Rishi Sunak’s proposed £10 fine for patients missing NHS appointments would only make matters worse, health chiefs have warned.
As part of its quest to succeed Boris Johnson as prime minister, the hopeful Tory leadership insisted that the policy remain in place until the backlogs are reduced to manageable levels.
But influential voices in the health sector said it was “terribly disappointing” that the move was even suggested.
The British Medical Association described it as a ‘re-warmed idea with no practical value’ and claimed it was ‘always firmly against the idea of charging patients for missed appointments’.
dr. Philip Banfield, chairman of the BMA board, said: ‘This latest suggestion would probably make things 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 provides free care when it is needed, for everyone.”
Meanwhile, the NHS Confederation, which represents the entire health network, argued that the cost of Mr Sunak’s proposed settlement “could be much greater than the money the fines bring in”.
According to official statistics illustrating the problem, more than a million GP appointments are missed in England every month.
As part of his quest to succeed Boris Johnson as prime minister, hopeful Tory leadership Rishi Sunak insisted that the policy remain in effect until the backlogs are cleared to manageable levels.
More than a million GP appointments in England are missed each month, according to official statistics illustrating the problem
Each consultation costs the NHS the equivalent of £30.
A similar problem arises with outpatient hospital appointments, which would also fall under the penal rule proposed by the former chancellor.
Announcing his pledge in an interview with the Sunday Telegraphthe 42-year-old claimed that patients would be given the benefit of the doubt the first time they miss an appointment.
But they would be charged £10 for not attending any subsequent appointments without adequate notice.
Sunak, who will face rival Liz Truss in the second Tory leadership battles tonight, stressed that fines are “the right thing to do when we have people screaming for treatment.”
Though controversial, it’s not the first time the idea has been floated that patients face fines for missing appointments.
In 2015, Jeremy Hunt, former health minister and Sunak supporter, said he had “no 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.
Though controversial, it’s not the first time the idea has been floated that patients face fines for missing appointments. In 2015, Jeremy Hunt, former health minister and Sunak supporter, said he had “no problem with the idea of charging people for missed appointments”
Record number of midwives stopped due to stress
The number of midwives is reaching dangerous levels that could endanger lives as data shows that for the first time in a decade, more staff are leaving than the profession is entering the workforce.
With record burnout and leave, NHS Digital’s 2021/22 figures show that nearly 300 more staff are leaving midwives than are employed, with 3,440 leaving and just 3,144 coming in.
Analysis of the data showed that a record 551 resigned in 2021 due to a lack of work-life balance.
The latest figures for May show that pregnant women have the equivalent of 21,685 full-time midwives in England – 551 less than a year earlier.
Midwives working in NHS maternity wards typically work 12-hour shifts, but many work longer hours with no extra pay to cover staff shortages and keep services up and running.
For the past ten years, GPs themselves have supported proposals to punish patients who do not keep their appointments.
But professional organizations oppose fines and fear they could target vulnerable patients, including those with dementia or mental health problems.
dr. Layla McCay, Policy Director of the NHS Confederation, said: ‘At a time when GP practice and other services are faced with record demand, health leaders are working hard to put their stretched resources to good use.
“This includes supporting patients to attend appointments, and there are several ways this support has already expanded, including home visits, extended opening hours and weekends, remote consultations and managing appointments via the NHS app.
“However, it is important to realize that the reasons why patients cannot or cannot attend their appointments will be complex.
“Unjustly punishing them will not solve the problem and working with local communities to address the root causes is essential.
‘The administrative burden that this entails for the NHS threatens to be considerable and could more than outweigh the money generated by the fines.’
She added: ‘Nor will this proposal solve the fundamental and long-term problems the NHS is currently grappling with.
“This includes the healthcare workforce with vacancies now standing at 105,000, as well as the impact of rising inflation costs on the NHS and continued pressure being felt across the system, including social care.”
The share of GP appointments that were face-to-face rose slightly last month to 64.8 percent, from 64.1 percent in May
Meanwhile, separate figures today showed that less than half of all appointments made last month were seen by qualified doctors. Nearly 47 percent of patients were seen by nurses or other staff, including acupuncturists and physiotherapists
Graph shows: The percentage 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 five minutes last month, and even higher rates were seen in some parts of the country. NHS Suffolk and North East Essex Integrated Care Board saw 20 percent of patients in five minutes or less
There were just 27,558 full-time, fully qualified GPs working in England last month, 1.6 percent less than the 18,000 registered in June 2021. It was 5.3 percent less than the more than 29,000 employed in June 2017.
dr. Banfield of the BMA added: “It is terribly disappointing that the candidates aspiring to become the next prime minister seem to have so little understanding of the realities facing our NHS, or what it would take to understand the impact of the repeated mistakes of the government and the now huge backlog in healthcare.
“While it’s frustrating when patients don’t come, the reasons why this happens should be investigated rather than simply punishing them.
“Financially punishing patients inevitably affects the poorest and most vulnerable in the community.
‘This could deter them from rebooking, exacerbating already worsening health inequalities and costing the NHS more.’
It comes amid the GP hiring crisis, fueled by crippling staff shortages and unprecedented demand in the wake of the pandemic.
Data from last week showed that the number of qualified GPs has fallen to an all-time low.
There were around 27,500 fully qualified, permanent GPs for NHS England last month, down from around 28,000 in June 2021 and 1,500 less than five years ago.
The figure comes despite Boris Johnson’s 2019 promise to increase the number by 6,000 by 2024.
Nearly one in five appointments nationwide lasted five minutes or less last month, which campaign groups say was a sign that GP practices have turned into ‘revolving doors’ in an effort to get patients in and out as quickly as possible to get through the massive workload.