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Rishi Sunak’s proposal to introduce a temporary £10 fine for patients that miss NHS appointments would exacerbate health inequalities and likely make the backlog “worse”, a major union has warned.
Unveiling the policy, the former chancellor, who is struggling to revitalise his bid for No 10 against rival Liz Truss, said the NHS is “meant to be free at the point of use, not free at the point of misuse”.
Around 6.6 million patients were waiting for planned care in May, and Mr Sunak’s team said tackling the 15 million missed appointments each year could be “instrumentation” to addressing the backlog.
Patients who miss an appointment for the first time would be given the benefit of the doubt, but further no-shows would ring up charges of £10 each time. GPs and hospital trusts would be able to use their “discretion” in “exceptional circumstances”, they added.
The British Medical Association (BMA), however, said the policy was not the answer to tackling the rising NHS backlog, saying a £10 fine for missing a GP appointment would “likely make matters worse”.
Professor Philip Banfield, the BMA council chair, stressed that charging patients for missed appointments would “threaten the fundamental principle that the NHS delivers free care at the point of need, for all”.
“While it is frustrating when patients do not attend, the reasons why this happens should be investigated rather than simply resorting to punishing them,” he added.
“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.”
Dr Gary Howsam, the vice-chair of the Royal College of GPs, also said that while missed appointments are “frustrating”, charging patients “is not the answer”.
He added: “It would fundamentally change the principle that the NHS is free at the point of need and would likely impact on our most vulnerable patients most – and it would add another layer of bureaucracy to a GP service already drowning in red tape.
“We also need to remember there are many reasons why this might happen. For some patients, missing appointments can be a sign that something more serious is going on, and that follow-up action is needed.
“For some, it will have been a case of human error. For others, particularly if the appointment was longstanding, it may have no longer been needed.”
Wes Streeting, the shadow health secretary, said: “Sunak’s attention-seeking gimmick will do nothing to solve the worst crisis in NHS history. This is a dangerous thin end of the wedge that will penalise the most vulnerable and would cost more in admin that it would raise.”
Announcing the policy, Mr Sunak added: “Missed appointments are a big cost for the NHS. But worse than the cost is the impact on other patients waiting to be seen.
“Everyone should be able to get an appointment with their GP, and those waiting to see a consultant should be seen as soon as possible. But the millions of appointments being missed make it harder for people to get the care they need.
“Under my government, there will never be charges for care in our NHS. But I will charge people who waste valuable NHS time by booking appointments and failing to attend.”
