Echo readers have called for patients to be fined if they don't turn up for medical appointments.
NHS England data has revealed that City Hospitals Sunderland NHS Foundation Trust has lost more than £2.5million so far this year due to no-show patients missing their appointments.
More than 21,000 patients either did not show up for an outpatient appointment or arrived too late to be seen between January and June 2018.
Now, many of you are calling for a fining system to be implemented so "vital appointments" aren't wasted.
Nine per cent of those with an outpatients appointment at City Hospitals Sunderland failed to turn up.
Almost 2.9 million appointments were missed across England in the first six months of the year.
Here's how you reacted to the story on social media:
Sarah Louise Fairclough: "As well as an appointment letter for either me or my kids I've also had a text or an automated call the working day before the appointment to remind me and the option to cancel/rearrange if any of us can't go.
"I do understand tho some people may not use mobiles or be too ill to go, but it's not hard to call up and say your unable to make it."
Tracy Pell Foster: "Can I just say sometimes this is the hospital's fault as twice my son has not received appointment letters. So it’s not always the patient's fault.
"It would be easier to text patients."
Joseph Kemetmüller: "If someone doesn't turn up for an NHS appointment, who is getting the bill and who is issuing the charge?
"Surely attending an appointment would cost more in money and resources?"
Susan Ophield: "Should be fined if they don't turn up people who are seriously ill waiting for appointments and cannot get them."
Lisa Cuthbertson: "They need fining for not turning up no the wonder we all wait months to be seen why make the appointment if you don't want it."
Billy Potts: "There should be a fine system in place for all missed hospital and GP appointments unless you have a good reason."
Elaine Davidson: "Perhaps some people need to talk to people in the US to find out how lucky we are. Stop making excuses."
Joanne Dobinson: "It would help if they had a designated cancellation line."
Pauline Johnson: "Disgraceful. Would only take a phone call to cancel and give someone else the chance of an appointment. No manners."
Lucy Greenwell: "No the wonder the NHS is struggling. There's no common courtesy these days. I wouldn't dream of wasting a vital appointment."
Pat Ross: "Make people pay for not cancelling appointments."
Catherine Mcmillan: "That’s why it should all be private and they pay for the appointment whether they go or not."
Nick Bonallie: "How hard is it to make a cancellation phone call?"