§ Dr. Tonge
To ask the Secretary of State for Health (1) what percentage of patients failed to attend their out-patient appointments for(a) general medicine, (b) surgery, (c) radiology and (d) professions allied to medicine, in the last 12 months; 
(2) what estimate he has made of the annual cost to the NHS of missed out-patient appointments; 
(3) what plans he has to penalise patients who fail to attend out-patient appointments; 
(4) what assessment he has made of the regional differences in missed out-patient appointments. 
§ Mr. Hutton
Information on patients who, in 2000–01, failed to turn up for their out-patient appointments for general medicine, general surgery and radiology is given in the table. We do not collect information on out-patient appointments with professions allied to medicine.
Percentage Specialty Did not attend (DNA) rate General medicine 11.0 General surgery 10.1 Radiology 8.7
DNA Rate: percentage of patients who failed to attend their first out-patient appointment without notifying the trust
QM08 quarterly returns
Regional variations for all specialities is given in the following table.
Percentage DNA rate Region 1996–97 2000–01 Northern and Yorkshire 10.2 10.6 Trent 10.1 10.3 Eastern 8.7 8.7 London 15.7 16.7
Percentage DNA rate Region 1996–97 2000–01 South-east 8.6 9.7 South-west 8.3 7.9 West Midlands 11.3 10.8 North-west 11.2 12.1 England 11.0 11.4
QM08 quarterly returns
We fully accept that missed appointments can result in wasted resources and patients waiting longer than they need to. It is not possible to estimate the financial cost of this to the national health service because trusts usually have systems in place to minimise the impact of patients failing to turn up.
We do not plan to penalise patients who fail to attend. Instead we are introducing booking systems that give patients the opportunity to choose a date and time for their appointment that is convenient for them. By knowing their dates well in advance patients are able to make work, child care or any other arrangements in good time. These systems also make it easier for patients to change their appointments if they find they cannot make the date they originally agreed. Booking systems have been proved to reduce DNA rates significantly.
Under our NHS Plan two thirds of out-patient appointments with consultants and elective admissions to hospital will be pre-booked by March 2004 and all will be pre-booked by the end of 2005.