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Xrayser: Prescription exemption is no minor matter

"We are going to the Department of Health asking to get paid for giving away free bottles of nit lotion"

Not everyone understands the meaning of an emergency, says Xrayser

“Why can’t I have an emergency supply?” demands the woman in front of me, having gone from yummy mummy to tiger mother in the space of 10 seconds. “Because it has to be an emergency,” I say. “You wanting a bottle of chlorphenamine syrup when your surgery is open means that it’s not an emergency.”

“I don’t have time to go to the surgery – Skyler is flying off to go skiing in half an hour!”

“You can buy a bottle for only £3.50…” I reply, leaving unspoken that Skyler’s frappe at the airport coffee shop will cost more. But that’s not the point. If you are exempt from the soon-to-be £8.40 charge, you can bring in a green FP10 shopping list for anything from toothpaste, deodorants and moisturisers to gluten-free food, sip feeds and baby formula. The stuff that everyone else buys for themselves.

It’s the same with the Minor Ailment Scheme (MAS). Ring out the bells and let there be rejoicing in the land because our CCG has commissioned the MAS for another year. And so for another year we can hand out for free the cheap, innocuous remedies that any sensible family will chuck into their shopping bag along with milk and bread. Instead of these essentials being doled out gratis, it should be considered a child safeguarding issue if parents don’t treat their offspring for nits and worms. So no wonder PSNC couldn’t get a national MAS if they were basing it on the current models, where we are the drug equivalent of a food bank.

And that’s not the only issue with the MAS. The sort of minor ailments we should be dealing with are those that require simple prescription-only treatment. Fungal nails, earache, uncomplicated UTIs, impetigo. I know damn well that a pharmacy scheme would be cheaper and quicker than a doctor, and being the OCD, anally retentive professionals that we are, we’d be more restrictive of those precious antibiotics than our cash-rich, time-poor GP colleagues.

To be fair, our local surgery has a notice that says “Don’t ask for paracetamol”, but the receptionists say everyone ignores it.

But the other reason for no MAS was best illustrated by a reporter on the radio this week. Reporting on the migrant crisis in mainland Europe, he was caught in the middle of a pitched battle between police and migrant when his girlfriend rang his mobile wanting to discuss their relationship, and couldn’t understand why it wasn’t an appropriate time to talk.

Meanwhile in England, as junior doctors are striking, A&E is at breaking point and the NHS is charged with saving £20bn, we are going to the Department of Health (DH) asking to get paid for giving away free bottles of nit lotion. No wonder Pharmaceutical Services Negotiating Committee (PSNC) got sideswiped by the pharmacy cuts letter. Like Skyler’s mum and the reporter’s girlfriend, not everyone understands what is and is not an emergency.


More from Xrayser

What's your experience of MAS?

We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information


Leon The Apothecary, Student

I still believe the first step is to have a universial charge for everyone for prescriptions, and spread the cost proportionally. I've discussed this at length before, and even with the upcoming price hike, it's still under £1 per item.

FIONA KIDD/142019450, Community pharmacist

If used in a real emergency the pharmacy first scheme is acceptable, but I think we are fostering a nanny state in which citizens are encouraged to demand too much for free, when they should be taking more responsibility for themselves and their children. Nothing comes free. Go to a market in Asia and see how poor people  have to survive.

Pharmacy HLP, Manager

Let us not mix up different situations.

AT present these items are ( sometimes ) available from a compliant doctor if a patient is exempt from prescription charges some people think it is their citizens entitlement to take up a Dr's appointment in order to obtain this essential product and show their child to GP at the same time to reassure themselves that nothing serious is going on with little Joey.

It costs about £45 per GP visit including the cost of drug so if this "essential activity" can be undertaken away from a surgery environment the the CCG will save money and free up doctors appointments. Win Win ?

As health care professionals we do not discriminate between minor or serious conditions we try and advise and support patients, if they want to take you advice or pay for any product is up to them.

The reality is that GP land is far more expensive to access's than the freebie pharmacy setting that NHS presently gets.

Minor ailments should be rolled out nationally and you are right some things should be jettisoned from the formulary.


GARY BROWN, Community pharmacist

we've been operating a (pilot) minor ailment scheme in Worcestershire for about 6 months now & not once have we had patient's abusing the scheme - It seems to have been working very well

Harry Tolly, Pharmacist

Thats a rather grand claim to make. The proper wording should be  :


""""Not once have we SPOTTED a patient abusing the scheme....."""""""  Glad to help.

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