Fining of patients who fail to attend appointments moved closed last night after Prime Ministerial candidate Rishi Sunak proposed a £10 charge.

The British Medical Association said the proposal “would likely make matters worse.” Mr Sunak, who is thought to be trailing his rival Liz Truss, said: “If they’re not being used, then that’s a waste. So if we can change that, then we basically get more out of the money that we’re putting in today. It’s a good example of a Conservative approach to that problem.”

BMA chair Professor Philip Banfield said it was “terribly disappointing” that the two Prime Ministerial candidates seem to have little understanding of the NHS. He said: “This latest suggestion would likely make matters worse. Charging patients for missed appointments would not only undermine the essential trust between doctor and patient, but ultimately threaten the fundamental principle that the NHS delivers free care at the point of need, for all. The BMA has always stood firmly against the idea of charging patients for missed appointments.

“While it is frustrating when patients do not attend, the reasons why this happens should be investigated rather than simply resorting to punishing them. Financially penalising patients inevitably impacts the poorest and most vulnerable in the community.”

The Royal College of GPs also rejected the proposal. Vice chair Dr Gary Howsam said: “When patients miss appointments, it’s frustrating as these are appointments that could have been used for other patients. But charging for appointments is not the answer. 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 most – and it would add another layer of bureaucracy to a GP service already drowning in red tape.

“We also need to remember there are many reasons why this might happen. For some patients, missing appointments can be a sign that something more serious is going on, and that follow-up action is needed. For some, it will have been a case of human error. For others, particularly if the appointment was longstanding, it may have no longer been needed. Practice teams work hard to ensure patients are aware of their appointments by sending reminders by text and email or encouraging them to manage their appointments online or through the NHS app. What is essential is that patients who are able to who no longer need their appointment, contact the surgery as soon as they can to let them know they won’t be attending, so that consultations can be offered to other patients.”

He added: “Ultimately, the bigger issue affecting patients’ ability to access GP care and services is the workload and workforce pressures family doctors and our teams are working under.”