Unveiling the policy, the former chancellor, who is fighting to revive his bid for No 10 against rival Liz Truss, said the NHS was “meant to be free at the point of use, not free at the point of misuse”. About 6.6 million patients were waiting for scheduled care in May and Mr Sunak’s team said tackling the 15 million missed appointments each year could be “instrumental” in tackling delays. Patients who miss an appointment for the first time will be given the benefit of the doubt, but further no-shows will incur a charge of £10 each time. GPs and hospital trusts will be able to use their “discretion” in “exceptional circumstances”, they added. The British Medical Association (BMA), however, said the policy was not the answer to tackling the growing NHS backlog, saying a £10 fine for missing a GP appointment would “probably make things worse”. Professor Philip Banfield, chair of the BMA council, stressed that charging patients for missed appointments would “threaten the fundamental principle that the NHS provides free care at the point of need, for everyone”. “While it is disappointing when patients do not attend, the reasons why this happens should be investigated rather than simply resorting to punishing them,” he added. “Financially punishing patients inevitably affects the poorest and most vulnerable in the community. This may discourage them from re-booking, exacerbating already worsening health inequalities and costing the NHS more.’ Dr Gary Howsam, vice-president of the Royal College of GPs, also said that while missed appointments are “frustrating”, charging patients “is not the answer”. He added: “It would fundamentally change the principle that the NHS is free at the point of need and would likely impact on our most vulnerable patients – and add another layer of red tape to a GP service that is already drowning in red tape. “We also have to remember that there are many reasons why this can happen. For some patients, missing appointments can be a sign that something more serious is going on and that further action is needed. “For some, it would be a case of human error. For others, especially if the appointment was long-term, it may no longer be necessary.” Wes Streeting, the shadow health secretary, said: “Sunak’s attention-seeking ploy will do nothing to solve the worst crisis in the history of the NHS. This is a dangerously thin end of the wedge that will penalize the most vulnerable and cost the administrator more than it would raise.” Announcing the policy, Mr Sunak added: “Missed appointments are a big cost to the NHS. But worse than the cost is the impact on other patients waiting to be seen. “Everyone should be able to make an appointment with their GP and those waiting to see a consultant should visit as soon as possible. But the millions of missed appointments make it harder for people to get the care they need. “Under my government, there will never be a charge for care in our NHS. But I will charge people who waste valuable NHS time by making appointments and not attending.’