General Chat

[HanoiVillan]

1 hour ago, sharkyvilla said:

Indeed, you'd either have to make NHS staff detectives which is going to be a massive waste of their time and incredibly difficult

In practical terms (since patients will obviously lie to avoid being fined) what this actually means is running all kinds of extra tests to find out the way in which they are lying. Which is an enormous waste of time, money and patience. And at the end of it, you have a large group of people who now have a burning resentment towards the NHS, which doesn't exactly help its 'politically untouchable' status.

1 hour ago, sharkyvilla said:

I agree that people who don't turn up for appointments should get fined, the other day when I went to see my GP there 76 missed appointments across the week, which is outrageous imo.

This is just more detective work. What if my car broke down? What if my mother fell down the stairs that morning and I had to take her to hospital? What if my boss sends me on a business trip to Buffalo at short notice? What if I'm under enormous mental and financial pressure after my wife died, and I just forgot? Etc etc.

[Chindie]

@HanoiVillan elaborates on what I was getting at last night. The whole idea sounds easy. It absolutely isn't, even if you remove the moral argument.

It is the same kind of thing the gammons have. Right on everything is simple just do it nonsense that completely falls assist the moment a seconds thought is given to it. Like Brexit.

[sharkyvilla]

5 minutes ago, HanoiVillan said:

 

This is just more detective work. What if my car broke down? What if my mother fell down the stairs that morning and I had to take her to hospital? What if my boss sends me on a business trip to Buffalo at short notice? What if I'm under enormous mental and financial pressure after my wife died, and I just forgot? Etc etc.

Then phone up and cancel.  There's a difference between cancelling an appointment even at short notice and just not turning up.  

[HanoiVillan]

2 minutes ago, sharkyvilla said:

Then phone up and cancel.  There's a difference between cancelling an appointment even at short notice and just not turning up.  

By definition, as a health service, you are dealing with people who are not in tip-top condition. Sometimes physically, sometimes mentally. You might think my examples are ridiculous, but those are the ones that would be on the front page of the Daily Mail. 'Cruel NHS Clinic sends £250 fine to mother-of-five on tax credits working two jobs because she missed an appointment'.

[blandy]

 

11 hours ago, Ingram85 said:

I’m very liberal and left leaning when it comes to most things. I voted remain. I am a very caring person but so can’t abide people abusing the very thing that is looking after them even though it’s on it’s last legs. People need to face up and take some responsibility for their actions when it comes to accessing the nhs. 

 

11 hours ago, Ingram85 said:

Then what do you do? Things will get worse for the nhs not better as it stands.

I've got a lot of sympathy with that (and with you and the NHS staff having to deal with the situation). I think, if I read you rightly, that you're saying people need to change the way they behave w.r.t. the NHS. I think maybe that what ought to happen is a bit of carrot and a bit of stick.

There are examples where perhaps people who have needed treatement because of criminal activity (drink driving, committing assault...whatever) and been convicted by the courts should have the cost of their treatment taken from them.

Where it's a lifestyle thing (falling off a mountain, pie-based, whatever) it's a slippery slope, ahem, as others have said, where to draw the line in terms of who gets invoiced and how to determine that. Perhaps better to do it via eduction. Not as quick, but ultimately perhaps a better way to change behaviours. It'll never be eradicated, but it can be reduced. Lastly some element of payment for delinquent wasting of time doesn't seem unreasonable - repeatedly missing appointments without genuine reason, repeatedly ignoring medical advice, particularly where help is provided by the NHS.

It's a shame it's come to this state of affairs, for sure.

[Demitri_C]

1 hour ago, HanoiVillan said:

In practical terms (since patients will obviously lie to avoid being fined) what this actually means is running all kinds of extra tests to find out the way in which they are lying. Which is an enormous waste of time, money and patience. And at the end of it, you have a large group of people who now have a burning resentment towards the NHS, which doesn't exactly help its 'politically untouchable' status.

This is just more detective work. What if my car broke down? What if my mother fell down the stairs that morning and I had to take her to hospital? What if my boss sends me on a business trip to Buffalo at short notice? What if I'm under enormous mental and financial pressure after my wife died, and I just forgot? Etc etc.

Say you had a dentist appoint you would still get fined if you did not notify them. For me its quite simple to do this. Get rid of one high level a manger on a six figure salary, appoint three people on band 3 salaries (20k a year so with all three 60k which actually saves money) this team would be based on strictly dealing with DNAs (did not attend) I would setup a generic email for each specialty in the hospital e.g Orthopedics, Urology where people can email in saying they cant attend with all their patient information. Also in case they don't know how to email or are unable to there would be a contact number to call. Therefore providing you two methods to get through. 

With email you can PROVE you got in contact with the hospital and tried to cancel. To start with I would trial it with one specialty that has the highest DNA's and see how it worked before implementing it. 

If your wife died which of course would be tragic there will be processes in place, as the GP notifies the hospital (if this death didnt occur here) that patients who passed away. If not just like with some airlines you can send them a copy of death certificate. Its not right but unfortunately there are some people who would just lie to avoid the fine so like with anything proof would be needed to refund/scrap the fine. If this reduces DNAs and also gives the fine money back to the NHS I dont see what the problem is. 

 

 

Edited February 9, 2018 by Demitri_C

[BillyShears]

I do not agree with any kind of patient-blaming. The real reason the NHS is in the state it is in is due to mis-management, by massively overpaid managers. It will not change because some of these managers are often involved in government. I'm an A&E Nurse, we have loads of people who really don't need A&E, but they all feel that they need to be there.

[Jon]

13 hours ago, Ingram85 said:

What’s class got to do with it? If you’re proved to a burden on healthcare pressure, you should pay for it. People need a deterrent from wasting the nhs time, charging for self inflicted harm is entirely fair I believe. Especially getting too pissed and needing stomach pumping or attention for fighting injuries.

A genuine wow post. Jeremy C Hunt would agree with this though. Almost as right wing as you could get.

"Self inflicted harm". Often the result of mental health issues. Charge all mental health patients? What about sports esp 'dangerous' sports players. Charge them when they get injured. Injured or lost fell/mountain walkers? Charge them. Boozers/smokers/fast food eaters - charge 'em.

etc.

"People need a deterrent". Jebus.

 

 

[mjmooney]

I can see that the 'health education' suggestion will produce scorn from some. There are some people who just won't learn. And it's a very slow, long term strategy. But it's still essential. And we need to do some lateral thinking, too. For example, gastric band/bypass surgery for the morbidly obese. It's expensive, crude, has serious health implications, and takes up valuable surgical resources. It would actually be cheaper (and more sensible) to pay for a personal trainer/lifestyle coach for each patient. One LHA round here (Wakefield, iirc) has tried it, and had considerable success. 

[Jon]

The gradual privatisations of the NHS.

Stage 1 - Underfund

Stage 2 - propaganda. The private sector can do it better/the NHS is inefficient etc

Stage 3 - Blame the patients. They're draining the NHS. Charge them.

Edited February 9, 2018 by Jon

[sharkyvilla]

1 hour ago, HanoiVillan said:

By definition, as a health service, you are dealing with people who are not in tip-top condition. Sometimes physically, sometimes mentally. You might think my examples are ridiculous, but those are the ones that would be on the front page of the Daily Mail. 'Cruel NHS Clinic sends £250 fine to mother-of-five on tax credits working two jobs because she missed an appointment'.

The fine doesn't actually have to be that much, it's amazing what a difference 5p per plastic bag has made to people's habits when shopping for example.  Putting a price on it might be a better way of making people understand how inconsiderate it is to miss an appointment, or not notify.  It doesn't have to be more than £5, and GPs or other doctors must know those who are most vulnerable and can waive the fee if they choose.  

[Demitri_C]

46 minutes ago, BillyShears said:

I do not agree with any kind of patient-blaming. The real reason the NHS is in the state it is in is due to mis-management, by massively overpaid managers. It will not change because some of these managers are often involved in government. I'm an A&E Nurse, we have loads of people who really don't need A&E, but they all feel that they need to be there.

This is a good point also and I agree with it

31 minutes ago, sharkyvilla said:

The fine doesn't actually have to be that much, it's amazing what a difference 5p per plastic bag has made to people's habits when shopping for example.  Putting a price on it might be a better way of making people understand how inconsiderate it is to miss an appointment, or not notify.  It doesn't have to be more than £5, and GPs or other doctors must know those who are most vulnerable and can waive the fee if they choose.  

This is a great point. No one is suggesting fining people £80-£90 a £5 fine I think is reasonable and fair. If the money goes back into the NHS then I am all for it. But if this did ever come into play the NHS has to improve ways patients can communicate like having more staff more ways for patients to get in touch.

I think this is a better method than raising National Insurance again. 

[snowychap]

1 hour ago, Demitri_C said:

Say you had a dentist appoint you would still get fined if you did not notify them.

I don't believe that's correct if you're an NHS patient.

[snowychap]

47 minutes ago, sharkyvilla said:

The fine doesn't actually have to be that much

It would have to be at least high enough to cover the administration of it (collection, payment systems to be introduced in to all GP surgeries, &c.).

[Demitri_C]

16 minutes ago, snowychap said:

I don't believe that's correct if you're an NHS patient.

 

Quote

"Your dentist should not: charge you for missed NHS appointments; however, ifyou miss any, your dentist can decide not to offer you treatment in the future. suggest that NHS treatment is sub-standard."

You are correct but I didn't say it was for NHS patients. If you are a private patient which alot of people are you receive a fine. I agree with this as I have had to wiat long periods for a dential appointment. They give me an appointment card, call me 24hrs before and leave a voice message if they cant get me on the phone to ensure and remind me. if I dont go or notify them I deserve the fine. 

[snowychap]

16 minutes ago, Demitri_C said:

You are correct but I didn't say it was for NHS patients.

Your implication was that it was the case for any missed dental appointment whereas charges may only apply for a missed appointment (depending upon the dental practice) for private patients.

For the sakes of the discussion about missed NHS appointments (be they in a hospital or in a GPs surgery), you may as well have started referencing the practices on Harley Street or within BUPA.

Quote

If you are a private patient which alot of people are you receive a fine.

For the sake of pedantry and clarity: no, you don't. A dental practice may decide to charge you for the missed appointment according to their terms/advertised policies. These can differ widely from practice to practice. They are not a fine.

Edited February 9, 2018 by snowychap

[Demitri_C]

59 minutes ago, snowychap said:

Your implication was that it was the case for any missed dental appointment whereas charges may only apply for a missed appointment (depending upon the dental practice) for private patients.

For the sakes of the discussion about missed NHS appointments (be they in a hospital or in a GPs surgery), you may as well have started referencing the practices on Harley Street or within BUPA.

For the sake of pedantry and clarity: no, you don't. A dental practice may decide to charge you for the missed appointment according to their terms/advertised policies. These can differ widely from practice to practice. They are not a fine.

They will definitely charge you for the missed appointment, if you had no treatment and still had to pay they might not title it a fine but thats exactly what is penalising you for not attending. I think this is the correct practice to minimise missed appointments. The amount of time that goes in per patient and the post, it needs to be addressed. This is better way to raising funds for the NHS than raising peoples taxes 

[snowychap]

17 minutes ago, Demitri_C said:

They will definitely charge you for the missed appointment, if you had no treatment and still had to pay they might not title it a fine but thats exactly what is penalising you for not attending.

A dental practice may decide to charge you (a private, non-NHS patient) for the missed appointment according to their terms/advertised policies. These can differ widely from practice to practice. This charge is not a fine.

 

Edited February 9, 2018 by snowychap

[Demitri_C]

2 hours ago, snowychap said:

A dental practice may decide to charge you (a private, non-NHS patient) for the missed appointment according to their terms/advertised policies. These can differ widely from practice to practice. This charge is not a fine.

 

Not by title but we know it is really 

[snowychap]

38 minutes ago, Demitri_C said:

Not by title but we know it is really 

It isn't but this is besides the point which is that the comparison of charging patients for missing NHS hospital/GP appointments and dentists possibly levying a charge on private patients if they miss (or cancel at short notice) an appointment is a poor one.

Edited February 9, 2018 by snowychap