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Prescription charges: to be or not to be?
Posted Friday 28 May 2010
With all of yesterday's news focussing on welfare reform and leaky oil wells, you’d have been hard-pressed to notice the long-awaited publication of the Gilmore report. The Gilmore report? Well, if you have a long-term health condition and fancy free prescriptions, this is a pretty important document.
I’m sure that many of you will be aware that Mind, as a member of the Prescription Charges Coalition, is campaigning for an abolition of prescription charges for people with long-term conditions. This is because the current situation simply isn’t working. Every year 800,000 people in England fail to get some or all of their prescriptions because they simply cannot afford the cost. The current system means that the more sick a person is, the more they will have to pay, and those with long-term conditions are hit the hardest.
Our campaign received a boost back in 2008 when the then prime minister Gordon Brown announced plans to expand the eligibility criteria for access to prescriptions free-of-charge. He commissioned Professor Ian Gilmore, president of the Royal College of Physicians, to have a look at which groups of patients should get free prescriptions, and how the government should go about making this happen.
That report has finally been published, and it makes a key recommendation: patients should not have to pay for their prescriptions if they have a long-term health condition that will persist for a period of at least six months.
Great news, but unfortunately things are never that simple. The government is under no obligation to implement the recommendations of this review, or any other review for that matter. In a written ministerial statement on the report, Health Minister Simon Burns MP said that any decision on the introduction of free prescription charges will have to wait until the major review of government spending due in the autumn. So, it's neither a 'yes' or a 'no', but a 'wait and see'.
What next? Well, Mind will continue to work with the coalition to persuade the new government to implement Professor Gilmore’s recommendations. It will be hard work, given the current economic climate. But you can help by writing to your MP or joining our facebook cause group. You can find out to do this and see all the details of our campaign here.
Colin Walker, Policy and Campaigns Manager, Mind
3 Comments
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I have said this before, but I will say it again.
I think Mind is missing the point here. We don't need free prescriptions. We do need better access to therapy, day care and inpatient services. The money saved by not offering free prescriptions can be used to improve these services. This is far more pressing.
If you are not earning or earn very little you will be entitled to free prescriptions anyway. Most people who have a long-term health condition will be eligible through this criteria as many won't be working due to disability.
If you have a long-term health condition that will need regular prescriptions, but are not eligible for free prescriptions due to higher income then you can pre-pay. You should be able to afford this. Just over £100 for a year for as many drugs as you need is not much considering how much your drugs may cost the NHS.
I have to prepay but I am happy with that. I get at least 4 prescription items every two weeks. Yes, if I had to pay £7.40 per item each time (£60 a month) then there would be a problem, but I can pre-pay. This probably won't even cover the cost of my drugs for the NHS, but I am making a contribution and that seems fair enough.
Surely no one would agree that millionnaires should get free prescriptions when it would mean nothing for them to pay the £100 a year for a pre-payment cert? This would happen if free prescriptions were expanded to other long-term conditions.
People who are unlucky enough to suffer a few short-term conditions in a year can often end up paying as much as I do in one-off charges, so why should it be any different if I have a long-term condition?
Prescription charges should be based on the means to pay and not the condition, which they are already (with the exception of Cancer/Diabetic Insulin and a few other cases). Why change things?
I actually disagree with the free prescriptions for all cancer patients on this principle too. I must admit, if any long term condition gets free prescriptions it is unfair not to offer them to all; a cancer patient is no more worthy than someone with schizophrenia or depression, but that doesn't mean we should be encouraging or expanding the scheme. The NHS cannot afford it. Services are bad enough already.
Please direct your attentions elsewhere. There are more important things you can be doing.
p.s. I understand you are working with other charities for different conditions on this, but I think you all probably have more important fights on your hands
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Many thanks for your comments. I really think that it’s worth emphasising that Mind’s campaigning activity is much broader than a simple focus on securing free prescriptions for those with long-term conditions. In fact, we campaign on a whole host of issues, including those that you refer to in your post. In the grander scheme of things, our activity on this particular issue is low-key when compared to our efforts elsewhere.
For example, Mind is currently leading the work of the We Need to Talk coalition to dramatically improve and broaden the range of talking therapies made available to people on the NHS, and to ensure that people are able to access these treatments with 28 days of referral. We’ve already enjoyed some great success, with all three parties making commitments in their manifestos to improve access, commitments that the coalition has recently reiterated in its programme for government document.
On acute & crisis care, we are currently working away to launch a major campaign to assess this vital sector and to develop a series of measures necessary to ensure that key improvements are made in its provision.
Elsewhere, we are engaged in a major campaign to work with employers to make workplaces mentally healthier; we have recently published a guide to help improve the way the police respond to people with experience of mental distress; we are campaigning to clamp down on poor practice by bailiffs, which can lead to further mental distress for people already struggling with debt; and are currently drafting a guidance paper for mental health practitioners to make it easier for men to seek help and get access to appropriate treatment.
However, with regards our work on prescriptions, the fact remains that 800,000 people in England fail to get some or all of their prescriptions because they cannot afford the cost – that is why we have joined a coalition of health charities campaigning against this injustice.
I hope that this reassures you that Mind is doing all it can to campaign to improve mental health services, and that this activity is focused across a number of different areas.
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Thanks for taking the time to reply to my comment.
I do support Mind and (almost) all that you do and I'm aware of most of the campaigns you are involved with. Improving the lives of people with mental illness and those affected by it (all of us!) is of course your entire purpose and I appreciate that wholeheartedly.
I think this is just one area I get frustrated by. The NHS can't do everything and we do need to prioritise more.
In Wales they offer free prescriptions to everyone - obviously most people appreciate this, but I am not sure they realise that this perk is at the expense of other areas of the NHS. Almost all waiting lists for routine operations in Wales are longer than in England, the longest ambulance response times are in Wales and there are many other pitfalls too.
Maybe what we should be doing is advertising how great the pre-payment scheme is? I don't think enough people realise how much money it can save them.
It's worth noting that if someone doesn't currently pre-pay and they don't currently get free scripts, but they suddenly find themselves needing 4 or more items in 3 months, they can actually pay for the scripts up front and ask for an FP57 at the same time. They can then apply for a pre-payment cert to be backdated to the date of the first purchase and they can go back to the pharmacy to claim a refund on the initial prescriptions. This will save the person paying for the extra prescription costs. (Info here on script costs: http://www.nhs.uk/nhsengland/healthcosts/pages/prescriptioncosts.aspx)
I am concerned though if people are saying they aren't getting scripts due to the cost. Is this really down to cost or a case of people prioritising other things above their health? Perhaps controversial, but I wonder how many people put a night down the pub or a pack of cigarettes before a £7.20 prescription?
Of course if people don't collect scripts it may end up costing the NHS more as people end up getting worse due to the lack of necessary medication - e.g. patients that end up as inpatients after not taking psychotropic medication.
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