Should the NHS charge for such things?

Totally agree with charging for meals in hospital… to start… and the A&E charge for people too (not children or aged people)!!

Perhaps then, so should people who play risky sports, along with horse riders, hill climbers, and so on.

How about people who are taken off to A and E having been dismissed by doctors when something is going wrong for them?

Like others I can see that given the current disorganisation in dispatching appointment letters it would be grossly unfair to charge for non attendance. Once this is improved, (if ever!) I think that a ‘three strikes and you pay’ policy would be reasonable.

With regard to meals; hospitals are not hotels. We pay for our food at all other times and places so why should food be free because we’re in hospital? This doesn’t happen in other countries, either people pay for their food while in hospital or their families or friends bring food in for them.

I don’t doubt that someone will be along shortly to describe an experience in which charging for food was inappropriate, but there are always going to be exceptions and we shouldn’t make decisions because of these. The situation of the majority needs to be the most important deciding factor, and the majority will be eating, or at least be served, three meals a day while they’re in hospital.

If a standard daily charge was levied for e.g. all adults, this would make the administration straightforward enough once set up. It could be set at a reasonable amount with possible exceptions for certain groups.

The NHS is in a desperate state and further taxation of the wealthy isn’t going to be enough to cure it. Fundamental change is needed and free food is an unnecessary drain on the much depleted coffers

Witzend

Well, I know it’ll never happen, since no government will ever dare to suggest it, but while I was waiting for a blood test at the GP today, there was something on the screen about the mass of missed appointments, and how many millions it was costing the NHS every year.
So why not charge say a tenner, if people can’t be bothered to turn up, or to cancel?

Then I spoke a Swedish friend (who lived in the U.K. for many years) yesterday - she’s in hospital in Stockholm, having fallen and cracked her sacrum, poor thing, but she mentioned the two nice meals every day, for which she has to pay the equivalent of £9 a day. She had told me about such charges before. They are not a new thing.

They also have to pay for GP and A&E visits, IIRC £20 equivalent, but children and IIRC the elderly over a certain age are exempt.

People so often go on about how much better healthcare provision is in ‘other countries’, perhaps especially the Scandi ones, but can anyone imagine any political party here ever including such things in their manifesto?

‘Free at the point of use’ is such a sacred cow.

My son's in Australia at the moment he's had some great health care but he does contribute towards it. When it's FREE like here it's abused, people go to the GP with a blocked nose to get spray free on prescription. It'll never happen but it's normal in most places. €70 for a GP appointment in Southern Ireland.

Witzend And taxation is higher. All we ever hear about is how cheap childcare is in Scandinavian countries.
A new NHS dentist has opened near me. If you sign up you accept that if you miss or give less that 24 hours of cancellation you will pay £1 per minute of the scheduled visit. The place is so busy the company is opening another surgery half a mile away. If people accept paying for dentists why not Drs.

4allweknow

Witzend And taxation is higher. All we ever hear about is how cheap childcare is in Scandinavian countries.
A new NHS dentist has opened near me. If you sign up you accept that if you miss or give less that 24 hours of cancellation you will pay £1 per minute of the scheduled visit. The place is so busy the company is opening another surgery half a mile away. If people accept paying for dentists why not Drs.

Do you mean paying for a missed appt or paying for an appointment? I think it’s quite usual for dentists to charge for missed appts - with mine it’s 48 hours notice but they take the circumstances into account eg sudden illness.

AngieLC

Totally agree with charging for meals in hospital… to start… and the A&E charge for people too (not children or aged people)!!

Why/

Witzend

My OP was referring to GP appts., not hospital ditto. I do agree that many such missed appts. are the fault of hopeless NHS admin.

My dh was once sent to the wrong centre for a small day-surgery procedure. It was a good half hour away from where he should have been sent, so that was an appt. wasted through no fault of his own.

Then a BiL was sent a letter about his oncology appt. to an address he’d left over 12 years previously! Other letters had been addressed correctly - they just hadn’t deleted his old one.

Luckily the new owners of the house forwarded it, just in time.

A major peeve of mine (don’t know whether it’s changed) was appt. letters being sent to my mother with (diagnosed) dementia, when she’d only hide them or throw them away, and certainly wouldn’t make a note of date and time!

I asked them repeatedly to send a copy to me or my brother as well - this was before we’d managed to activate her old style P of A - since otherwise the appt. would certainly be wasted.

Oh, not, they couldn’t do that, because of ‘patient confidentiality’.
Zero common sense!!

This is happening with my ex-husband. Our children are the contacts for his care, and despite them telling the surgery repeatedly that one of them needs to be present at his appointments (& needs to know about them beforehand so that they can take time off work) the surgery and hospital are still sending the letters to him; he either bins them, hides them - or attends and pretends that there's nothing wrong...! It's driving us all mad - no idea how many appointments he's missed 🙄

Mollygo

It’s a balance really. Norwegian citizens earn higher wages, but they also pay higher tax contributions towards healthcare.
In return for that, I like their idea of a cap on the amount you pay for treatment before it becomes free.

Norway has the same ring up at 8.30 for an appointment system that we do.
Dickens you may know the answer to this.
Do they sometimes have to wait longer than 3 weeks for an appointment like we do once they get through?

Whenever we ask about health care or old age care either from family members living in Europe or even the guide on a coach trip in Portugal, their first comments are about how much tax they are required to contribute.
Successive governments might see that as a way to go here, but I worry that higher taxes would still not get me a quick appointment.

Things have changed considerably since I left Norway in 2007 - and post-pandemic - when a phone call to the surgery could land you an appointment either that day or the next, depending on the urgency of your symptoms, though during holiday periods it could take longer.

I stay in touch with my former work colleagues - but we don't normally chat about GP appointments (!) so I've no idea how 'things' are now and had to look it up.

Urgent Care: In both countries, truly urgent cases are typically seen on the same day. However, satisfaction surveys in Norway show that roughly 63% of patients can reliably secure a same-day or next-day emergency appointment

Routine Appointments: If a condition is non-urgent, Norwegian patients typically wait a few days up to two weeks, depending on how busy their specific doctor is. In the UK, average non-urgent waits frequently stretch into a few weeks.

Bypassing Wait Times

If a Norwegian patient faces a long wait or wants to skip the public system, it is much easier and cheaper to go private than in the UK. Private walk-in clinics (such as Dr Dropin) allow patients to secure a face-to-face appointment in hours. A private GP consultation generally costs between 500 and 800 NOK (£37–£60), and these costs contribute toward an annual state co-pay exemption card (frikort) that makes healthcare largely free once you reach the cap

I don't know how up to date that information is because I used one of these private 'drop-in' clinics back in the late 1990s and paid around NOK 500 (because I was panicking over my symptoms!). The appointment was immediate, lasted around 40 minutes and I came out with a prescription and a recommendation. But, don't we now have the same clinics here, too?

Tax - undeniably, it's higher in Norway. I don't want to take up too much space with too much detail, so I will just say this... generally - in spite of the higher taxation - Norwegian workers enjoy a significantly higher standard of living.

We, my late partner and me, worked in Norway from 1995 to 2007... our finances were a lot healthier when we returned than when we left!

AngieLC
Totally agree with charging for meals in hospital… to start… and the A&E charge for people too (not children or aged people)!!
Why/
‘
There’s two ‘why’s’ - why charge for meals at all and secondly, why should children and ‘aged’ people not be charged in A and E but everyone else should be?

The NHS app is very useful, in my experience, when you (or husband in my case) are under the hospital. All letters are posted in the app, with a text to tell him every time there is new correspondence. The hospital also sends reminders via the app for his next appointment a few days beforehand. The GP surgery also sends text reminders the day before. The app means we are not reliant on the increasingly unreliable post. If people are sent electronic reminders, but still don’t show up, crises excepted, one has to wonder how serious their medical issue was in the first place!

A child or aged person is using the same service as anyone else.
If its purely based on costs, they cost the same as the next person.
.

JenJenT
Apparently about 75% of the population are signed up to the app. So that’s quite a lot still not using it and relying on the telephone/post. I know some people not signed up - they don’t have smartphones and never will now I’m sure. So any system has to be predicated on that and take their needs into account. I’d like to see more research into why people miss appts rather than just lazy assumptions about those that do in order to better address the problem. Someone up thread posted about making your own appt rather than just passively receiving one (Which I agree with for hospitals) - but that doesn’t apply to GP surgeries.

Means tested fees for GP's appointment has already been discussed at Government level.
Having tried and failed twice this week to get a GP appointment, I would happily pay a small fee to secure a slot ! However I expect that those appointments would still be taken up by those that do not have to pay and they would probably still not have to pay for missed appointments either so it would be a fairly pointless system.

No definitely not.

mokryna, a French friend of a dd - living and working in the U.K. - bitterly resents having to pay IIRC €250 a month for the care of her father in France, since she says he was always a workshy layabout, and a hopeless dad.

twaddle

Yes, I can imagine it very easily. I think it's precisely what Reform would do.

Yes.

I definitely think that people should be charged for missed dental, medical and hospital appointments.

Except where there go has been a genuine mix up with letters or the ambulance hasn't turned on time,or at all to take them there. Especially with mobility issues. And of course just too ill to attend

Went to my GP.yesterday and the the Surgery post this missed appointments infomation.on paper sheets on the reception room notice board every month.

Something like 10 per cent of people did not turn up for appointments.

I think people who do not attend without a good reason should be charged a £25 fine. And should be given 3 chances. Then struck off as a patient.

God Bless the NHS.

Please don't abuse it.

I’m actually really conflicted on this issue because missing appts without good reason seems unacceptable. . But and it’s a big but, I think we should first try and understand why this happens and if there’s anything that can be done to mitigate it. Secondly I’m against it because it would be incredibly difficult to implement a fair scheme and I think it would take up more resources than if would save.

I had a blood test booked, but fhere were no cabs a available and no traffic on the roads at all.
I phoned around 20 mins before the appointment, and told them i was probably not going to make it.

The woman said it was fine and fo keep them updated, as they would wait.
Every 15 mins I phoned them, with my last call explaining that 2 horses had got out and onto the road leading onto the island where i live.

Traffic was gridlocked, with nobody able to move anywhere.
She explained thay she now knew what had happened, but that they couldnt hold the appointment any longer.

When i next attended, i got shorf shift for being a "no show" last time.

I forgot an appointment once and was mortified. I went in to apologise and rebook and the receptionist was really nice about it and booked me for the next week - it was for my second shingles jab so just with the nurse. I would have thought if you had a doctor's appointment it is more likely to be something you wouldn't forget. I sometimes find the reminder texts pretty annoying but maybe they are necessary for some people and hopefully waste less time.
I understand airlines overbook knowing that some passengers don't turn up. Perhaps a similar system is what is required, as long as the doctors are prepared to work a bit longer if everyone does turn up!

MissAdventure And that's the problem, the right hand doesn't know what the left hand's doing. There doesn't seem to be adequate, or in some cases any, communication on records. In your case it should have been fully documented what caused you to miss the appointment, and all your updates to them. How many people were in a similar situation to you that day and missed appointments? Locally to me there is a roadworks situation that's been ongoing for months now and causing horrendous tailbacks and total gridlock at times. What should be a 15-20 minute drive at most has taken up to 2 hours sometimes. The hospital though are aware and taking the attitude 'you get here when you can and we're really flexible on appointment times. We aim to see you as soon as possible after you arrive'. The buses no longer have a running-time timetable because it's unpredictable when they'll get through.

Its a simple system at my dentists, when you make an appointment they take credit/debit card details and if you dont turn up they charge. You get an e-mail and a text reminder, one a week before, with a link to re-arrange, and one 24 hours before. They dont get involved with reasons why you were a no show at all.

Tuliptree

I’m actually really conflicted on this issue because missing appts without good reason seems unacceptable. . But and it’s a big but, I think we should first try and understand why this happens and if there’s anything that can be done to mitigate it. Secondly I’m against it because it would be incredibly difficult to implement a fair scheme and I think it would take up more resources than if would save.

Secondly I’m against it because it would be incredibly difficult to implement a fair scheme and I think it would take up more resources than if would save.

I think you are right.

The admin would add yet another layer of red tape, particularly if patients refused to pay-up, or decided to argue their case instead. Ultimately, will they be taken to Court for non-payment? Refused treatment?

There has to be a better way, but I don't know what it is.

What is the main reason why people don't show up - apart from genuine reasons like emergencies/illness/accidents/etc? Is it because they CBA? And, if so - what do you do with such individuals?

Fines will not solve the problem - if you need to understand why-so, just Google AI and ask it - the reasoning is sound and logical!