a risk which is uneven. There does need to be an insurance scheme to even out this risk. Most of the people needing care need it for health reasons, not social reasons. A flat rate cap means the very poor don't pay, it hardly affects the rich and the squeezed middle are penalised again.

Yes!!
I my DF had an appointment booked for bloods but after an emergency stay in hospital where bloods were taken he didn’t need it any more so I called surgery to cancel and they were really grateful for me letting them know and basically said people don’t usually call to cancel. I was slightly shocked. Unless there’s an emergency (does happen, my dentist had to be missed as I went into early labour so hadn’t called them from the hospital whilst I was giving birth) but people who just don’t turn up should be penalised.

move worked and volunteered for organisations that get funding to put free training on. We get no shows and it’s frustrating. We had a waiting list for an event not so long ago, one person cancelled so we got another on it last minute but then another 3-4 didn’t turn up on the day. Wasted meals, wasted time and effort, wasted resources from training, and people who could have had those spots.

@Iliketeaagain

Look at those who request a paracetamol prescription from the GP - you can get them much cheaper in the pharmacy or supermarket, but because they've "paid in all their lives" they think they should be entitled to it.

Another example is dentists issuing a NHS prescription for flouride tooth paste which is incredibly common. My SIL is a dental nurse and they have pre-printed pads of flouride toothpaste prescriptions which the dentists basically hand out to anyone who asks for one. It's another one of these examples where people "in the know" know how they can game the system, i.e. they tell their friends, family, neighbours, etc. Then they justify it to themselves by saying "well her at number 23 gets free toothpaste so why shouldn't I?"

Our GP won’t prescribe anything you can buy cheaply. My antihistamines were cancelled as they became available to but but for someone with a payment exemption it’s made it quite tricky to afford as they’re not cheap. But paracetamol is really xheap. Less than a £1 and not a regular medication for me like the antihistamine.

I get toothpaste from the Dentist but not free if paying for dental and prescriptions. It’s got a higher fluoride in than can be bought and is prescription only. If it was available to buy I’d definitely just buy it. Prescription charges are really high compared to buying them and it’s not worth a prepaid thing for those either but can see why people on free prescription might get them.

But they paid for it all their working lives!!

I don’t have children in school, but I still have to support education through my taxes. It’s how our society works.

Except many didn't.
My MIL gave up work at 25 to raise her two DC and never retuned to the workplace. She's 80 now.
Many women of that generation the same.

Out of interest, what do you mean by this?

As another poster has already said the toothpaste prescribed is pom (prescription only medication). It is not the NHS’s fault that that practice is prescribing unjustifiably. A better example is corsodyl mouthwash which dentists can no longer prescribe as it is available over the counter.