Should the NHS charge for such things?

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.

My husband has been in hospital 6 days following a second stroke. I don’t think we should be charged for basics but I wouldn’t mind paying extra for decent meals. He is on a Red Tray and is supposed to get help with feeding but he never has yet.

Most of the pay to view TVs on his ward are not working. He was very uncomfortable yesterday as he only has one working arm which needs to be on a pillow. He has one from home which the paramedics took when he was bluelighted. He needed another to support his other arm which has a cannula in but the nurse said there are no more available. I will have to take another one in tomorrow.

A younger man opposite has not spoken or opened his eyes since Sunday and looked very uncomfortable with his head flopped over for hours on the bed rails. No nurses came near him. I had to go and find a nurse as the elderly man next to my husband was climbing over the bed rails to get out and cannot stand unsupported. I was terrified he was going to fall on the floor. There are plenty of nurses but never there when you need one.

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.

Ilovecheese

More trouble than it would be worth.
But Reform would like the idea, it would be their first step to privatisation.

Exactly. Introducing charges for those things is the first step on a very slippery slope indeed.

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

Totally agree Witzend that care should be free at the point of use.
However if an appointment is missed then the service is being abused, not used, and a charge should be made I think. My dentist charges, the taxi driver has the meter running from the time the taxi was booked…

A £10 fine was tried a few years ago (precovid) at some surgeries local to where I lived then but stopped. I’m not sure why.

As long as patients can charge, too, I'm all for it.

I had to make outpatients appointments as part of my job in the NHS. I had access to Registrar's and Consultant's clinic lists and was always disappointed to see so many spaces with 'No Show' added to the patient details. They all had waiting lists which were made worse by patients failing to keep their appointments. Making a charge would reduce this, I'm sure. Also charge people who use ambulances like taxis.

More trouble than it would be worth.
But Reform would like the idea, it would be their first step to privatisation.

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.

Also in France people can chose a date that is convenient to them and the hospital suggests times or other dates. Why not? It works here instead of being told an inconvenient date, it would help people.

mokryna

In France you have to pay for meals, full price, even if it is a yogurt, three meals a day.
I also have to pay missed appointments for specialist.
But people are texted/ messaged a week in advance as well as days before hand asking if they would like to cancel free of charge, so there is no excuse.

If I didn’t have someone overnight in the same house/flat where I was sleep after a GA, I would have to pay for the night in the hospital because I was well enough to leave.

I think this would also stop bed blocking as AC have to pay for a level of parents’ care, depending on income, however, parents cannot disinherit children.

What happens if you can't pay? I'm guessing people aren't left to starve.

It would cost a fortune to charge people even for simple things because people would have to be employed to take the money and "keep the books" . I think it would be a non-starter. Who would pay, would one have to receive a specific amount of salary or pension? What about the refusnicks?

I spent 3 days in hospital recently and the food was disgusting. The same food every day. I didn't want it when free, and I certainly would not have paid for that slop.

In France you have to pay for meals, full price, even if it is a yogurt, three meals a day.
I also have to pay missed appointments for specialist.
But people are texted/ messaged a week in advance as well as days before hand asking if they would like to cancel free of charge, so there is no excuse.

If I didn’t have someone overnight in the same house/flat where I was sleep after a GA, I would have to pay for the night in the hospital because I was well enough to leave.

I think this would also stop bed blocking as AC have to pay for a level of parents’ care, depending on income, however, parents cannot disinherit children.

Cabbie21

The number of wasted appointments is disconcerting, though sometimes there is a good reason eg not having received the appointment letter! I think it would be fair to levy a charge the second time an appointment is missed, but I am not sure how it could be implemented. An alternative is being struck off.

As for meals, in theory I would be happy to pay for meals in hospital provided the food was decent. But there will be patients whose conditions need special meals. Should they pay? Surely not? And what about people who refuse to pay and get their relatives to bring food in. I wouldn’t want to be on a ward smelling of curry, for example. ( No, I am not being racist. Curry is a popular dish and easily obtained. I just don’t like it.)

When I had my first baby, 1971, the best meals on the maternity ward were for people who had ticked for Asian menu. We'd all be waiting for all the Asian ladies to get their meals so we could have a curry instead of slop.