Rishi Sunak’s £10 fine for patients who miss NHS appointments would only ‘make matters worse’


Rishi Sunak’s proposed £10 fine for patients who miss NHS appointments would only ‘make matters worse’, health bosses have warned.

As part of his quest to succeed Boris Johnson as Prime Minister, the Tory leadership hopeful insisted the policy would stay in place until backlogs are cut to manageable levels.

But influential voices working in the health sector said it was ‘terribly disappointing’ that the move was even suggested.

The British Medical Association described it as a ‘reheated idea of no practical value’, claiming it has ‘always stood firmly against the idea of charging patients for missed appointments’.

Dr Philip Banfield, BMA council chair, said: ‘This latest suggestion would likely make matters worse. 

‘Charging patients for missed appointments would not only undermine the essential trust between doctor and patient, but ultimately threaten the fundamental principle that the NHS delivers free care at the point of need, for all.’

Meanwhile, NHS Confederation, which represents the entirety of the health network, argued the costs of Mr Sunak’s proposed scheme ‘could well far outweigh the money brought in by the fines’.

More than a million GP appointments in England are missed every month, according to official statistics illustrating the problem. 

As part of his quest to succeed Boris Johnson as Prime Minister, Tory leadership hopeful Rishi Sunak insisted the policy would stay in place until backlogs are cut to manageable levels

More than a million GP appointments in England are missed every month, according to official statistics illustrating the problem

More than a million GP appointments in England are missed every month, according to official statistics illustrating the problem

Each consultation costs the NHS the equivalent of £30. 

A similar problem exists for hospital outpatient appointments, which would also fall under the ex-Chancellor’s proposed penalty rule.

Announcing his pledge in an interview with the Sunday Telegraph, the 42-year-old claimed patients would be given the benefit of the doubt the first time they miss an appointment. 

But they would be charged £10 for failing to attend any subsequent appointments without providing sufficient notice.

Mr Sunak, who faces rival Liz Truss in the second Tory leadership hustings tonight, stressed penalty payments are ‘the right thing to do when we’ve got people crying out for treatment’.

Although contentious, it is not the first time the idea of patients being slapped with fines for missing appointments has been mooted.

In 2015, former Health Secretary and Sunak-backer Jeremy Hunt said he didn’t ‘have a problem with the idea of charging people for missed appointments’. 

He argued it was time for the public to take ‘personal responsibility’ for how precious NHS resources are used. 

Although contentious, it is not the first time the idea of patients being slapped with fines for missing appointments has been mooted. In 2015, former Health Secretary and Sunak-backer Jeremy Hunt said he didn't 'have a problem with the idea of charging people for missed appointments'

Although contentious, it is not the first time the idea of patients being slapped with fines for missing appointments has been mooted. In 2015, former Health Secretary and Sunak-backer Jeremy Hunt said he didn’t ‘have a problem with the idea of charging people for missed appointments’

Record number of midwives have quit due to stress 

Midwife numbers are reaching a dangerous level which could put lives at risk, as records show more staff leaving than joining the profession for the first time in a decade.

As a record number suffer burnout and leave, the figures from NHS Digital for 2021/22 show almost 300 more staff abandoned midwifery than joined the service, with 3,440 leaving and only 3,144 coming in.

Analysis of the data showed a record 551 resigned in 2021 because of a lack of work-life balance.

The latest figures for May show pregnant women have the equivalent of 21,685 full-time midwives in England – down 551 on 12 months previously.

Midwives working in NHS trust maternity units typically work 12-hour shifts, but many work longer for no additional pay to cover staff shortages and to keep services running.

Over the past decade, GPs themselves have backed proposals to penalise patients who fail to attend their appointments.

But professional bodies oppose fines and fear they could target vulnerable patients, including those with dementia or mental health problems. 

Dr Layla McCay, NHS Confederation’s director of policy, said: ‘At a time when general practice and other services are facing record levels of demand, health leaders are working hard to use their stretched resources well. 

‘This includes supporting patients to attend appointments, and there are a range of ways this support has been extended already, including home visits, longer and weekend opening hours, remote consultations and managing appointments via the NHS app.

‘However, it is important to recognise the reasons patients do not or cannot attend their appointments will be complex. 

‘Penalising them unfairly will not solve the problem and working with local communities to address the root causes is essential. 

‘The administrative burden this would place on the NHS risks being considerable and could well far outweigh the money brought in by the fines.’

She added: ‘This proposal will also not solve the fundamental and long-term issues the NHS is currently grappling with.

‘These include health service staffing levels with vacancies which now stand at 105,000 as well as the impact of spiralling inflation costs on the NHS, and the ongoing pressures being felt across the whole system including in social care.’

The proportion of GP appointments that were face-to-face rose slightly to 64.8 per cent last month, up from 64.1 per cent in May

The proportion of GP appointments that were face-to-face rose slightly to 64.8 per cent last month, up from 64.1 per cent in May

Meanwhile, separate figures today showed less than half of all appointments made last month saw patients seen by qualified doctors. Nearly 47 per cent of patients were seen by nurses or other staff, which can include acupuncturists and physiotherapists

Meanwhile, separate figures today showed less than half of all appointments made last month saw patients seen by qualified doctors. Nearly 47 per cent of patients were seen by nurses or other staff, which can include acupuncturists and physiotherapists

Graph shows: The proportion of patients seen by a fully qualified doctor at GP appointments in different regions of England in June

Graph shows: The proportion of patients seen by a fully qualified doctor at GP appointments in different regions of England in June

One in six appointments in the country lasted up to just five minutes last month, with even higher proportions seen in some areas of the country. NHS Suffolk and North East Essex Integrated Care Board saw 20 per cent of patients in five minutes or less

One in six appointments in the country lasted up to just five minutes last month, with even higher proportions seen in some areas of the country. NHS Suffolk and North East Essex Integrated Care Board saw 20 per cent of patients in five minutes or less

There were just 27,558 full-time equivalent, fully-qualified GPs working in England last month, down 1.6 per cent on the 18,000 recorded in June 2021. It was down 5.3 per cent on the more than 29,000 working in June 2017

There were just 27,558 full-time equivalent, fully-qualified GPs working in England last month, down 1.6 per cent on the 18,000 recorded in June 2021. It was down 5.3 per cent on the more than 29,000 working in June 2017

The BMA’s Dr Banfield added: ‘It’s terribly disappointing that the candidates standing to be the next prime minister seem to have so little understanding of the reality facing our NHS, or what it will take to turnaround the impact of the Government’s repeated mistakes and the now mammoth backlog of care.

‘While it is frustrating when patients do not attend, the reasons why this happens should be investigated rather than simply resorting to punishing them. 

‘Financially penalising patients inevitably impacts the poorest and most vulnerable in the community. 

‘This may discourage them from rebooking, exacerbating already worsening health inequalities and costing the NHS more.’

It comes amid the GP appointments crisis, fuelled by crippling workforce shortages and unprecedented demand in the wake of the pandemic.

Data last week showed the number of qualified GPs has dropped to its lowest level on record. 

There were around 27,500 fully-qualified, permanent family doctors working for NHS England last month, down from about 28,000 in June 2021 and 1,500 fewer than five years ago.

The figure comes despite Boris Johnson’s 2019 manifesto pledge to boost numbers by 6,000 by 2024. 

Nearly one in five appointments nationally lasted five or fewer minutes last month, in what campaign groups said was a sign GP surgeries have turned into ‘revolving door’ practices in an effort to get patients in and out as fast possible to get through huge workloads.

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