Should the NHS charge for such things?

Musicgirl

It’s a good idea in theory but I remember receiving a high handed phone call telling me that, as I had missed my appointment, my name would be put at the bottom of the waiting list. My reply was that the reason I had not attended my appointment was because I had not received the letter informing me that I had an appointment. An apology ensued - to be fair it was hardly the fault of the lady at the other end of the line - and a new appointment was made for me. After this, I heard of many others in the same position. I agree that something has to be done about the vast numbers of missed appointments but it has to be remembered that there are many people like me who fail to attend their appointments through no fault of their own.

Letters ned to be phased out and replaced with texts, phone calls and emails. People are not available 24/7, and won't always be able to pick up a paper letter on time, even if the information in it isn't out of date before it arrives.

Silvershadow

I think people who miss appointments should be charged, yes. Meals, it would very much depend on the food quality. However, if charging a small amount improved the food on offer I’d be happy to pay it.

I was in my GP waiting room recently. It’s a big practice. Several did not turn up to their appointments when called over the tannoy. Unless there’s a serious reason why not, then a charge just might concentrate their minds.

So in a case like mine, I didn't get the letter changing the appointment, how do I prove it didn't arrive,? Should I have to pay?

spent a month inhospital for a parasite good food 3 meals and snacks and midnight turkey sandwiches and ice cream meal drinks too
usa not private the girls in the kitchen brouhg mr mini cakes for my birthday too
after 65 and poor too was treating like queen

mokryna

*What happens if you can't pay? I'm guessing people aren't left to starve*
I would think there would be help,as the social system is good. However, most people eat at home so it is replacing that.

Surely they charge more than the cost of ingredients? Someone might be able to manage in a budget that wouldn't pay the costs associated with food cost plus staff costs to prepare, serve and clear up after the meal.

It’s a good idea in theory but I remember receiving a high handed phone call telling me that, as I had missed my appointment, my name would be put at the bottom of the waiting list. My reply was that the reason I had not attended my appointment was because I had not received the letter informing me that I had an appointment. An apology ensued - to be fair it was hardly the fault of the lady at the other end of the line - and a new appointment was made for me. After this, I heard of many others in the same position. I agree that something has to be done about the vast numbers of missed appointments but it has to be remembered that there are many people like me who fail to attend their appointments through no fault of their own.

Doodledog 👏🏻👏🏻👏🏻👏🏻

DaisyAnneReturns

I'm really not sure being so judgemental helps. Systems are (or should be) designed to solve problems and to do that you need to understand what problems will be encountered on the way to that goal.

I'm afraid I just don't think the NHS is good at this. I ask myself why hairdressers had well functioning appointment systems long before the NHS saw them as a priority. I don't find an answer!

I'm really not sure that being naive helps either.

If the problem that is encountered on the way to the goal of full attendance is a sense of entitlement, then the only way to deal with that (other than denying further treatment) is to penalise offenders. If they are given ample opportunity to cancel or change appointments, and to let receptionists know if they are unavoidably held up, what more do they need?

On other threads we have seen that many people are let down by friends dropping out of social events, that people are often viewed as 'takers' rather than 'givers'. Restaurants now charge deposits as people drop out after they've ordered food and rostered staff, and so on. I'm sure most of us have experienced this sort of thing in our own lives, too.

I don't know why it's happened, but I see it all the time - people drop out, don't show up and expect others to cover their share of the bill, message at the last minute when friends have made arrangements and are ready to go out. IMO, this is an extension of that behaviour. Being 'anxious' is seen as an excuse for being rude and behaving selfishly. On a personal level we can drop people who behave like this, but on the level of the NHS, where the cumulative effect is massive, there needs to be some sort of action.

Steps can be taken to avoid penalising those who can't help missing appointments, but with the right channels for cancelling or rearranging them in place, that should be the exception rather than the rule.

Tuliptree

Oreo

My point on being fair was a daily food charge to patients in hospitals.

Then I disagree even more. Apart from begging the question about quality of food, what if a patient was not feeling well enough to eat when the food was delivered? But my main criticism is that for many households, having someone in hospital can be very expensive - travelling to see them, paying for parking, taking in a treat. This can cost far more than the amount ‘saved’on a meal at home. And would everyone have to pay regardless of their income level? And how would they pay? Would the servers come round with a card machine? What about infection control? What if their card was declined, would they go without the meal? Or would they be given a bill when they left? What if they wouldn’t pay? What if they died part way through their hospital stay? Would there be a special form for staff to complete to claim from the estate?

Feel free to disagree.
If other countries can do this then so could we, it isn’t rocket science.

Because the NHS is free many people abuse it. I’d say definitely charge for missed appointments.
We all know the NHS can’t continue without charging somewhere along the line because standards are slipping. Nobody wants this but we will have to accept it.
I had six follow-on appointments for a fracture and was sent 6 separate letters each containing a separate sheet of information about how to get to the hospital - a total waste of money when I had already been given the appointments written on a card.
So 6 large envelopes, 6 letters, 6 information sheets and 6 lots of postage! No private company would accept this nonsense.

I'm really not sure being so judgemental helps. Systems are (or should be) designed to solve problems and to do that you need to understand what problems will be encountered on the way to that goal.

I'm afraid I just don't think the NHS is good at this. I ask myself why hairdressers had well functioning appointment systems long before the NHS saw them as a priority. I don't find an answer!

The meals I was served in my last stay in a French semi-private hospital were awful. I looked at the lady who served it and she apologized and added it is was the same as the staff had in their canteen.
Oh, and I take a little electric kettle in to make tea.

I know it would be difficult and probably not cost-effective to administer, but I also think that too many people are entitled these days, and always put themselves first. If they were penalised even a bit, it might stop so many missed appointments, which would speed things up for others waiting for treatment.

In an emergency, people could call the hospital or surgery and explain that the train was late or they couldn't get care for someone they're looking after (etc) then appointments could be sped up with less waiting around for people who can't make it.

At my surgery the appointment is kept open for the ten minutes it was allotted, with the GP or nurse trying twice in that time to call for the patient, and then it is lost. Sometimes I've seen people come in 30 minutes late or more, and expect to be seen. If they had called, the receptionist could have tried to 'bump up' others in the waiting room, and the latecomer may have been able to take someone else's place instead, but often people only see things from their own point of view.

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.

Running institutions is only easy for those not actually doing it (and that includes me.)

Let's take payment for not attending an appointment. What about people who are misdirected in the hospital, people who simply cannot contact anyone to cancel etc? People whose NHS transport limitations make difficulties for them?

And re paying for meals? What about those who lose benefits after a period of time - money they lose because the NHS is looking after them? What level of catering will people expect? Food is often used as medication with people following specific dietary regimes - will hospitals improve in this area. That could be expensive but it's very poor state moment.

Putting things in the "too difficult box" doesn't solve problems. I know,that but neither does blaming those who have no influence on the systems which, themselves, may be over/under or miss-reporting.

Message withdrawn at poster's request.

As with so many things, the decision not to attend often comes down to personal choice. Increasingly, I find that people put their own personal convenience first, and ignore the impact on others - whether that is the cost to the NHS, or to the hassle for others who were planning to do something social with them.

If we all know at the time of making an appointment that the onus is on us to attend or pay, it is our choice whether to keep it or not. There are always text and email reminders for appointments, with options to cancel or change the appointment, so if something does crop up people can use them, so there should be no need for judgement over what is an acceptable reason or not - either you go or you don't.

Appointments not made by the patient should be exempt until they confirm them, and if there is no confirmation before a given time (eg 2 days before) the appointment should automatically cancel. That way, appointment letters that arrive late, or arrive to coincide with the patient being on holiday etc, will be provisional until the patient has seen and agreed to them. Appointments show up on the NHS app, too, so people could confirm them on there if they are not in to pick up a letter - I find that I am notified by text of letters before they arrive.

Any charge should, IMO, be applied to all. If we start means-testing there will be those with carte blanche to please themselves, and others with only slightly higher budgets who are penalised.

As regards paying for meals, I am less sure about that. Personally, I would much prefer to pay for something I enjoyed eating, but wouldn't want to see anyone unable to afford a meal - particularly when recovering from an operation. Maybe having a free option and a 'premium' one would work, with patients having a choice? That might not be practical, but it could bring in some money without disadvantaging anyone.

One thing I would like to see scrapped is high fees for watching television. People lying in bed all day have little else to do, and charging them a lot to watch seems unreasonable. Most will have a TV licence anyway, if that makes a difference.

I think people who miss appointments should be charged, yes. Meals, it would very much depend on the food quality. However, if charging a small amount improved the food on offer I’d be happy to pay it.

I was in my GP waiting room recently. It’s a big practice. Several did not turn up to their appointments when called over the tannoy. Unless there’s a serious reason why not, then a charge just might concentrate their minds.

MissAdventure

I think they wouldn need fo4get their own house in order, first.
Appointment letters arriving a week after the event, urgent refferals arriving 6 weeks after someone has died, etc, neing unable to reach anyone to change or cancel an appointment.
Appointments being made to discuss blood results when you're unable to get a blood test spring to mind...

Oh yes!
The online docs appointment when he queries what has been done as a result of your last blood test? You must get an appointment with your doctor ASAP.
The blood was taken as part of a previous treatment, not as a routine blood test and no follow up information or suggestions have been made.

Oreo

My point on being fair was a daily food charge to patients in hospitals.

Then I disagree even more. Apart from begging the question about quality of food, what if a patient was not feeling well enough to eat when the food was delivered? But my main criticism is that for many households, having someone in hospital can be very expensive - travelling to see them, paying for parking, taking in a treat. This can cost far more than the amount ‘saved’on a meal at home. And would everyone have to pay regardless of their income level? And how would they pay? Would the servers come round with a card machine? What about infection control? What if their card was declined, would they go without the meal? Or would they be given a bill when they left? What if they wouldn’t pay? What if they died part way through their hospital stay? Would there be a special form for staff to complete to claim from the estate?

Charleygirl5.... Is right the cost to recoup the money wouldn't be worth it, in a Hospital setting.
The only way is Insurance, then you bill the company.
The NHS is technically a non profit making organisation!

GP land is completely different as the GP's own the practice, they might charge in the future, tbh I would pay to see a GP

Being in hospital saves money after all, no gas, electricity, water charges or food to pay. that only fully computes if you live alone. Heating the oven for two meals isn't halved if you're only cooking for the remaining one at home. Heating a room doesn't halve because one of you is in hospital. Food costs may be less but will a hospital charge a commercial rate or what the person's share would have been at home? It really isn't that easy or straightforward. Don't we read that supposedly recoverable hospital costs incurred by foreign visitors are often not recovered because the method for pursuing is too costly?
If you are in hospital for any length of time I think certain benefit payments are reduced. I believe my D-I-L lost carers allowance when she was hospitalised for a week, as she couldn't do the caring. At least that's what she thought would happen when she notified the relevant authority.

My point on being fair was a daily food charge to patients in hospitals.

One of my friends and I came up with a plan years ago. She was a practice manager. £10 put on a babies account at birth.
£5 deducted for the first missed appointment, £5 for the second. After that no appointments until the £10 was repaid.
Apart from emergencies of course. Note would have to be taken of those who needed reminders.
Yes it would take some time but everything is computerised now and we do have a lot of people looking for jobs.

Oreo

It needn’t be a ‘slippery slope’ to other things at all.I think many people would see it as fair.

Well being seen as ‘fair’ would depend on what counted as an acceptable or unacceptable reason for not attending. And an appeals system ( like with parking fines). And even if it were deemed that a charge was payable, what would happen if people wouldn’t or couldn’t pay? Would they be prosecuted?

It needn’t be a ‘slippery slope’ to other things at all.I think many people would see it as fair.

Rosie51

Dentists do usually charge for missed appointments as do many other services. I'm concerned about charging for missed hospital appointments, the problem is some letters giving hospital appointments are turning up after the date of the appointment. I know this is probably not the case for most but it is becoming an increasing problem.
I wanted to cancel a GP appointment a few months ago. I telephoned the surgery and was in a long queue, after 30 minutes hanging on I rang off and drove to the surgery to cancel in person. The receptionist said they normally only take cancellations by phone 🙄

Yes my dentist charges for forgotten appointments but will be sympathetic to illness so they say.
I would agree on payment for meals on a standard £10 per day for everyone bar children and teenagers up to 18 and those of pension age and anyone not in work. Being in hospital saves money after all, no gas, electricity, water charges or food to pay.