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MP calls for no-show fines
20th Mar 2007
An MP has called for dentists to be allowed to fine patients who continually fail to keep their appointments. Sandra Gidley, the Liberal Democrat spokeswoman on dentistry, called for further scrutiny of missed appointments after the government admitted it had no plans to keep any records centrally. Mrs Gidley said: ‘Given the interest in missed appointments in the medical area, I would have thought someone would have been keeping an eye on this in the dental area. ‘Some dentists have arranged their working practice to fit in as many people as they can to fulfil their new contracts. If people don't appear it scuppers that and makes it much more difficult to manage. ‘We need to look at this more as the provision of NHS dentists dwindles. If people don't have a good reason for not turning up it is not fair on those who can't access services and more attention needs to be paid to the problem.’ But Mrs Gidley added: ‘It's so difficult to get a dentist I can't imagine why anybody would not keep their appointment.’ The MP tabled a Parliamentary question to ask whether the government would ‘take steps to ensure that figures for missed dental appointments in each primary care trust in England are collected centrally’. Health Minister Rosie Winterton replied: ‘The department has no plans to introduce a national requirement that dentists report on numbers of missed appointments.’ Mrs Gidley told Dentistry magazine: ‘Without knowing the statistics, it's very difficult to get an idea of how big a problem it is. ‘If there's no excuse given (by patients who miss appointments repeatedly) maybe there should be some forfeit. I think some surgeries deserve the right to charge. If it's a big problem something should be considered as long as it's made clear up front.’ A spokesman for the Department of Health said: ‘We have no plans to allow charging for failed appointments. There is no provision in health law to charge for failed appointments in the NHS and dental contracts are no different. This would require new primary legislation.’ A Whitehall source said ministers were concerned about the fairness of fining low-income patients who might be exempt from dental charges – a concern shared by Mrs Gidley. A briefing paper produced by information resource NHS Primary Care, called Contracting in March 2006 suggested practices try using text messages to remind patients their appointment was coming up. It advised PCTs that although fining patients for missing an appointment was ‘not legally appropriate’, the law did allow for a patient to be asked to pay a charge prior to an appointment. The patient would then be refunded the charge whether or not they attended. The paper adds that ‘PCTs will want to consider how reasonable this is, as very early payments would net practices additional income in interest payments. Quite possibly, advance charges are therefore only worth obtaining in cases where there is a very strong probability this will result in preventing a failure-to-attend.’ Urging caution, the paper warns that people who miss appointments ‘tend to be the more vulnerable and socially disadvantaged members of society, such as the old, the young, the unemployed and the homeless.’ By Andy Tate, parliamentary correspondent
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