§ 7. Sir David Priceasked the Secretary of State for Social Services what is his estimate of the effect upon National Health Service costs of patients failing to keep their outpatient appointments.
§ 19. Mr. Adleyasked the Secretary of State for Social Services what further information he has received, since he last answered oral questions, on the number of National Health Service patients not keeping appointments duly made for them at National Health Service hospitals; and if he will make a statement.
§ Mr. John PattenWe do not at present collect the information which would be needed to estimate the cost of failed appointments.
The Health Services information steering group has recommended that the number of failed appointments should in future be included in statistical returns to health authorities and to the Department, and health authorities have been asked to plan on this basis.
If patients are to be encouraged to keep their appointments, it is important to look carefully at the way the clinics are run. This is primarily a local responsibility, but we are considering whether the Department could usefully give further guidance on the organisation of outpatient appointment systems and will be discussing this with the medical profession.
§ Sir David PriceTo encourage my hon. Friend and his Department to follow the line of action that he has proposed in his reply, may I ask whether he is aware that in one hospital in Hampshire, in the month of March, 1,200 patients failed to keep their outpatient appointments? Does he agree that this not is a unique experience and that it is a matter to be taken seriously at the Elephant and Castle?
§ Mr. PattenI am aware of my hon. Friend's concern and of the problem in the Southampton and South-West Hampshire district health authority. Two things have to obtain. First, clinics have to be well and efficiently run. Secondly, prospective patients must recognise their moral responsibility to turn up on time for appointments in order not to waste valuable National Health Service resources.
§ Mr. AdleyIs my hon. Friend aware, pursuant to my raising this question at the last DHSS Question Time, that asking patients to rely on their moral responsibility is hardly concomitant with the Government's responsibility effectively and efficiently to manage the Health Service? I am glad that one of my hon. Friends says nonsense, because that confirms the rectitude of my view. Will my 748 hon. Friend confirm that the Wessex area health authority is not unique in this regard and that a large sum of money and the time of many skilled doctors are wasted as a result of what is going on?
§ Mr. PattenI agree with my hon. Friend. I said as much to our hon. Friend the Member for Eastleigh (Sir D. Price) a moment ago. My hon. Friend is right. As at the last DHSS Question Time, I point the finger at the need for more effective management in the Health Service. That is why we rely so much on the recommendations of the Griffiths report, which my right hon. Friend has commended to the House.
§ Mr. MeadowcroftWill the Minister accept that one reason for failed appointments is that the time that elapses between making the appointment and the appointment date is lengthening in many areas? Will he institute research into the link between lengthening waiting times for appointments and failed appointments?
§ Mr. PattenI can give the hon. Gentleman some good news. We are discussing with the West Midlands regional health authority the possibility of running an experiment in that area—a bed bank experiment—to look at exactly these issues.
§ Mr. Allan RobertsIs the Minister aware that one of the reasons why people find it difficult to keep appointments is the long distances that they have to travel because small community hospitals, such as the Waterloo hospital in my constituency, which provide a worthwhile service are being closed? Many people who travel long distances cannot get financial assistance, even though they are unemployed or on low incomes. A constituent of mine will go blind if she does not get financial assistance from the Health Service to enable her to travel to London for treatment.
§ Mr. PattenIt is the policy of my right hon. Friend the Secretary of State to keep a good balance of Health Service provision in large and small hospitals. The hon. Gentleman has only to look at the figures for GP beds in such small hospitals to see that they have not gone down in the last five years.
§ Mrs. Jill KnightWill my hon. Friend accept that, although he has been unable to give the House any figures, the cost of these missed appointments must be great, as must be the effect on waiting lists? Furthermore, any patient who knows that he cannot keep an appointment can always telephone and say so. Will my hon. Friend consider the possibility of improving arrangements to encourage patients to keep appointments?
§ Mr. PattenOf course we will. I am grateful to my hon. Friend for her remarks. It may be of interest to her and to my right hon. and hon. Friends to know that the average cost of a broken appointment seems to be between £20 and £50.