A lack of respect by younger generation
It has become an increasing problem. The problem seems to be focused on young men and women. Older people respect the service.
They understand it is a community service and they use it appropriately and carefully.
Young people seem to see it as a convenience service and if it isn't convenient for them, they simply don't turn up. We have patients missing appointments, not just once or twice but repeatedly.
I think GPs are very clear that they don't want to charge patients or don't want to fine patients and I think that runs contrary to the relationship we have with patients. But we need patients to recognise that they can't repeatedly miss appointments.
The point is if you fail to turn up for an appointment, you deprive somebody else of that appointment and we don't have sufficient resources for all the patients who want to be seen at the moment.
What is happening now is a lot of practices have introduced three strikes and you're out policies.
So if you miss three appointments in a calendar year, you will be asked to leave the practice and go and avail of services elsewhere.
What happens is if you miss an appointment, a letter will be sent out to say they have missed an appointment. If they miss two, they are told the practice policy is that they will be removed if they miss another appointment within the calendar year.
If you miss a third one, a lot of practices will remove them from the list. We have the increasing problem now of practices that are struggling to take on new patients and a reason behind that is they cannot recruit doctors. What we are mostly talking about here are young, healthy people who regard General Practice as a convenience to drop in and out of.
Tom Black is the chair of the Northern Ireland General Practitioners Committee