Sky Blue Pete
Well-Known Member
How many we thinking 5000??
Do you want to discuss boring politics? (27 Viewers)
- Thread starter mrtrench
- Start date
Ian1779
Well-Known Member
Combined IQ? Yeah
You say that, but our numbers aren’t massively out of whack with private systems. In the US the figure can be up to 54% (!).
Interestingly it seems the number has risen along with the rise in telephone appointments, which would I assume also involve lower costs but not sure.
The changing face of missed appointments - PMC
www.ncbi.nlm.nih.gov
On fine as a way to reduce behaviour generally, I always remember this story made famous by Freakanomics:
A Fine is a Price
The deterrence hypothesis predicts that the introduction of a penalty that leaves everything else unchanged will reduce the occurrence of the behavior subject tpapers.ssrn.com
Basically a nursery had issues with parents dropping kids late. So they introduced late fees. And the number of late parents went up because paying the fee absolved them of guilt for being late so they tried less hard to be on time.
Had a quick scan down that link. Strange that it says missed appointments were 7m, yet the attached also on nhs, says 15m (both 2019) NHS England » Missed GP appointments costing NHS millions
Pretty sure we got it down to 14m this year though.
Sounds like the US has only recently started implementing penalties. Not sure who has previous covered the cost ? Insurers ?
Why wouldn’t we even try though ? What we’re saying is it’s ok for the council to charge us £30 parking fine for getting back to our car 10 mins late but we can’t charge people anything for not bothering to call to cancel an appointment that someone else might need for a potentially serious health condition ? Madness
Ps worst case it’s a few hundred million to cover the cost of additional/replacement appointments but I’m pretty confident it would change behaviours
shmmeee
Well-Known Member
I think in reality you’d end up raising not a lot and charging a bunch of working parents, people with executive function issues, and pensioners. If we aren’t particularly out of whack with any other countries and it hasn’t really changed over decades, it seems more likely that this is a feature of healthcare with a busy populace rather than some great moral failing of the British public.
On 15m vs 7m that’s 15m overall, 7m GP I think: NHS England » Missed GP appointments costing NHS millions
You’ve never posted something shared on another social media site to take the piss?
fernandopartridge
Well-Known Member
fernandopartridge
Well-Known Member
Missed appointments cost time but don't cost money as such. GP contracts are paid on the size of the registered list + extras for additional and enhanced services. They are not paid per appointment.
Grendel
Well-Known Member
fernandopartridge
Well-Known Member
Mucca Mad Boys
Well-Known Member
I don’t disagree with the principle at all but as mentioned with the late fees, it can drive this up and the costs of chasing unpaid late fees could be costly.
In other systems, you pay to see a doctor in advance of the appointment, it varies country to country but using France as an example, the cost is €23 iirc and it’s capped above a certain threshold per month or annum. Even things like charging nominal fees for hospital beds and what not could raise extra capital for hospitals.
There’s a lot of abuse for the service too because they’re taking advantage of a free service at times. The same reason we introduced prescription fees too.
In short term, I think the next government needs to take out as much demand from the NHS as possible. Perhaps they should bring back VAT exemptions for private health insurance and perhaps incentivise employers to put their staff on PHI with tax breaks. This isn’t a silver bullet but could do something to get people off waiting lists.
fernandopartridge
Well-Known Member
How can free prescriptions be abused? Doctors control it not the patients
Mucca Mad Boys
Well-Known Member
When the NHS was founded, prescriptions were free of charge and this was scrapped in 1952. They tried a abolish said charges in 1965 and reintroduced in 1968. The reason because people were overusing the system and it put pressure on the system.
Hence, we have means tested free prescriptions.
shmmeee
Well-Known Member
What’s your source for people “overusing the system”? Everything I can find says it was a simple revenue raising policy.
nicksar
Well-Known Member
As a pensioner I get free prescriptions... but in Scotland they are free to all.
Years ago when working at Landrover I worked in a small team and I was the only one that actually paid for my prescriptions...the others just signed to say they received benefits of some kind....maybe these days you have to have proof (I'm not sure tbh).
I do wonder how many people working and not qualifying for free prescriptions just can't afford the cost?...nigh on £20 for two items....big hit for many lowish paid workers and families.
Sick Boy
Super Moderator
They really should be free for those under a certain income. As usual the narrative takes the focus off those avoiding paying millions in taxes, which is where the real problems are.
nicksar
Well-Known Member
Totally agree...Sunak paid only £400k this year and his wealth rose by £121 Million in the tax year...I pay income tax on (tbh) a modest pension.
With rises in the cost of a variety of regular bills I'm worse off.
Philosoraptor
Well-Known Member
Let's talk NHS appointments.
An interesting thing I heard recently is the people who book regular NHS appointments. There is nothing wrong with this.
Just to open up the debate a little.
30 million appointments a month for GP services
10% of patients don't turn up.
Frequent attenders account for 4 in 10 of consultations. Again, not saying there is anything wrong wiith this.
It seeems another 40,000 NHS appointments Labour is committed to a month is really piss poor in every way.
You could have an extra 3 million appointments a month by getting people to rearrange or cancel NHS appoinjtments if required, or even turning up for them.
www.bbc.co.uk
11:20-14:45
An interesting thing I heard recently is the people who book regular NHS appointments. There is nothing wrong with this.
Just to open up the debate a little.
30 million appointments a month for GP services
10% of patients don't turn up.
Frequent attenders account for 4 in 10 of consultations. Again, not saying there is anything wrong wiith this.
It seeems another 40,000 NHS appointments Labour is committed to a month is really piss poor in every way.
You could have an extra 3 million appointments a month by getting people to rearrange or cancel NHS appoinjtments if required, or even turning up for them.
More or Less: Behind the Stats - Shopping, shipping and wind chill-ing - BBC Sounds
We investigate the cost of a weekly shop and explore the workings of wind chill
www.bbc.co.uk
Last edited:
Mucca Mad Boys
Well-Known Member
The argument was made by Attlee’s government (including Bevan) and his early Tory counterpart McLeod. The exact quote is something about being a deterrent against ‘overwhelming surgeries’.
Again, since its inception the issue of extra costs have been floated about. Specifically around GP visits and ‘hotel’ fees. It was either Beveridge or Nye Bevan that supported this.
Something high level for you:
2 - Clement Attlee’s Crisis Prescription Charges, 1951 - Lecture 2: Clement Attlee’s Crisis; - Studocu
Share free summaries, lecture notes, exam prep and more!!
www.studocu.com
D
Deleted member 5849
Guest
What frightens me is the way it's going, I might turn up as a source one of these days...
Skybluekyle
Well-Known Member
The NHS is a really sad case. I suffer from chronic insomnia and occasional mental health issues. The service is slow, but when you do have access, it's exceptionally good, based on my experience
I've also used private when I had a quite severe lapse in my mental health at the tail end of 2021, and the service there was just as good, but a lot quicker. I think there is a lot of will in the NHS to be a healthcare service it wants to be, there is just not enough staff, money etc...
I've also used private when I had a quite severe lapse in my mental health at the tail end of 2021, and the service there was just as good, but a lot quicker. I think there is a lot of will in the NHS to be a healthcare service it wants to be, there is just not enough staff, money etc...
Sick Boy
Super Moderator
100% spot on.
shmmeee
Well-Known Member
The argument was made by Attlee’s government (including Bevan) and his early Tory counterpart McLeod. The exact quote is something about being a deterrent against ‘overwhelming surgeries’.
Again, since its inception the issue of extra costs have been floated about. Specifically around GP visits and ‘hotel’ fees. It was either Beveridge or Nye Bevan that supported this.
Something high level for you:
2 - Clement Attlee’s Crisis Prescription Charges, 1951 - Lecture 2: Clement Attlee’s Crisis; - Studocu
Share free summaries, lecture notes, exam prep and more!!
Sorry I meant an actual source showing over demand.
Without wanting to sound arsey, what’s with you posting this kind of source? Under grad essays and student resources are a bit, um, weak shall we say. Politicians saying things as we know doesn’t necessarily line up with reality.
shmmeee
Well-Known Member
Let's talk NHS appointments.
An interesting thing I heard recently is the people who book regular NHS appointments. There is nothing wrong with this.
Just to open up the debate a little.
30 million appointments a month for GP services
10% of patients don't turn up.
Frequent attenders account for 4 in 10 of consultations. Again, not saying there is anything wrong wiith this.
It seeems another 40,000 NHS appointments Labour is committed to a month is really piss poor in every way.
You could have an extra 3 million appointments a month by getting people to rearrange or cancel NHS appoinjtments if required, or even turning up for them.
11:20-14:45More or Less: Behind the Stats - Shopping, shipping and wind chill-ing - BBC Sounds
We investigate the cost of a weekly shop and explore the workings of wind chill
Point of order that’s not what the podcast says. It says 30m in general practice half of which (15m are GP appointments) and 10% of those (1.5m) are missed.
shmmeee
Well-Known Member
This is a decent breakdown, but again seems pretty skeptical on the evidence just saying Attlee believed there was over use.
torchomatic
Well-Known Member
I get free prescriptions as I have to take a combo of drugs every day because of my transplant. Should be free for all.
It’s not really the physical cost I’m bothered about, more the fact that 14-15m appointments are wasted and other people have missed out. Understand though in terms of docs playing catch up so the fines could be used for giving GPs extra to extend hours in evenings/weekend. I’d also consider using it to have a GP stationed at night in the busiest A&Es to try to get through any standard GP type queries/appts on entry to A&E.
Idea is to more to try to deter missed appointments (not even calling to cancel)
chiefdave
Well-Known Member
Paying for GP visits is already coming in by the back door anyway. When I go to the pharmacy to pick up my prescription they make sure to tell you every time that if you can't get an appointment with the GP they offer a same day appointment service for £80. Given its near impossible to get a GP appointment, and if you can there's even less chance you can get it at a time that fits around work, these services will be used more and more until they become the norm.
When I was in hospital recently chatting to one of the doctors there he said they had seen a huge surge in the last couple of years in the number of people turning up at the hospital because they simply had nowhere else to go, therefore A&E ends up overwhelmed.
You're right on the two tier system as well. During my recent stay in hospital they found an issue with my blood. Not urgent enough to be sorted there and then but something that's a relatively high priority to get resolved. Got my appointment through for that, it's June 2015. Do I spend a year hoping it doesn't lead to further problems or pay to get it sorted privately even though I can't really afford it?
shmmeee
Well-Known Member
Philosoraptor
Well-Known Member
What on Earth are you wittering about. It is as clear as day as what was said.
Philosoraptor
Well-Known Member
You posted it
Oh, I meant Labour's side where they said actual GP appointments and not appointments at GPs.
You must have a reliable source.
D
Deleted member 9744
Guest
This is exactly what people who talk about alternative models to the NHS want. Basically they want poor people to get worse care and the rich to be able to pay for the best. Problem is most people won’t appreciate the NHS until we lose it.
Philosoraptor
Well-Known Member
You posted it
Could I interest you in voting green?
Ccfcisparks
Well-Known Member
The March was fantastic today. Quality representation of our society. All races, religions and ages.
chiefdave
Well-Known Member
In practice how would that work? Fines are only effective if there is some threat of something happening if you don't pay. Are we going to start jailing people who miss a doctors appointment, or cut off peoples access to healthcare?
Think before you even consider fining people you have to fix the appointments system because, with my GP at least, it is completely broken.
Pre-covid if you needed a non emergency appointment you could book months ahead using an online system, therefore you could plan round work etc. That system has been removed.
You now can't book any appointment in advance only on the day so everyone who needs an appointment but it emergency, a follow up you've been requested to book by the GP or hospital, routine, are all in the 8am scramble.
Inevitably by the time you get through there's no appointments. If you're 'lucky' you might be offered a phone appointment. That means at any point in the following 10 hours the GP will ring you, if you don't answer you've missed an appointment and are back to square one.
The GP also point blank refuses to discuss more than one thing in an appointment so if, as I do currently, you have several health issues at the same time that need routine appointments you have to constantly phone at 8am for an appointment. And in the event you can't get one eventually, as happened to me recently, you end up in hospital for several days with doctors and consultant furious at the GPs lack of action.
chiefdave
Well-Known Member
Don't even get me started on this. I got referred for a mental health assessment a while back. Took several months for the assessment to take place. The 20 minute assessment end up taking 90 minutes and resulted in me being made a priority and given emergency contact numbers for places like that samaritans. Which was all a bit strange to me as I was discussing life long issues I'd never really realised before that didn't affect everyone.
Was then on a waiting list for 2 years to see someone. Had a couple of meetings, via Skype, that were OK but then my job changed and working from home wasn't an option anymore and the system seems to have no capacity for either in person treatment or anyone who doesn't have enough privacy at work for Skype sessions in working hours to be practical.
End result after all that waiting was being told there was no treatment available.