The patient view on scrapping OTC treatments from prescriptions
NHS England's drive to make all patients pay for over-the-counter (OTC) medicines will reduce the living standards of those on benefits, says patient Robin Kenworthy
I am a diabetic pensioner with complex needs. I already pay for three vitamin supplements, which cost almost £20 together, which I need to take. There are more than 10 items on my repeat prescription. I also pay for ulcer dressings, toe-to-knee bandages, and podiatry. If I did not pay for podiatric treatment, I would probably have been an amputee several years ago.
I seriously wonder what the long-term effect of making more items only available OTC will be? I suspect complications and more cost to the NHS, as patients will have other priorities.
The Digital Minor Illness Referral Service is an excellent idea for people with a new minor illness who are in full-time employment. The concept of a healthy living pharmacy has been designed to encourage this category of patient to take responsibility for their own health. This should take pressure off GPs, the ambulance service and A&E.
However, in the case of patients and their unpaid carers whose only income is from welfare, we should be looking at medicines reviews and other ways of preventing wastage – perhaps the pharmacist prescribing repeat prescriptions?
When the NHS was established in 1948, all prescriptions were free. The power to charge for them was introduced in the NHS (Amendment) Act 1949. Proposals for charges were a factor in the resignation of Labour health secretary Aneurin Bevan from the government in 1951.
Charges were introduced in 1952 by the Conservative government at a rate of one shilling (5p) per prescription. I can recall the days when patients receiving benefits, often with terminal conditions, had a prescription for several days until benefit pay day, before spending the afternoon in a smoke-filled and crowded waiting room claiming back a few shillings from the National Assistance Board.
There were prescription exemptions for people in receipt of National Assistance benefits or a War Disability Pension, children under 16 or at school, and patients with venereal disease. In 1956, the rules changed so that a charge applied to each item prescribed. In 1961 it was doubled to two shillings. Charges were abolished by Labour in 1965 – although the party reintroduced them three years later at a higher rate, but with a wider range of exemptions. The prescription charge in England is now £9.
Over the last 60 years the administration and the names of benefits have changed, but the principle remains that people in receipt of benefits or in certain age groups with a continuing need for medication will get it for free. Most patients receiving benefits are on fixed incomes. An example of their outgoings may be: retirement pension £120; amiodarone around £3; packet of paracetamol £1. The total is £124.
If items are no longer free, the patient still has to purchase them, The money they have for living is reduced. It then becomes a question of: do we eat, keep warm, go without medication – or another element of the quality of life?
It’s over 75 years since the Beveridge Report paved the way for the NHS. Prescription charges were introduced by later legislation. Surely any change should be authorised through parliament – not unelected NHS officials and clinical commissiong groups trying to meet budgets by transferring the burden to those least able to afford it?
Robin Kenworthy is a lay representative of the government’s pharmacy and public health forum