A depressing truth about our world - people don't value things which are free:

Missed hospital appointments cost the NHS almost £1 billion a year and deprive patients of vital care, the health service’s top nurse has said.

As the service heads into what is likely to be the busiest week of the winter, Jane Cummings, the chief nursing officer for England, called for the public to be more responsible about wasting time and resources.

A million more cataract operations or 250,000 hip replacements could be funded if the NHS did not have to pay for appointments that people failed to attend, she said.

Official figures show that 7.9 million appointments were missed in 2016-17, meaning that patients do not turn up to one in 15 of the 119 million scheduled. At an average cost of £120 per slot, this indicates that doctors’ time worth about £950 million was wasted last year.

This is, of course, a pure economic waste. We are being made poorer by this amount simply because people are not turning up to those "free" appointments. This is, equally of course, something that we'd like to change.

We could, yet again of course, just insist that all should buck up and do their duty. Or we could follow Polly Toynbee's constant and consistent mantra, that we should be more like Sweden. That is, have a little judicious application of economic incentives.

The overall costs of an appointment there are about as they are here, perhaps 1,800 to 2,000 SEK, or in that £160 to £180 range. Given government accounting that is pretty similar to our own costs. But the Swedish insist that the patient - or would be patient perhaps - must personally cough up in the £10 to £20 range for the service. 

No, this isn't some charge to pay for the system at all, it's purely an incentive for someone to turn up when they say they wish to turn up, it's a management of the capacity of the system charge, not a revenue raiser. In much the same manner as we pay a prescription charge in fact. Larded around with all of the exceptions as well, people who need many prescriptions/visits pay a reduced or capped amount.

The thing being that people value more what they've got to pay for. Even at a 90 to 95% discount, people still value such things more if they've got to cough up for them.

Or as we could also put it, as those socially democratic Swedes do it, at least one solution to the problems of the NHS is to stop it being free at the point of use.