THE thorny issue of Worcestershire's controversial strategic health review, and its detrimental effect on the lives of thousands of county people, returned to this column yesterday.

The point that echoed from dozens of previous We Says was this: The concentration of specialist services at the Royal Hospital, in Worcester, and Redditch's Alexandra means huge numbers of patients and patients having to travel arduous distances for the privilege of being made well.

Today, the boot's on the other foot. Our spleen is vented not at the bureaucrats who came up with the reorganisation of county health facilities - but the patients themselves.

Growing waiting lists are one thing, but 40,000 people missing their appointments, and not having the courtesy or the consideration to let their hospitals know, is simply breath-taking.

The estimated cost - £250,000 - isn't to be sneezed at.

However, the true impact is being felt by people who are waiting for consultations, oblivious to the fact that - in theory - one in 10 appointments on any day is free.

We're rarely reticent to take the county hospitals trust to task when we feel the public's being let down. Not today.

But trust officials have bent over backwards to make it easier for patients to contact the right people to cancel their appointments.

They've called for the public, clinical staff, managers and admin staff to work together in improving waiting times.

Shame on any patient, no matter how they are, or where, who ignores that vital responsibility.