Fines proposed for missed appointments

Patients who miss their dental appointments would face a £10 penalty charge under plans being considered by the Liberal Democrats.

Norman Lamb, the party’s shadow health secretary, told the Lib Dem autumn conference in Bournemouth last month that the ‘persistent’ failure of a minority of people to attend appointments was a form of ‘irresponsible behaviour that needs tackling’ in the health service.

He said: ‘Some patients have legitimate reasons for not keeping appointments, such as their condition means they are forgetful or suffer real stress.

‘But for the rest perhaps we should hit persistent offenders in the pocket by letting
doctors and dentists levy a discretionary charge of, say, £10 for missing an appointment.

‘That would help make sure they don’t miss them in the future.’ Mr Lamb said afterwards that the problem of patient time-wasting was ‘quite significant’ across the health system.

He said: ‘Missed appointments are clearly a big problem across the NHS and there is an enormous cost attached to that. We have to look at ways in which we can try to provide extra encouragement and incentives to ensure [patients] are taking this seriously.’

Mr Lamb, MP for North Norfolk, cautioned that people with conditions including mental health problems would have to be treated sensitively to ensure they were not charged unfairly.

He stressed he was not trying to ‘condemn’ everyone who had missed an appointment – ‘we are all capable of it’, he said. But he went on: ‘At least having the potential to impose a charge on persistent offenders has to be considered.’

Mr Lamb said under the Lib Dems’ ‘vision’ of a reformed, decentralised health service, local health trusts would be given the option of piloting a penalty charge scheme, rather than being forced to adopt one.

But he added: ‘If they wanted to pilot a scheme that had the effect of reducing wasted time it would be worth trying because of the cost to all of us. It’s not just a problem for professionals.’

Mr Lamb said he would also encourage trusts to experiment with text message reminders – of the kind used by some hospitals and Specsavers opticians – to try to reduce missed appointments.

‘It’s not rocket science,’ he said.

Mr Lamb joined in the political criticism of the government’s 2006 dental reforms, arguing that changes to the NHS contract were ‘not working’.

He said: ‘Everybody hates the contract and it hasn’t worked as the government claimed it would. It has resulted in fewer people working in NHS dentistry – the opposite to what they claimed would happen.’

The health spokesman said that, given the chance, he would reform the system to provide additional incentives for dentists to work in disadvantaged areas.

He said: ‘We want to move away from the dead hand of Stalinist commissioning and take a different approach with enhanced payments for dentists serving patients in deprived communities.

‘There are also things one can do to move away from the treadmill of the unit of dental activity (UDA), including more emphasis on quality standards,’ he added.

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