Patients to be fined for wasting NHS time

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A crackdown on patients who abuse the health service, including possible fines for missing an appointment, is being prepared by ministers in return for Gordon Brown's £40bn boost for the NHS from taxes.

Patients will be required to sign new contracts with their doctors, setting out their responsibilities as well as their rights. Ambulance staff may be told to ignore time-wasters.

Secretary of State for Health Alan Milburn is under Treasury pressure to deliver more efficiency in return for the landmark 7.5 per cent increase in health spending by the Chancellor over the five years to 2008.

"We have a right to expect decent services and to know where the money has gone in the health services. But patients also have a responsibility to use them wisely," Mr Milburn said.

On the possibility of fines he added: "We will have to look at that." The Wanless report into the NHS found 1.56 million missed hospital appointments ­ 12.5 per cent of the total in 2000. It estimated there could be 30 million missed appointments with family doctors each year ­ around 600,000 a week.

Private dental practices have imposed similar fines for some time. The British Medical Association last night condemned charges for missed appointments as "bureaucratic and unworkable".