UK Politics #9

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Shinythings said:
See I don't think this is an excuse. Everyone has a phone these days, even the most deprived people. Failing that you can ask someone to call for you. Or if you have carers, they can do it for you. Have it like schools were there's a separate line to cancel appts (like when you have to press 1 to report your child absent). You can leave a message, or email or cancel on an app.

When you sign up to a GP, you give them your bank account details (like you do if you stay at a hotel or rent a car etc). No message to cancel, you are charged. It doesn't have to be a big amount. Even sat £10 would raise a decent amount over the course of a year.

I'm sorry but we can't constantly keep pandering to a minority of people. People have to start taking personal responsibility.
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I missed an appointment a few months ago as the letter telling me about it didn’t arrive through the post until a week later, I didn’t have the opportunity to defer or cancel, it’s really not as simple as just fining people.
 
Shinythings said:
See I don't think this is an excuse. Everyone has a phone these days, even the most deprived people. Failing that you can ask someone to call for you. Or if you have carers, they can do it for you. Have it like schools were there's a separate line to cancel appts (like when you have to press 1 to report your child absent). You can leave a message, or email or cancel on an app.

When you sign up to a GP, you give them your bank account details (like you do if you stay at a hotel or rent a car etc). No message to cancel, you are charged. It doesn't have to be a big amount. Even sat £10 would raise a decent amount over the course of a year.

I'm sorry but we can't constantly keep pandering to a minority of people. People have to start taking personal responsibility.
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Having worked at the NHS in previous roles, I think we need to focus on stopping paying consultants thousands of pounds a day and wasting money on things like hot desking and streamlining processes. I know plenty of older people who don't have a phone and fining people for missed appointments just won't work, it will create more admin and costs.
 
HelloStereo said:
I'm not sure about this. People from most deprived backgrounds are more likely to miss nhs appointments. If you charge for missed appointments surely all it will do is put them off booking an appointment at all and any health issues will become more costly to treat.
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I had an outpatient appointment once and while I was waiting I saw an interpreter arrive for a patient and the receptionist said they hadn't turned up yet. The interpreter waited a good 15-30 mins then left. So we had the missed appointment and the cost of the interpreter. Something really should be done about that. I also think we should absolutely charge for non UK citizens/residents.

One massive problem IMO is that the trusts are far too big. Smaller trusts would make them easier to manage.
 
I genuinely think the NHS cannot be salvaged and we need to stop trying and start phasing over to a new European style system. Many people are passionate about the NHS and push back against any suggestion of change but I've noticed a real shift in recent years, with more people open to a change. People are fed up with not being able to see a GP, with two year waits for surgeries, year long waits for referrals and having to dip into savings for private care.
 
HelloStereo said:
So then you get a situation where people who can't afford the fees are just avoiding going to a GP altogether. Resulting in more expensive treatment, or going to A&E instead.

Or they argue down to the wire that they did send a message to cancel and you're having to employ people spending their time chasing up these payments or going through communications to find their emails.

It's not any more efficient to charge people for missed appointments.
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Or maybe you could have a marker on the record that makes them exempt for X reason for those who are particularly vulnerable and they don't have to worry.

But for most people, there is no excuse. There will always be proof, in your sent emails, phone logs etc. We have this all the time at work with the 'magic postman'. They never get the appointment letter or the one after that asking them to make contact by X date if they still want a referral open but they ALWAYS get the one saying they've been discharged. You could argue it's a huge waste of resources chasing them up too. We actually have a messaging system that works exactly like WhatsApp we can see they have opened and read the message, but they'll swear blind they never got the message 🙄 In the private sector, say you're seeing a therapist, you don't show up, you get charged, no questions and you sign a contract when you start agreeing to that. Tough tit.

It's a wider issue anyway really of personal responsibility. People have become too reliant on the NHS. They want a quick fix instead of making a harder lifestyle change. People would much rather take a pill than do the work that's actually going to help them. Look I'm an NHS veteran. I wish I could be more optimistic, but I see it day in, day out.

I really don't see any other way we can encourage people to think about personal responsibility or the way they use the NHS more other than starting to charities things either through insurance or paying outright for things.
 
Shinythings said:
Or maybe you could have a marker on the record that makes them exempt for X reason for those who are particularly vulnerable and they don't have to worry.

But for most people, there is no excuse. There will always be proof, in your sent emails, phone logs etc. We have this all the time at work with the 'magic postman'. They never get the appointment letter or the one after that asking them to make contact by X date if they still want a referral open but they ALWAYS get the one saying they've been discharged. You could argue it's a huge waste of resources chasing them up too. We actually have a messaging system that works exactly like WhatsApp we can see they have opened and read the message, but they'll swear blind they never got the message 🙄 In the private sector, say you're seeing a therapist, you don't show up, you get charged, no questions and you sign a contract when you start agreeing to that. Tough tit.

It's a wider issue anyway really of personal responsibility. People have become too reliant on the NHS. They want a quick fix instead of making a harder lifestyle change. People would much rather take a pill than do the work that's actually going to help them. Look I'm an NHS veteran. I wish I could be more optimistic, but I see it day in, day out.

I really don't see any other way we can encourage people to think about personal responsibility or the way they use the NHS more other than starting to charities things either through insurance or paying outright for things.
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And so you think GP practices will go yo the effort of looking through call logs, letters, emails etc to recoup all of £10 for a did not attend? And what if the patient cannot afford it?

It's not even a matter of personal responsibility, it's that enforcing fines for non attendance is an inefficient, unworkable, stupid idea.
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FenellaTheWitch said:
I had an outpatient appointment once and while I was waiting I saw an interpreter arrive for a patient and the receptionist said they hadn't turned up yet. The interpreter waited a good 15-30 mins then left. So we had the missed appointment and the cost of the interpreter. Something really should be done about that. I also think we should absolutely charge for non UK citizens/residents.

One massive problem IMO is that the trusts are far too big. Smaller trusts would make them easier to manage.
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Do you know their personal circumstances and why they did not attend?
 
HelloStereo said:
And so you think GP practices will go yo the effort of looking through call logs, letters, emails etc to recoup all of £10 for a did not attend? And what if the patient cannot afford it?

It's not even a matter of personal responsibility, it's that enforcing fines for non attendance is an inefficient, unworkable, stupid idea.
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Do you know their personal circumstances and why they did not attend?
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No it's not. My GP surgery used to put up how many appointments were missed that month. It was regularly 200+. That's an enormous amount.

Whenever people talk about changing the NHS everyone automatically starts mentioning the USA which is stupid. European countries like France and Germany have much better systems that we should look at.

The NHS is/was a brilliant concept but it is not fit for purpose in a lot of ways.
 
FenellaTheWitch said:
No it's not. My GP surgery used to put up how many appointments were missed that month. It was regularly 200+. That's an enormous amount.

Whenever people talk about changing the NHS everyone automatically starts mentioning the USA which is stupid. European countries like France and Germany have much better systems that we should look at.

The NHS is/was a brilliant concept but it is not fit for purpose in a lot of ways.
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Where have we mentioned the USA?

It is stupid. Did not attends count for 5% of overall appointments which while not insignificant is not an enormous amount. All you do with charging is push the problem onto a&e while spending NHS resources trying to chase down a tenner.
 
FenellaTheWitch said:
No it's not. My GP surgery used to put up how many appointments were missed that month. It was regularly 200+. That's an enormous amount.

Whenever people talk about changing the NHS everyone automatically starts mentioning the USA which is stupid. European countries like France and Germany have much better systems that we should look at.

The NHS is/was a brilliant concept but it is not fit for purpose in a lot of ways.
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I agree. It was vital and badly needed when it was established after World War II but it's now treating millions more people for thousands more conditions and it isn't working. France is a country with a similar size population to us and nobody waits two years for surgeries
 
PeteM said:
I'd certainly agree with charges for missed appointments.
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So, I'm fully able bodied, need no assistance in life in any way, on paper I'm not the person who would accidentally miss an appointment... I've recently started using the NHS app and randomly decided to check my appointments as I've been having some health concerns.

I saw an appointment had been booked in without there being any direct communication with me. Luckily, I caught it early enough to reschedule but as a new user of the service I didn't even realise an appointment could be booked without my confirmation or explicit knowledge.

I know I'm due future appointments so now I know to check the app every other day or so to see if one has been booked in. But all it takes is for that to slip my mind or me to for whatever reason not check until the night before and I could miss an appointment.

I used to be in favour of charging for missed appointments, maybe not the first missed one but if it's a regular problem but that was before I knew some appointments were being booked like this.
 
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Baby Giraffe said:
I missed an appointment a few months ago as the letter telling me about it didn’t arrive through the post until a week later, I didn’t have the opportunity to defer or cancel, it’s really not as simple as just fining people.
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Good point.
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bluefoot said:
I regularly have to wait 30 mins plus beyond my appointment time for the dr to be free. When I was once delayed by the bus the dr refused to see me as I was late. I’d have been fined for that I guess. That said, some people do take the piss.
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I'd say not as you can call to let them know. I'm talking about where people just never show up.
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On consideration of what people are saying perhaps charging for missed appointments isn't the way forward.

As I said before I think we need to move towards some sort of hybrid where certain things remain as they are and some situations start to move towards an insurance or paid type system. I think that's the fairest solution.

Personally I'd like to hope if I got cancer I'm not going to be crippled by medical fees and I can have treatment without worrying about money like I would under the current system. But I'd also be happy to pay for arguments sake, £15 a month to know I can see a GP when I want, get dental treatment, treat (enter minor ailment here).
 
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I had a physio appointment recently and they decided to refer to the hospital for further tests.
Today I got a letter from the hospital on lovely thick good quality paper to tell me that they would be sending me a letter with my appointment.
 
Mollywobbles said:
We need to get into the habit of using pharmacists a lot more.
On the continent you would consult your pharmacist before going to see a doctor.
These days they can prescribe things for minor illnesses like sinusitis, insect bites, uti’s.
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I think this is sort of the main problem. In the UK a pharmacist isn’t really advertised as the first point of call and there’s very few/no alternatives to NHS GPs

Some people can probably afford to go private for the small things but don’t know how to go about it

I tried to find a private dermatologist recently - because the NHS wait times and I would think privately it’s more direct than having to go through pointless appointments just to get a referral months down the line - but couldn’t actually find one near me
 
there are now quite significant waiting times for some private doctors and surgeries too, especially anything to do with hip and knee. A relative had her knee replaced privately but she still had to wait 3 months, which would never have happened a few years ago
 
HelloStereo said:
Where have we mentioned the USA?

It is stupid. Did not attends count for 5% of overall appointments which while not insignificant is not an enormous amount. All you do with charging is push the problem onto a&e while spending NHS resources trying to chase down a tenner.
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I meant generally when the NHS is being discussed on radio, TV etc etc ....

And it is an enormous amount when people are having a hard enough time as it is getting appointments for anything, especially GP's. As for pushing people to A&E that's happening anyway. The whole service needs changing not just GP appointments. Everything from GP to Specialist referrals needs reviewing and changing.

I've used private GP's three times this year because of the state of our local services.
 
FenellaTheWitch said:
I meant generally when the NHS is being discussed on radio, TV etc etc ....

And it is an enormous amount when people are having a hard enough time as it is getting appointments for anything, especially GP's. As for pushing people to A&E that's happening anyway. The whole service needs changing not just GP appointments. Everything from GP to Specialist referrals needs reviewing and changing.

I've used private GP's three times this year because of the state of our local services.
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That may be so but adding extra administration duties around chasing payments for non attendance just adds to the bloat.

What would realistically happen if people couldn't pay anyway.
 
Merpedy said:
I think this is sort of the main problem. In the UK a pharmacist isn’t really advertised as the first point of call and there’s very few/no alternatives to NHS GPs

Some people can probably afford to go private for the small things but don’t know how to go about it

I tried to find a private dermatologist recently - because the NHS wait times and I would think privately it’s more direct than having to go through pointless appointments just to get a referral months down the line - but couldn’t actually find one near me
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I think people who can afford private healthcare prefer to do so out of urgency and frustration, apart from that I feel there's some resentment if people have to pay for something we all pay tax for and are told is free at the point of use.

Healthcare schemes through work are more common which helps but who are these doctors? isn't it that NHS doctors freelance in private healthcare?

Eta I imagine some people would flat out refuse to pay for healthcare as a form of protest because they believe this will lead to the end of the NHS
 
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