[dev_north_east]

[Immigrant in UK] I'll never forget at one party/gathering where in a conversation I proposed that some base charge should be applied to those who book appointments with their GP and don't show up. I suggested a fiver (which I think is very low tbh). I was then subject to the most unexpected arguments, accusations and outrage! I truly got it then that the NHS is the real state religion in Britain.

[Jonnax]

Because when you start charging, the price will only go up.

University used to be free in the UK. Then tuition fees at University started at £1000ish a year, went up to about £3000, and is now £9000. All in about 10 years.

Also small fees like these affect the poor more than the well off. If I miss an appointment and it costs me £5, I wouldn't miss the money.

A quick search apparently shows that a quarter of British households have less than £100 in savings. [0] When that's 5% of their money that's just punishing the poor.

[0] https://www.thisismoney.co.uk/money/article-4234518/Savings-...

[dev_north_east]

I've literally heard all of this before.

I'll say "Well they shouldn't miss the appointment, they can cancel if they can't make it"

To which you'll reply something about people and last minute, completely unavoidable things which prevent appointments being made.

To which, I'll reply that blah blah and on and on.

I've learned there's no point. I don't think fees for that are abnormal (have seen them and their handling of scenarios in operation in other countries to no big alarm) but it's against NHS dogma! Don't get me wrong, I like the NHS but there's seriously zealot-esque thinking towards it from many corners. It's not a case of "totally free" or the USA.

But as said, I'm an immigrant and have learned to keep quite on such matters.

[Jonnax]

GP appointments are 10 to 15 minutes long. Are missed appointments such a issue for GPs?

If someone doesn't show they move onto the next person.

Usually GPs have an issue in that appointments take longer than planned, so there's often waiting on the side of the patient.

Most GPs have appointments reserved to be bookable on the day if you call up in the morning.

What problem are you proposing a solution for?

Your comment about religious zelotry is condescending. Saying that anyone criticising your viewpoint is a blind fanatic.

[dev_north_east]

First off, apologies. I mean more of a rigid, defensiveness in general among British people? Do you know what I mean? No offense meant and I withdraw that.

> Are missed appointments such a issue for GPs?

"Patients who miss GP appointments are costing NHS England £216m a year, officials have said." - https://www.bbc.co.uk/news/health-46732626

And the incident I described what started due to one of the girls, a receptionist in a GP, bemoaning how many missed appointments they have and what a backlog it begets. People agreed. Just now I checked my doctor's online portal and I can't get an appointment for over two weeks (they advise to ring up at 8 on the morning if it#s an emergency and they'll try to fit you in). Unfortunately recently I had cause to have 6 appointments over a two week period, I saw a lot of names being called and no-one attending.

> If someone doesn't show they move onto the next person.

This presumes that people without an appointment, just hang around the waiting area... As said the backlog grows.

[pjc50]

Yeah, there's a real .. bimodality? to NHS service users. A small fraction of people, usually elderly and/or disabled, with essentially infinite health problems, take up most of the time. Everyone else has to fit in around them.

Often their inability to keep appointments is inextricably linked to the medical condition, too - either physical or mental. Often it's linked to poverty or insecure living too.

We could start trying to price them out, which will at the margin result in someone dying of a preventable condition. This seems to be becoming more politically acceptable (see benefits system, food banks, refugees etc), but it's also something people are right to be squeamish about.

[IneffablePigeon]

I can see your argument, although while £216m is a lot of money it's still a drop in the bucket compared to the NHS's total budget (about 0.2%).

Personally, I think the situation can be improved by more education. I think a fine would unfairly affect the less well off, not only because it would be a much more significant amount to them but because those are the same people who are more likely to have unforseen circumstances that mean they can't make an appointment, such as a job where they might just change your shift with little/no notice.

I think the actual booking system could fix a lot of these issues at most surgeries, too. My last surgery held back 75% of appointments such that you couldn't book them until the day of the appointment. This meant that you could almost always get a same day appointment as long as you called at 8:30am, and also meant you probably had a much better idea of whether you were going to be able to make that appointment or not. People who needed to get an advance appointment could still do so, and would have to wait a couple of weeks usually but that's no worse than most other places. It really did seem to fix a lot of the problems I've seen - I don't know why more places don't do it.

[switch007]

> but it's against NHS dogma...there's seriously zealot-esque thinking towards it

It's not dogma but yes it could be classed as zealotry, and not in a derogatory way. There are worse things to be a zealot about than public health. I cherish one part of our country that actually has written, founding principles.

They shaped what the NHS has been for over half a century, and what many people still want the NHS to be.

[lozenge]

It's funny because they already pay a prescription charge (small fixed fee regardless of the contents of the prescription) at a pharmacy and there aren't enough dentists taking NHS patients for everybody to avoid paying for private dental services. So it isn't as if it is all literally free. I guess the difference is the NHS logo on the door.

[HerpDerpLerp]

In Scotland there is no prescription charge.

In England if you know you are going to be getting a lot of prescriptions you can pay an amount upfront, then prescriptions are at no extra cost than that. https://www.nhs.uk/using-the-nhs/help-with-health-costs/save...

The state of dentistry in the UK is shocking.

[heavenlyblue]

These are the same people who forget that a single visit to an NHS dentist is about £20 anyway.

[tialaramex]

It isn't if you have the certificate saying you proved you can't afford this sort of thing. Most NHS dentists have the paperwork and posters advertising it if you are somehow unaware those exist. Everything is free if you're both poor AND fill out all the paperwork.

There is a debate to be had about whether "make poor people fill out paperwork" is a justifiable approach, but it doesn't have to cost you £20 for the check-up.

[IneffablePigeon]

I was going to do this when I was a student and the form was so long and convoluted I decided to just pay. It all seemed just slightly designed to stop you claiming it.

[wackro]

I filled that form out too. It wasn't the quickest, but it wasn't difficult either. Definitely didn't get the impression that it was some kind of barrier.