NHS Costs and charging: Publicity, shame and complexity

Commenting on today’s press about Jeremy Hunt has created waves with his new plan to state the cost of medicines on the label and with his comment last night (July 2nd) on Question Time that he is not opposed to charging patients for missed NHS appointments. The story is covered here.

2020Health’s top messagesChaging the culture 2010

  • Our short paper ‘Responsibility in healthcare: changing the culture’ (2010) recommended publicising the cost of medicines, devices and A&E attendance
  • We all need reminding to use NHS resources wisely – advertising the costs of treatment or missed treatment would help inform us
  • Flat fines for missing NHS appointments would hit those with the most complicated lives

Our take – clinical and political

2020health does not want to see anyone deterred from seeking medical advice when they feel they need it; flat fines for missed appointments may have this unintended consequence.

We value things more when we know what they are worth – especially the Brits who are more interested in value for money that European counterparts

All Political Parties should support schemes to reduce waste in the NHS

Some in the press have called this idea ‘shaming’ – feeling shame is important – shame means we feel we have done wrong and are more likely to redress a situation and try better next time.


Julia Manning, CEO of 2020health said: “We would not want to see a child who has just left care, or someone who is homeless, being told they can’t’ rebook an appointment until they have paid a fine. However we agree that we value things more when we know what they are worth and we recommended five years ago that we start publicising the cost of medicines on the packet. We think this will lead to a reduction in waste.”

About Julia Manning

Julia is a social pioneer, writer and campaigner. She studied visual science at City University and became a member of the College of Optometrists in 1991, later specialising in visual impairment and diabetes. During her career in optometry, she lectured at City University, was a visiting clinician at the Royal Free Hospital and worked with Primary Care Trusts. She ran a domiciliary practice across south London and was a Director of the UK Institute of Optometry. Julia formed 20/20Health in 2006. Becoming an expert in digital health solutions, she led on the NHS–USA Veterans’ Health Digital Health Exchange Programme and was co-founder of the Health Tech and You Awards with Axa PPP and the Design Museum. Her research interests are now in harnessing digital to improve personal health, and she is a PhD candidate in Human Computer Interaction (HCI) at UCL. She is also dedicated to creating a sustainable Whole School Wellbeing Community model for schools that builds relationships, discovers assets and develops life skills. She is a member of the Royal Society of Medicine’s Digital Health Council. Julia has shared 2020health's research widely in the media (BBC News, ITV, Channel 5 News, BBC 1′s The Big Questions & Victoria Derbyshire, BBC Radio 4 Today, PM and Woman's Hour, LBC) and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week.
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