Stop letting time-wasters drain the NHS: Why missed appointments should come with a fine
More funding, more staff, and more hospitals. Much of that is justified, but it has also become the only conversation we are willing to have. Hardly anyone wants to ask what the public owes the NHS in return, and that has become one of the biggest blind spots in the debate about its future.Missed appointments are not just an unfortunate administrative problem that can be brushed aside at the end of the day. They are empty consulting rooms while patients sit on waiting lists, clinical staff lose valuable time, and taxpayers pay the bill for appointments that go unused. Every appointment that’s missed without warning is another opportunity lost for someone who really needed it.The NHS estimates that around 15 million GP appointments are missed every year, costing roughly £600 million, which is around £30 to £40 per appointment missed. We wouldn’t shrug our shoulders if that amount of money was wasted elsewhere, yet when it comes to missed appointments, we’ve somehow convinced ourselves it’s just one of those things, which it isn’t. It’s a drain on a service that is already struggling to keep up with demand.We’ve become so focused on criticising governments that we’ve stopped talking about patient behaviour. Of course, the government is responsible for funding the NHS properly, recruiting enough staff and planning for rising demand. However, not every problem starts in Westminster. Some start with people booking appointments they never intend to keep or deciding not to turn up without giving any notice.That is why the idea of a modest £10 or £20 fine for repeatedly missing appointments without a valid reason deserves a serious conversation instead of instant outrage. This isn’t about charging people to see a GP or abandoning the principle of healthcare free at the point of use. The NHS should remain free for everyone who needs it. The fine isn’t for receiving treatment; it’s for wasting a public resource that someone else could have used.The argument against fines is usually built around the people who would never be the target in the first place. What about someone having a mental health crisis? What about a patient with dementia? What about somebody whose circumstances genuinely prevented them from attending? They’re all genuine concerns, which is exactly why any system would need exemptions. A well-designed policy can achieve both compassion and accountability.People rarely talk about those who do everything right. The patients who turn up on time after waiting months for an appointment. The patients trying to get their child seen. The worker desperate for treatment so they can get back to their job. Every empty appointment means someone like them waits longer, not because there wasn’t time to see them, but because someone did not turn up. That’s the argument we’ve ignored for far too long.As a proprietor of Charles Rippen and Turner (CRT), which has supported GP practices since the inception of the NHS in 1948, I’ve seen firsthand how much pressure surgeries are under. I’ve seen dedicated clinicians working flat out to meet rising demands, which is why it’s so frustrating to watch valuable appointments go to waste when they could have been given to another patient.None of this suggests missed appointments are the biggest reason the NHS is under pressure. Workforce shortages, ageing infrastructure and years of underinvestment are some of the biggest challenges facing the service. But pretending patient behaviour doesn’t matter is as unrealistic as pretending another funding announcement will solve everything. The NHS cannot become more efficient if millions of appointments are missed each year without consequences.We’ve also become oddly uncomfortable talking about personal responsibility. Every NHS debate centres on what the government should do, what managers should do, and what clinicians should do. Those conversations matter, but they shouldn’t exclude the role patients play in protecting a publicly funded service. Rights and responsibilities have to sit alongside each other if the NHS is going to keep stable.The NHS is one of Britain’s greatest achievements because it’s built on the principle that everyone should receive care regardless of their ability to pay. That principle shouldn’t change. What should change is the assumption that free healthcare means people are free to waste it. Respecting an appointment is one of the easiest ways patients can help protect a service they all rely on.If we’re serious about saving the NHS, we need to stop pretending every failure sits with politicians and managers. Sometimes protecting the NHS starts with something much simpler: recognising that the public has responsibilities too.____________________Vijay Acharya is Managing Director of medical accountants at Charles Rippin and Turner.LBC Opinion provides a platform for diverse opinions on current affairs and matters of public interest.The views expressed are those of the authors and do not necessarily reflect the official LBC position.To contact us email opinion@lbc.co.uk
