B1497 – Missed GP Appointment Bill 2019 (Second Reading)

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B1497 – Missed GP Appointment Bill 2019 (Second Reading), TSR Libertarian Party
Missed GP Appointment Bill 2019

An Act to deter people from missing GP appointments by charging a fee.

BE IT ENACTED by The Queen's most Excellent Majesty, by and with the advice and consent of the Commons in this present Parliament assembled, in accordance with the provisions of the Parliament Acts 1911 and 1949, and by the authority of the same, as follows:—

1.Missed GP Appointment Fee
(1) A fee of £10 will be payable if an appointment is missed without reasonable excuse, which is at the discretion of the GP.
(2) A reasonable excuse may be, but is not limited to, one of the following reasons:
(a) The patient cannot get to the surgery due to public transport delays or cancellations
(b) The patient is in or on their way to the hospital
(c) The patient is looking after someone who is ill who is awaiting an ambulance or on the way to the hospital
(d) The patient is looking after a child who is ill and is waiting to see a GP or to go to the hospital.
(3) Payment shall be paid either online, or in person at the surgery, and pay the £10 by debit/credit card.
(4) It is up to individual surgeries to decide whether they will accept cash deposits in person and is up to them to make sure they have sufficient float to make this possible.

2.Cancelled Appointments
(1) An appointment will be classed as cancelled if it is cancelled
(a) online through the surgery's online booking tool,
(b) in person at least 2 working hours before the appointment,
(c) by phone at least 2 working hours before the appointment, and where the phone line is busy, a voice message left will suffice,
(d) by email at least 2 working hours before the appointment, if the surgery accepts email cancellations,
(e) by text at least 2 working hours before the appointment, if the surgery accepts text cancellations.

3.Exemptions
(1) Anyone who is under the age of 18.
(2) Pensioners of state pension age.

4.Fine
(1) The individual has 28 days to pay the fee according to clause 1.
(2) Failure to pay the fee within 28 days will incur a court order demanding payment.
(i) Fine will be 50% of the original fee on top of the fee.
(ii) Fine must be paid within 14 days.
(3) Failure to pay the fine within 14 days will result in no access to GP services until the outstanding fine has been paid.

5.Short title, Commencement, Extent
(1) This act may be cited as the Missed GP Appointment Act 2019
(2) This act comes into force on 1st April 2020
(3) This act extends to the United Kingdom

Notes
More than 15m GP appointments are wasted each year because patients do not turn up and fail to warn the surgeries they will not be attending. There are around 307 million sessions scheduled with GPs, nurses, therapists, and other practice staff every year and 5% – one in twenty – are missed without enough notice to invite other patients. Of these, around 7.2million are with busy family doctors, which adds up to more than 1.2 million GP hours wasted each year – the equivalent of over 600 GPs working full time for a year.

Each appointment costs an average of £30, putting the total cost to the NHS at more than £216million pounds on top of the disruption for staff and fellow patients that would pay for:

The annual salary of 2,325 full-time GPs

224, 640 cataract operations

58,320 hip replacement operations

216,000 drug treatment courses for Alzheimer’s

The annual salary of 8, 424 full-time community nurses

We believe this is unacceptable and waste of NHS resources which is already overstretched, as such, we are charging patients £10 if they miss an appointment and to encourage them to attend or cancel in advance.

2nd reading changes
*Updated clause 1 (1)
* Added clause 1(2) relating to reasonable excuses.
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LiberOfLondon
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Aye - the NHS is in bad enough state already without people using and abusing it at will.
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ecolier
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Again, please read my comments against this from a doctor's point of view.

https://www.thestudentroom.co.uk/sho...php?p=80547332
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BosslyGaming
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Personally feel this bill should involve a 'three strike' system before the fee is payable, or at least one warning before first fee. It's an issue which needs fixing, but handing people a fee on first offence shouldn't be the fix.
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04MR17
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I like the amendments to the first reading, this has certainly made the bill more appealing. However, I do question how much of the £216 million will be returned to the public purse if this is all at the discretion of GPs. The issue of GPs time is also something I question. Free slots in the day is a GP's opportunity to complete the inordinate amount of paperwork they have to go through on top of seeing and treating patients. This legislation would (ideally) reduce the amount of spare time a GP has in their working day and increase the workload without the time to do it, which will logically increase the professional's stress and therefore probably decrease the quality of care being provided.

4.3 is abhorrent as a measure and this compounds my disliking of the legislation itself.
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(Original post by ecolier)
Again, please read my comments against this from a doctor's point of view.

https://www.thestudentroom.co.uk/sho...php?p=80547332
Thank you for reminding us of what you said for the first reading. Whilst I come from it on the grounds that fines are expensive to collect and bear most on lower incomes, the other points you make are valid ones. The experience of the only other area where people independent of government levy fines is that of schools, which has not attracted widespread support.
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agree
(Original post by 04MR17)
4.3 is abhorrent as a measure and this compounds my disliking of the legislation itself.
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(Original post by 04MR17)
....
Your opinion is absolutely spot on.

A lot of clinic lists (this is for hospital appointments, not GP) are purposefully overbooked to ensure that the waiting list comes down, relying on the fact that some people miss their appointments.

Some doctors also truly value the time they gain from people missing appointments, in order to do paperwork.

:ta: for understanding this from the other side of the fence.

(Original post by barnetlad)
....
:yy: :ta:
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Mr T 999
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(Original post by BosslyGaming)
Personally feel this bill should involve a 'three strike' system before the fee is payable, or at least one warning before first fee. It's an issue which needs fixing, but handing people a fee on first offence shouldn't be the fix.
Three strike system still cost the NHS money if they miss all three appointments, I'm open to a first warning before fee.
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Make it easier to make appointments, have texts and other forms of reminders, and also a system if significantly running late that allows you to go and other things and come back. See what that does. Perhaps have a two tier prescription charge, lower if you have never missed an appointment, as an incentive.
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(Original post by 04MR17)
I like the amendments to the first reading, this has certainly made the bill more appealing. However, I do question how much of the £216 million will be returned to the public purse if this is all at the discretion of GPs. The issue of GPs time is also something I question. Free slots in the day is a GP's opportunity to complete the inordinate amount of paperwork they have to go through on top of seeing and treating patients. This legislation would (ideally) reduce the amount of spare time a GP has in their working day and increase the workload without the time to do it, which will logically increase the professional's stress and therefore probably decrease the quality of care being provided.

4.3 is abhorrent as a measure and this compounds my disliking of the legislation itself.
So we should let people miss their appointments and cost the NHS £216m just to free up GP schedule? Many GP's are able to cope with the paperwork with a fully booked schedule, it's not like stress will suddenly increase because we have fewer missed appointments. As mentioned in the notes this money can provide an annual salary of 2,325 full-time GPs, it can even be used to increase the GP salary which may increase job satisfaction.

4.3 is a measure that will rarely be used because most people should be able to afford the first fee of £10. This is a reasonable punishment and will ensure people actually attend their appointments rather than missing it.
(Original post by ecolier)
Your opinion is absolutely spot on.

A lot of clinic lists (this is for hospital appointments, not GP) are purposefully overbooked to ensure that the waiting list comes down, relying on the fact that some people miss their appointments.

Some doctors also truly value the time they gain from people missing appointments, in order to do paperwork.

:ta: for understanding this from the other side of the fence.



:yy: :ta:
Check my comments to 04.
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Mr T 999
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(Original post by barnetlad)
Make it easier to make appointments, have texts and other forms of reminders, and also a system if significantly running late that allows you to go and other things and come back. See what that does. Perhaps have a two tier prescription charge, lower if you have never missed an appointment, as an incentive.
Most GP already have text reminders and online booking platform. Why would we lower the fines if you never miss an appointment? You only pay the fine when you miss an appointment.
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This bill is in cessation.
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Division! Clear the lobbies!
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