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‘Labour will scrap script fees so pharmacists aren’t NHS gatekeepers’

Jonathan Ashworth: Pharmacists tell me there is increasing confusion over prescription exemptions
Jonathan Ashworth: Pharmacists tell me there is increasing confusion over prescription exemptions

Scrapping prescription charges in England is the “fair thing to do” and will prevent pharmacists from being “gatekeepers for the NHS”, Labour MPs have told C+D.

The Labour party has pledged to abolish prescription charges in England – which are currently charged at £9 – should it win the next general election.

Explaining the decision to C+D at the Labour party conference in Brighton yesterday (September 23), shadow health secretary Jonathan Ashworth said: “We think it’s the fair thing to do to get rid of the prescription charge in line with Scotland, Wales and Northern Ireland.”

“There are people with severe chronic conditions, perhaps in low-paid employment, that forego picking up a prescription,” he claimed. “So we think this is a fairness intervention.”

Mr Ashworth often hears from pharmacists that there is “increasing confusion around [prescription fee] exemptions”, he told C+D, pointing to cases of “people ticking the wrong boxes on forms and finding that they have hundreds of pounds worth of fines as a result”.

“I think it’s a simpler system and a fairer system and it’s about equality as well,” Mr Ashworth added.

Last week, the Public Accounts Committee called for a “fundamental overhaul” of the “heavy-handed, inefficient” system for fining patients for incorrectly claiming prescription exemptions.

Pharmacists shouldn’t be NHS gatekeepers

Speaking at a roundtable event organised by the Pharmaceutical Services Negotiating Committee at the Labour party conference, Labour MP for Burnley Julie Cooper said she is “really excited” about the announcement.

“This is something that I have been working on for ages and we’ve now made the financial case,” she said.

“I always thought it was wrong for pharmacists to be gatekeepers for the NHS, having to grill people on their financial circumstances. It is absolutely ridiculous,” Ms Cooper added.

Some “sympathetic GPs” have also told her that fewer patients approach them for medication when they need an extra supply, because they cannot afford them, she claimed.

She is “absolutely delighted” that Mr Ashworth and Labour party leader Jeremy Corbyn have endorsed the new policy, Ms Cooper added.

Poll

Do you think the prescription charge should be scrapped in England?
25 Comments
Question: 
Do you think the prescription charge should be scrapped in England?

Naresh Chauhan, Community pharmacist

The Labour Party - the same party which is still sitting on the fence on almost every issue? Trust their promises at your peril.

Tony Schofield, Community pharmacist

Do we have information on how much it costs to check exemption status? I suspect it will be significant and as good a reason as any to scrap Rx charges. I really don’t believe waste should interfere with thhs decision and there are things pharmacists could do to reduce waste. They should be incentivised so to do

C A, Community pharmacist

Off the top of my head - the DoH quoted less that £15 million to police the exemption status and the Levy brings in £575 million. So there is plenty of funds left over to put towards hospitals, doctors, dentists, government expenses etc.

Leon The Apothecary, Student

Waste is an interesting one. I think there are several factors that contribute to it. Patient behaviors, prescribing habits, turnaround times and process, availability, management of medications, treatment regimes, and reviews all contribute.

SP Ph, Community pharmacist

I am not a big fan of these pre-election promises from any of the Political Parties, as they have never fulfilled their promises made to Pharmacy Sector, rather they have done exactly opposite.

But then it is unfair to tax someone and let others take things free.

Could anyone point to a place where it is documented that in Wales and Scotland free prescriptions have lead to a huge wastage?

In my opinion, if at all there is wastage in England then it is already happening. Most of the wastage, if at all from free prscriptions, can be easily controlled by the GP practice (now with extra help from Clinical Pharmacists) So why tax hard working people just because they do not have one of the boxes to tick? It is unfair and must be abolished.

One of the basic foundations of NHS is Health Inequality. So if a patient does not fill his/her prescription because hehe/s cannot afford to pay the charges, then it is a BIG contributor to the Health Inequality factor. Just saying the GP/Hospital appointments are free, you are not fulfilling this factor.

Bob Dunkley, Locum pharmacist

Why is it in this debate that the powers that be ie Labour, PSNC, the RPS are gung Ho for free Rxs yet every community pharmacist who sees the waste generated is shouting Nooooooo... ? The people who are for this dogs dinner do not operate in the real world but assume they know what’s best. The Tines article has it right Free Prescriptions - an Invitation to Waste.

 

Leon The Apothecary, Student

I respectfully disagree with that statement, I think all prescriptions in the UK should either be free or have a supplementary charge, compared to the tiered system we currently have. My personal opinion is that a small charge contributes to a significant reduction in wastage - as can be evidenced by the plastic bag charge.

However, it must be carefully managed, something I would challenge and say that hasn't been a strong point of surgery nor pharmacy in the past that allows things like excessive ordering and hoarding to occur.

Rajeshvari Patel, Community pharmacist

Instead for abolishing, charge just £1 for each item to all patients, even children. This will reduce wastage, tackle ‘poly-pharmacy’ and GPs will start reviewing all medicines effectively. All dosette box patients to apply for an exemption signed by a GP to assess if it’s absolutely necessary and not because the family members or care agency is asking for it. This will reduce unnecessary MDS dispensing going on where able patient prefer someone else to organise their medicines, saves them taking time to do their own.  Last week, the driver who collects our waste of returned meds said he collected 18 bins from a pharmacy and on average 4 bins per Pharmacy.  That’s definitely where some of the millions are going.

 

Leon The Apothecary, Student

I believe the German model charges a subscription fee for MDS that allows the pharmacy to cover the cost of the significant extra work they require. Something worth exploring?

Lucky Ex-Locum, Superintendent Pharmacist

Good sense this one.

The wastage from care homes is horrendous. If they had to pay for each item(or rather if they had to take it from the residents income) that may well sharpen their minds a little.

Caroline Jones, Community pharmacist

No.....better to say everyone has to pay....with the exception of children and Px for contraceptives 

Lucky Ex-Locum, Superintendent Pharmacist

Why free contraceptives?

Caroline Jones, Community pharmacist

There’s always going to be a group of people who refuse to pay (any amount for a prescription), as it is now this is the only item that is ‘free’ to everyone who needs it.....for obvious reasons really......

Lucky Ex-Locum, Superintendent Pharmacist

Fair enough but for equalities sake, condoms should then be free for men.

I would include children in the payments as well. The amount of times I've heard someone refuse the price of OTC paracetamol liquid and say they'll get it off the doctor for free is huge. Parents should take some responsibility rather than expect the state to pay for their brood.

Caroline Jones, Community pharmacist

I think condoms are free already!

The children one is difficult; in an ideal world I’d agree, but unfortunately some parents would choice not to get a medicine for their child.....and the child would suffer:(

 

Lucky Ex-Locum, Superintendent Pharmacist

You obviously don't look at that particular aisle in the supermarket. They are most definitely not free and are rather expensive in fact. You can sometimes get them free on these weird C-Card schemes if you can find somewhere that does it.

Yes, some parents would choose not to get medicines for their child but I can 100% state that those parents would also have the latest iPhone. It's all about priorities and an awful lot of parents get theirs wrong.

Leon The Apothecary, Student

As a man over the age of 25 Caroline, I can wholeheartedly, equivocally, and categorically state that they are not.

Clive Hodgson, Community pharmacist

Well argued article in the comment section of the Times today by Angela Epstein

Hard to disagree with the title: “Free prescriptions are an invitation to waste or hoard”.

Lucky Ex-Locum, Superintendent Pharmacist

Yeah and Labour has also promised everyone a 4 day working week with no loss of pay. 'Dreamers' is one of the words that spring to mind. I couldn't possibly say what the other ones are because I don't want to incur the wrath of the C+D police.

However, and it slightly pains me to say this, I agree with them on this one. I do think that it is grossly unfair that Wales and Scotland have no prescription charges which is basically funded by English taxes. It's the inequalities that drive me round the bend. We are still a United Kingdom and rules should apply across the board.

Allan Wilson, Community pharmacist

People in Wales, Northern Ireland and Scotland also pay taxes-we do not pay Rx charges due to decisions made by the respective devolved Governments and nothing to do with 'hand outs' from English taxes

 

 

Lucky Ex-Locum, Superintendent Pharmacist

Yes, but it's one tax that you don't have to pay and we in England do. You can't tell me that only Welsh or Scottish taxes are spent in Wales or Scotland. The populations aren't big enough for that.

Angela Channing, Community pharmacist

But we're not really are we? United.  Tony Blair saw to that with his devolution. We basically operate 4 different NHS services in each home country.  This is why after Jim Callaghan lost a vote on this and lost the Nationalists support, he lost a vote of No Confidence and it was 1979 and in was swept 'The Lady not for Turning'  The Rt. Hon. Mrs Margaret Thatcher, who could see exactly what devolution would do and kicked it into the long grass for 20 yrs. Sadly TB found it and we are where we are, 4 different services. And regarding script charges and everyone at the Conference for the Bleeding Hearts party ..... it's £104 a year. That's 10 DD payments of 10.40 a month.  If you buy a lottery ticket each week, you can afford a PPC and we should be pushing more people into that category and also as most people do some work in their 60s still, push the age exemption in line with the retirement age. Not popular, but will save loads. No huge Morrisons bags of bottles and bottles of lactulose and gaviscon returned the other day!! Mostly untouched. 

Leon The Apothecary, Student

I'll do you one even better. Based on HSCIC data, if everyone shared the number of charges equally based on who paid previous, we'd be looking at roughly 80p an item. 

Caroline Jones, Community pharmacist

Exactly......it’s totally affordable

I’d said this above but seem to have got lots of thumbs down ......I wonder are these the people who think all medicines should be ‘free’....really?

Lots of other countries have to pay for their medicines......Australia is something like $29/item or about $5/item (if you can claim veterans rate); plus the quantity is limited to 28 days - at least it used to be! 

This would just become the new norm and it would become an expected expense just like pet/car/building insurance etc

Lucky Ex-Locum, Superintendent Pharmacist

It's your exemptions from charges that got the thumbs down. It's all or nothing, else you create inequalities just the same as the present system. I've never understood why the very definitely life threatening condition of asthma is not exempt whereas the far less lifethreatening hypothyroidism is.

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