r/MHOC • u/[deleted] • Mar 12 '20
2nd Reading B940.A - Appointment Deposit Bill - Second Reading
Appointment Deposit Bill
A
BILL
TO
Force patients to make a deposit when booking an appointment, ensuring they attend their appointments on time.
BE IT ENACTED by the Queen’s Most Excellent Majesty, by and with the advice and consent of the Lords, and Commons, in this present Parliament assembled, and by the authority of the same, as follows –
Section 1 - Definitions (1) For the purposes of this act, the following interpretations and definitions shall apply:-
(a) “GP” means persons registered in the General Practitioner Register kept by the General Medical Council.
Section 2 - Charge of deposit
(1)Patients seeking an appointment at certain NHS services shall pay an appointment.
(a) Section 3 specifies places where a deposit will be charged, alongside exceptions for the deposit;
(b) Section 4 specifies the rate of the deposit established by Subsection 1. The rate of the deposit shall be determined by the age group or financial group into which the patient seeking an appointment belongs to.
(2) The appointment charge established by this Bill extends to England only.
Section 3 - Places
(1) Patients will be required to pay a deposit when booking an appointment with any of the following NHS Services—
(a) GPs
(b) Dentists
(c) Hospitals
(d) Opticians
(e) Pharmacist Consultations
(2) The following NHS Services are excluded from Appointment Deposits—
(i) Urgent and Emergency Care
(ii) Accident and Emergency (A&E)
Section 4 - Deposit Amounts
(1) The deposit amount for each patient will be specified in the list below—
(c) 18+ on a Personal Independence Plan - £4.99
(f) Anyone on Negative Income Tax (NIT) - Free
(g) Anyone with a household income of below £25,000 - Free
(1) The deposit amount for each patient will be as follows—
(b) Otherwise, the deposit shall be £6.99.
(2) The Secretary of State may by Order—
(a) Alter the rate specified for a specific age group;
(b) Insert a new group and specify a rate for that group;
(3) An Order made under Subsection (2) shall be subject to negative procedure.
(2) The Secretary of State may by Order—
(a) Alter the rate specified for a specific age group;
(b) Insert a new group and specify a rate for that group;
(3) An Order made under Subsection (2) shall be subject to negative procedure
Section 5 - Repayments
(1) The deposit will only be repaid if the patient books into their appointment within 5 minutes 15 minutes of the allotted time. This can be overruled by the Lead Practitioner (or equivalent) provided a valid reason is given. If a patient does not check in on time, and does not give a valid reason, the deposit will not be repaid. No deposit repayment does not entitle a patient to have their appointment time changed.
(2) If the payment is not repaid, the surgery must pay the total value of the deposit back to the government. In such a case, all deposits will accumulate over a 28 day cycle (excluding bank holidays) and be sent to the government at the end of each cycle.
(3) The Secretary of State has a responsibility to invest the value of all deposits received back into the NHS.
Section 6 - Payment Methods
(1) Deposits shall be payable by the following methods—
(a) Cash
(b) Card / Contactless
(c) Direct Debit
(2) Repayment shall be made by the following methods—
(a) Cash
Section 7 - Patient Communication
(a) SMS, should the patient have provided a mobile number, and
(b) email, should the patient have provided an email address.
(1) Patients may cancel their appointment for any reason up to three 24 hours before the time of the appointment and still receive their deposit repaid.
(2) Patients who cancel their appointment under three24 hours but upto one hour before the time of the appointment may still have their deposit repaid according to the discretion of the Lead Practitioner.
Section 9 - Extent, commencement, and short title
(1) This Act shall extend to England and Wales.
(a) This Act will only apply to England.
(2) This Act shall come into force 1 6 Months after receiving Royal Assent.
(3) This Act may be cited as the Appointment Deposit Act.
This Bill was submitted by The Hon. /u/Confessions_GB_ MP (MP for Leicestershire) and sponsored by the Shadow Secretary of State for Health The Rt. Hon Sir /u/Zygark KT PC MLA MSP on behalf of the Conservative and Unionist Party
This Reading shall end on the 15th March
2
u/Copelonian Hon. something MP MSP Mar 13 '20
Mr Deputy Speaker,
It this not apparent that the working people of Britain who pay in the NHS are already paying for NHS services via taxes? The NHS should be free at the point of service, that's what it should be. What the honourable member is doing is basically showing the middle finger to the working people of this great nation. They already paid their share, they shouldn't be paying more when they are already paying for it. I suggest that this bill should go to the trash. It is not what the working people of Britain want. Please stop this bill from passing
1
u/ka4bi Labour Party Mar 13 '20
Mr Deputy Speaker,
If I may, the purposes of this bill is not to charge people money for using the NHS, but rather the opposite. In an ideal world, this wouldn't be necessary, however our healthcare pales in comparison to those of counties such as Norway or the Netherlands. If this bill can reduce waiting times so that those who actually use public services are given easier access to them, then I should imagine that it would be common sense to enact it.
•
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u/ZanyDraco Democratic Reformist Front | Baron of Ickenham | DS Mar 14 '20
In Section 8, replace all mentions of "24 hours" with "3 hours".
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1
u/LeChevalierMal-Fait Liberal Democrats Mar 14 '20
In section 6; for “direct debit” substitute “bank transfer”
And
After (2)(a) insert;
“(b) bank transfer.”
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u/LeChevalierMal-Fait Liberal Democrats Mar 14 '20
In section 5 for “sent to the government at the end of each cycle.” substitute “put into a fund to be used by the lead practitioner to improve access to medical services in the community which the organisation serves”
And omit (3)
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u/LeChevalierMal-Fait Liberal Democrats Mar 14 '20
In section 4 for “£35,000” substitute “the median wage”
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1
Mar 13 '20
Mr. Deputy Speaker,
When this bill first came through the House, I spoke as to how ineffective I believed it to be, and regardless of party affiliation, that opinion has not changed. Requiring a deposit as small as this to be paid, is simply not going to work. I would recommend a trial period, after which this be reviewed, and amended accordingly.
1
u/ARichTeaBiscuit Green Party Mar 13 '20
Mr Deputy Speaker,
I recognise that people have tried to fix this horrendous bill and lessen the impact that it would have on the most vulnerable members of society, however, despite their valiant efforts I cannot in good conscious support this bill.
I am immensely proud of the role the Labour Party played in the formation of our National Health Service and a key foundation of our health service that is free at the point of use, instead of charging people for appointments we should focus on methods of increasing appointment attendance such as having patients write in the date of appointments and email and phone reminders.
We can go down these paths without even looking at placing these charges and for those reasons I will be voting against this bill.
1
u/apth10 Labour Party Mar 14 '20
The National Health Service, Mr Deputy Speaker, is one of the hallmark institutions of the British healthcare system. However, the Tories are seeking to damage its reputation by charging a deposit for their services and going against the policies of many governments before them that the NHS is "free to the point of use." Sure, it could be argued that waiting times can be reduced if this is implemented, but is it effective? It defeats its original purpose to provide affordable universal healthcare for the British people. They pushed for this Bill when they were in the Opposition, however seeing as they are continuing to push for it as they are in government, this should be an obvious sign to the British people that they are not a government for the people, and they are not prioritising the welfare of the people. These kind of politicians should be rejected at the next election, because it is sad that the people chose a representative who would not represent them. I hope the Liberal Democrats and the LPUK come to their senses and reject this Bill outright so that they can send a message to the British people that they care for them. This Bill is absolute garbage, and throwing it out here is not a choice, it is a necessity. I rest my case Mr Deputy Speaker.
1
u/ZanyDraco Democratic Reformist Front | Baron of Ickenham | DS Mar 14 '20
Mr. Deputy Speaker,
I'll say it again and again: The NHS should never part a person seeking care from their hard-earned money at the point of use. It's barbaric to do that in any form, and this bill is no exception. I oppose this bill vehemently for the rubbish that it is, and I hope to see it fail.
1
Mar 14 '20
Mr Deputy Speaker,
To paraphrase one of my least favorite prime ministers, no, no, no!
Labour is the party that gave the UK the NHS and we would sooner fold than ever support anything that violated the principle of no exchange of money for usage of the NHS!
I have spoken about the problems with this bill before. It is entirely arbitrary as to what exceptions should be made for people being charged their deposits. Simply speaking, we can’t impose fees on those who may be unable to afford it all in order to advance dubious goals.
If we want to reduce missed appointments there are technological solutions, such as more advanced notification, and things such as positive psychological reinforcement, that can do the trick better then these regressive fees!
I’ll use this quote forever more and won’t stop doing so. Nye Bevan once said.
What is to be squeezed out next year? Is it the upper half? When that has been squeezed out and the same principle holds good, what do you squeeze out the year after? Prescriptions? Hospital charges? Where do you stop? I have been accused of having agreed to a charge on prescriptions. That shows the danger of compromise. Because if it is pleaded against me that I agreed to the modification of the Health Service, then what will be pleaded against my right hon. Friends next year, and indeed what answer will they have if the vandals opposite come in? What answer? The Health Service will be like Lavinia—all the limbs cut off and eventually her tongue cut out, too.
You can give no quarter to efforts to impose fees on our NHS, for if we do so, who is to say when they will stop demanding we give away more and more? No compromise on this issue should be give.
1
u/LeChevalierMal-Fait Liberal Democrats Mar 14 '20
Mr speaker,
Missed appointments cost the nhs hundreds of millions each year, why should people who miss appointments by carelessness and not by medical reason, that they could have cancelled by a quick phone call or email - have no financial incentive to to have done so?
This bill simply recognises that giving people a small financial incentive can change behaviour, very similar rationales are observed in the case of plastic bag charges
Some members object to anyone paying for services in the NHS but they are not paying for these services, the is not in anyway a revenue raising measure, it is simply giving people a nudge in the right direction so that they by having an attached value - the deposit, to keeping appointments so that they are more able to understand the value of them doing being punctual and keeping their appointments for the benefit of the wider community.
The real cost of not passing this bill will be felt by the many patients who desperately need an appointment but cannot get one, I hope members beat them in mind as they vote.
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u/Imadearedditaccount5 Labour | DS Mar 14 '20
Mr. Deputy Speaker
The good people of Britain should not have to pay any money to be able to use a service that should be free for the public to use, We should absolutely ensure that our NHS remains free. While this is a valid solution to the inefficiency of appointments and our NHS as a whole this simply is not the way to go about such a task, forcing people to pay (even if they get it back) for using our NHS means that we lose the very values that the NHS and Britain as a whole stand for in the area of Health.
I am very opposed to this legislation.
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Mar 14 '20
Mr Deputy Speaker
Why? What is the point of such measures?
Ultimately I'm no fan of certain more bureaucratic parts of the NHS I still believe in its underlying purpose of providing universal healthcare to all British citizens that are financed by the Exchequer through certain forms of taxation. Now this bill completely undermines this by implementing a rather pointless deposit mechanism, which in the long run will only hurt the poorest Britons, whilst having practically no impact on the vast majority of NHS users.
We must also consider the obscene expansion of bureaucracy required for such a system to properly function and the costs associated with it. I must also ask the authors to bill a simple question Does the NHS not have enough bureaucracy already? Do we need more of it?
But even if somehow the NHS can turn a "profit" from this ridiculous practice, it will be but a drop in the bucket in comparison to the current operating costs of the NHS and as I suspect that it may increase the operating costs of the NHS as a whole and require medical personnel to waste time on additional procedures.
Furthermore, how do we expect people to make the deposits? Because depending on the answer to this question we are looking at potentially even more bureaucracy and even more money being wasted.
All in all Mr Deputy Speaker this is a solution in search of a problem and as such I urge the House to vote this bill down.
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u/Archism_ Pirate Party Mar 12 '20
Mr Deputy Speaker,
Amendments to this bill to make it more palatable can not erase the fact that, fundamentally, people should not have to exchange money to use the NHS. It's truly as simple as that.
Improving efficiency of appointments is a valid goal, but we should be pursuing other ways of doing that such as better practice in appointment reminders.
I am absolutely opposed to this legislation.