GPs have called for patients who miss appointments to be fined in order to ease the pressure on over-subscribed medical practices.
The demand is among measures being proposed at an annual conference of local British Medical Association (BMA) committees next week.
A crisis in GP recruitment that has seen 53 of surgeries close their books to new patients is “putting great physical and emotional strain” on family doctors, the conference is expected to be told.
GPs will warn that NHS may not survive because “of the ever increasing demand and inadequate funding”.
Dr William McAlpine, the secretary of the Ayrshire and Arran local committee proposing the measure, said large practices had hundreds of missed appointments per month, representing a huge amount of wasted resource at a time when surgeries are struggling to meet demand.
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Health authorities have not compiled national statistics for missed GP appointments, however a 2015 study by NHS Health Scotland found that missed appointments across the NHS cost £21 million per year.
“We don’t want to stop people from coming to see the doctor,” Dr McAlpine said. “In fact, we want people who are unwell to have the ability to see the doctor quickly.
“If you have this issue that you have a small minority who are a bit selfish and who book appointments without bothering to keep them, it just creates a problem for other people.”
Dr McAlpine added: “The problem we’ve got is that GPs are basically maxed-out. We don’t have enough appointments for the number of patients who want to see us. We’ve got a workforce and workload problem facing general practice.
“In Ayrshire, I think at the moment we’ve got a third of the practices that are short of a doctor. That inevitably puts strain on the other doctors and clinicians in the practice.
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“It’s more from a sense of frustration than anything else. If people make appointments and then don’t turn up, it simply means other people wait longer to see a doctor.”
The motion calls on the BMA’s Scottish GP committee to lobby the government in favour of a penalty charge for patients, but Dr McAlpine voiced doubts about whether the proposal would be “acceptable to society”.
Dr Amy Small, who works as a GP in Prestonpans and sits on the Scottish GP committee, said moral is “really low” among her colleagues because of their overwhelming workload.
She said demand for GP services had to be reduced, adding: “We cannot have the ‘all you can eat’ buffet we have at the moment.”
Last year David Cameron rejected calls to fine patients after the health secretary, Jeremy Hunt, indicated he was open to the idea.
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GPs in England have previously suggested a fine of £10 per missed appointment, although the proposal was rejected by the BMA.
Shona Robison, the health secretary, said: “Scotland has the highest number of GPs per head of the population of the four UK countries and under this government the number of GPs working in Scotland has increased.”