Prioritising prescription charges

Neil Churchill - Chief Executive

Tagged: Prescription charges, NHS, Michael Moore, Inhaler, Students

I watched the Michael Moore film Sicko recently. It was shocking to witness: a man who’d lost his fingers in an accident was given a price to sew back each one - $12,000 for ring finger, $60,000 for index finger etc - whilst other people were denied life-saving treatment by their private health insurer.

The film praised the NHS and made me breathe a sigh of relief that all political parties here are committed to a healthcare system which is free at the point of use.

In the last scenes of the film, Michael Moore took some 9/11 workers with mainly respiratory problems to Cuba to get treatment, because they couldn’t afford it at home. One woman was surprised to see an inhaler she pays $120 for on sale in a Cuban pharmacy for the equivalent of 5 cents.

Again, we are lucky not to face the full cost of prescriptions, but those of us in England do pay £6.75 for each one, and if you have a lot of medicines that adds up. If you live in Wales, prescriptions are free and Scotland is heading that way too.

I know that many of you believe prescriptions should be free in England too and we are making that case strongly. But we may need to get there in stages and need to think about what the stages might be.

I have been thinking that people with multiple conditions or with multiple prescriptions should benefit sooner rather than later from free prescriptions. And I think there is a strong case to make prescriptions free for students in higher education – at present free prescriptions only last until you are 19. The Scottish Government has argued that it is harder to make prescriptions free for certain medical conditions, as you would have to decide which to put on the list and which to exclude.

But this is running against a previous commitment in which they said they would make prescriptions free to people with asthma, and other conditions. What are your views? Should prescriptions be free to everyone or only people with long-term conditions? If we have to get there in stages, who should be prioritised?

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Bob

22 January 09
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I did a search recently for online pharmacies that will supply Ventolin inhalers with private prescription. It didn't take long to find one that charges about £3 an inhaler. Well below the cost of the £7.10 prescription charge. Even with a PPC you would have to use a lot of inhalers to make it worthwhile. The prescription charge has just become a way to charge for doctors visits, and made all the more expensive by the continual increase in the charge, and the refusal to supply more than 28 days supply at a time. I think that either prescriptions should be free, or that doctors should have to provide a private prescription if you ask for it, then we can be free to buy the neccessary medicines for a fair price.

neil

6 February 08
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Good ideas, both about the free scripts and the promotion of the certificate. Practical things we can be doing - thanks

CathBear

4 February 08
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GPs possibly won't hold information about the PPC as it's a pharmacy based thing. Generally I find that pharmacists and pharmacy assistants are very good at flagging up to people who have been having a lot of prescription items, and telling them about the PPC. I agree that it may be helpful for a poster to be displayed, perhaps both in pharmacies and in GP waiting rooms, regarding the PPC to publicise its existence. Access to it has improved a lot, as you can now apply and pay online for a PPC. But anyway, that's all a bit besides the point, and I'm conscious of keeping the discussion on track. If you're talking about who should get free scripts, then an easy answer would be - anyone who needs maintainence medication for a long-term health problem. Whilst being obviously biased and thinking that many asthmatics should get free scripts, I also bear in mind that in the general population, the grand majority of asthmatics do *not* need maintainence ICS therapy (or above) and may only need a couple of salbutamol inhalers per year. Much the same as diabetics (who get free scripts only if they need tablets or insulin to control their condition), perhaps there should be a tiered approach to prescription exemption in asthma? And should that exemption only apply to asthma meds, and not to medications for other conditions?

Peaksteve

4 February 08
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Perhaps Asthma UK could help promote the existance of the Prescription Prepayment Certificate in the meantime?

neil

4 February 08
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Prepayment certificates for prescriptions are good value. But how easy is it to find out about them? I had never heard of them until recently and my GP surgery has no information on them. You have to do a lot of work to get to the point when you can get one, and many people are simply missing out. You would have thought that government is making them deliberately hard to find, so they will keep most people paying more money. Scotland is certainly pressing ahead with free prescriptions for all. I'd like to see England follow the example, but I doubt we will. The question is, if they agree to make some smaller changes to the policy, who should benefit first?

Jen

3 February 08
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Personally I believe that all asthmatics should receive their meds for free. I live in Scotland and I'm hoping that I will soon qualify for free prescriptions as I understand that more condtions will be added to the list ahead of free prescriptions for all in a few years. I have 3 regular meds for asthma, 2 for heart probs and 2 for mental health. Then on top of that you can add in antibiotics, short courses of oral steroids etc. I'm on Incapacity Benefit but because I live with my folks my income is classed as being above the rate where I qualify for free prescriptions by about £10 per week. They don't take into account that my folks are both pensioners and that I contribute. And how is it fair that people with epilepsy and diabetes get their meds for free when we can as easily die from asthma and yet we have to pay? How does this work out? Surely anyone with a condition that requires daily meds and is potentially life threatening should get free meds.

CathBear

24 January 08
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I think it is very difficult to think in black and white terms when it comes to prescription charges. I *do* think that the current prescription exemption list is arcane and needs a serious overhaul; however, potentially you could extend that list indefinitely. I agree that there is a strong case for higher education students receiving free scripts; I remember myself being a student and for some bizzare reason not being eligible (they assumed you had taken all of your student loan even if, like me, you didn't want to get yourself into stupid amounts of debt so were scraping by without) - and then having to spend a small fortune on eczema treatments. I still beleive a good compromise exists in the prescription prepayment certificate. As you point out, we are extremely lucky in this country not to have to pay the full amount for medications that can cost £100s a pop. When you think of the amount of money spent on alcohol, cigarettes, etc per year, £98.70 over a year (which can now be paid for in 10 monthly direct debits of £9.87) really, really isn't a lot to pay for keeping yourself ticking over. Which reminds me, I must go and renew mine...