It's not about Health but illness – instead of keeping us healthy it's focused on treating us when we're not. And it's not a Service – created in the 1940s, it's more suited to a time when open rationing was the norm and we were grateful for whatever we were given.

But although there's a lot that's still true about those statements, huge efforts have been made in recent years to adapt the NHS to the modern world.

Under its forward-thinking chief executive Simon Stevens – who has been in place since 2014 – the NHS has made great strides in waking up to the idea that the "S" in NHS is critical.

The NHS is there to serve us, rather than making us simply fit in with what is on offer. This is especially true for general practice – the field in which the majority of us have most contact with the NHS.

For many years, too many GPs behaved as if patients were annoyances who interfered with the smooth running of their day rather than the entire point of their existence.

Some surgeries would be open only at restricted times and on limited days – such as between 9am and 4pm, Monday to Friday.

If the surgery was first come, first served, you might have to queue for hours just to be seen. So even if you wanted to see the doctor for only a few minutes, you might still have to take a day off work.

And even if you were with a GP who used appointments, you'd sometimes have to wait a fortnight for the privilege. As a patient, you would have to be ridiculously patient.

In an age when we can order a three-course meal on an app and have it delivered within 20 minutes, and when we are used to being in control of every aspect of our lives, that aspect of the NHS was an anachronism.

In Simon Stevens, the NHS has a chief executive who understands that it needs to adapt to the 21st century.

And one key aspect of that has been how we are able to access our GP. That's why so much time, effort and, yes, money is being spent on introducing evening and weekend appointments – giving patients the chance to see a GP at a time that is actually convenient.

Until now, these have been only pilot schemes.

This week, however, the Government has made clear that, by March, everyone will have the chance to see a GP in the evening or at the weekend.

A lot of nonsense has been written in response to this, arguing that it's all a waste of money.

According to figures from the pilot schemes, more than £15million has been "wasted" through a total of 501,396 of these newly extended GP hours not being used.

The plan is nonetheless to push ahead with spending more than £500million on the scheme to have full 8am-8pm GP surgery opening times, seven days a week, by 2020/21 – even though 37 per cent of Sunday appointments are so far being left unused, 23 per cent of Saturday appointments and 23 per cent of evening appointments.

But this misses the point completely.

For one thing, very few of us realise that these pilot schemes exist.

And as NHS England pointed out in response to the figures, in a survey for Pulse magazine, six out of 10 CCGs did not respond to the survey, and "the more representative results of the annual GP survey and the patient response to new digital first GP providers is clear – patients want quicker access to a trusted GP, both during the working week and outside traditional surgery hours. And patients are prepared to vote with their feet to get it."

Take one of the pilot schemes, the brilliant GP At Hand app.

I registered with it a few months ago and it is wonderful. If I need to see a GP, I go to the app and an appointment is usually available within the hour.

Then I have a video consultation with a GP – and I can do it while I'm at work.

If the NHS is to survive in anything like its present form, it simply has to adapt.

But this works both ways. Because one of the worst problems the NHS has to deal with is people who do have an appointment but simply don't turn up for it.

Oddly, there are no central statistics for this, but in 2015 NHS England estimated that more than 12 million GP appointments are missed every year.

Since every 10-minute GP slot costs the NHS about £25, that means in the region of £300million is wasted every year. This is NHS – and therefore taxpayers' – money down the drain.

It can't carry on. The NHS needs to adapt to our needs, yes. But it's under increasing financial strain to do so. Every penny counts.

In return for making the NHS more responsive to our needs, we need to make patients responsive to the basic need of the NHS for us all to stick to our appointments.

Urging people isn't working.

So we need to start charging people who waste their GP's time by booking an appointment and not turning up.

Perhaps a £10 charge for a no-show would make people think twice. There's even a case for charging the full, wasted £25 cost.

Whatever the sum, it's time to make sure all patients realise that if they want to keep an NHS free at the point of use, they have to stop abusing the idea.

Source: Express