Reilly: Charge no-show patients for appointments

Health Minister James Reilly wants hospitals to use text messaging to manage out-patient appointments.

“I want all out-patients attendees to be texted at least three days in advance and to text back either ‘Y’ or ‘N’ as to whether they are going to attend or not,” he said.

Dr Reilly said patients would be reminded again by text message on the day of their appointment.

“And if they don’t turn up and don’t respond, then I don’t believe it’s unreasonable that we should charge them the next time they wish to come.”

Dr Reilly, speaking at a conference in Dublin yesterday organised by the Health Management Institute, said out-patient departments should also show people some respect in managing appointments.

He said 35 patients should not be asked to turn up at 9am for just one appointment slot.

“That just displays disdain to our fellow citizens and that is possibly part of the reason why many people do not turn up,” he said.

Dr Reilly told how a paediatric clinic in the West had changed monthly appointments to better suit parents and their children.

“Quite often at these monthly sessions, it becomes clear that the parents and children did not really need to attend at all.

“So we are dragging parents away from their jobs, dragging children out of school — wasting time, wasting money.”

Dr Reilly said parents were texted in advance of the appointment and were delighted to be invited to be a real part of the team taking care of their child.

Many parents who replied to the text messages said their children were making progress and did not need to attend the clinic.

“This is a hugely important cultural change, where we bring the clients and the patients who use our service into the decision-making process. As a GP, I long ago [rejected] the paternalistic attitude that doctor knows best.”

Dr Reilly also said the importance of strong leadership in the health services was insufficiently valued.

Dr Reilly said the HSE’s Succession Management Programme was being piloted in each of the four health service regions.

An initial 30 people have completed the 12-month programme, a further 10 people started the programme last month, and an additional 60 would take part over the next year or so.

“This has to be a very positive development,” said Dr Reilly.

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