There's a lot of merit in what you say, though I'm always concerned about taxing the sick, even if it is only a nominal charge. Whenever I go to the surgery I see the figures for 'wasted' appointments, and do wonder if that is exactly the way we should be looking at it. My surgery tends to be overbooked. People rarely even get a 10 minute consultation; and it's not as though the doctors are sitting there twiddling their thumbs waiting for the next patient because someone didn't bother to turn up. Just a thought. Edited to add: Of course, if people are not making use of booked appointments they are preventing other people from booking them.