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What I want in the Budget: penalties for those who miss NHS appointments

16 March 2014

Every year the Budget comes and goes, amid a flurry of live blogging and urgent blog posts at The Spectator. And almost every year, the papers are full of the minutiae which make for entertaining headlines. So this year, I say: Please, no more pasty taxes.  They just lead to days and days of stupid headlines, which might be fun (for the first hour), but simply end up detracting from the more serious announcements; or rather, the ones that will actually affect most taxpayers.

Anyway, moving on. For selfish reasons, I am entirely in favour of raising the basic income tax threshold. I know that the Tories and the Lib Dems have been squabbling over who it is that we have to thank for this proposal, but either way, thank you, and please continue.


On Saturday morning I was reading about the magician, Paul Daniels, whose late mother’s house is in his name so he will have to pay 28% tax if he sells it. This all seems a bit rum to me. Plenty of people in Britain need homes and want to buy them, so why not make it easier for people to sell the houses that they no longer want, or need? Decreasing capital gains tax might, it seems to me, encourage more people to sell.

When it comes to the NHS, I think that we’re jolly lucky to have it – despite the criticism levelled at it. But, it is extremely expensive. For starters, I would charge people for missed appointments. Obviously, they’d have to make sure that appointments are easy to cancel (via text, online, phone etc). But if people had to pay a tenner every time they didn’t show up at the doctors’ or hospital, it might prevent NHS employees’ time from being wasted.

And finally, in his recent Spectator Notebook, the Chancellor seemed inspired by the ‘infrastructure of the future’ that he saw in Singapore and Hong Kong. I’m still not convinced about HS2, but I’m all for Mr Osborne increasing our airport capacity.

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  • saffrin

    What I want is to see patients being financially compensated every time the NHS cancel an appointment or operation, paid in multiples of if either lead to an unnecessary death.

  • tjamesjones

    NHS would IMO be improved if you just charged for *all* appointments, say £10 or £15. As we already do with dentists. (&I think this is how they manage primary care in Australia). And so making a doctor’s appointment then has a useful hurdle to disincentive the bored, lonely and addicted. So it’s not a “fine” it’s a charge.

    After all, we expect people to pay for their own food, paying nominal amounts for medical care is hardly a different case. So long as we leave in insurance for catostrophic cases, which is quite a separate matter.

  • Daniel Maris

    “For starters, I would charge people for missed appointments.”

    A sure sign of someone who’s never had to organise anything in the real world. How much do you think it would cost to administer such a system with all the complicated and contested appeals that would be involved?

    Most of the people who miss the appointments will of course be alcoholics, drug addicts, and patients with severe neuroses or psychoses. Are you going to fine a schizophrenic because they were having hallucinations when they were supposed to be turning up. And what about novovirus patients who turn up to find the notice telling them not to proceed into the surgery? What about alzheimer’s patients who forget their appointments? What about cancer patients too scared to turn up?

    • Wessex Man

      Oh do get real, get off your Class Charger for a few minutes, On Thursday I had to have a Cardiograph, on the Reception wall wall a notice stating that in February 98 appointments had been missed, on Friday my first phyio appointment, missee February appointments 129.

      Don’t tell me they were all genuine in one small hospital that we are lucky never went the way of others when Blair and Brown were closing Cottage Hospitals.

      Reception Staff tell me it was far worse in January, yet the nearest floods were 15 miles away and some miss at least half a dozen before attending.

      On the back of my appointment letters were translations into- Albanian, Arabic, Bengali, Chinese, Farsi, Gujarati, Hindi, Polish, Portugese, Punjabi, Somali, Turkish and Urdu.

      You couldn’t make it up. All missed appointments should be charged at £10, two missed appointments charged £25 and three means you don’t get any more. If you can’t speak English get someone to translate for you or learn yourself!

    • Aberrant_Apostrophe

      They should do what airlines do – overbook by a number equivalent to the average number of passengers who fail to turn up. I have a sneaky suspicion that’s what my surgery does already.

  • JimmyLinton

    What I want is a reduction in the 45% tax rate. Simple. I, along with my fellow 1%’ers, am fed up bankrolling this circus.

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