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 Manning is a social entrepreneur, writer, campaigner and commentator. She is based in London and is the founder and Chief Executive of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal. Through networking, technology, research, relationships and campaigning 2020health has influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer at City University, a visiting clinician at the Royal Free Hospital, working with south London Primary Care Trusts and as a Director of the UK Institute of Optometry. She specialised in diabetes (University of Warwick Certificate in Diabetic Care) and founded Julia Manning Eyecare in 2004, a home and prison visiting practice for people with mental and physical disabilities using the latest digital technology, which she sold to Healthcall (now part of Specsavers) in 2009. Experiences of working in the NHS, contributing to policy development, raising two children in the inner-city and standing in the General Election in Bristol in 2005 led to Julia forming 2020health at the end of 2006. Julia is a regular guest on TV and radio shows such as BBC News, ITV’s Daybreak/ GMB, Channel 5 News, BBC 1′s The Big Questions, BBC Radio, LBC and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week. She is mum to a rugby-mad son, a daughter passionate about Shakespeare, and wife of a comprehensive school assistant head-teacher. She loves gardening, ballet, Zimbabwe, her Westies Skye and Angus, is an honorary research associate at UCL and a Fellow of the RSA.
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