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Independents' Day

More patients should be charged for prescriptions, think-tank says

Exempting fewer people from prescription charges while lowering fees could bring £2bn in to the NHS, a think-tank report has claimed.

An analysis by the King’s Fund concluded that the current system ‘makes little sense’ after finding that 90% of the 1 billion prescriptions dispensed in 2012/13 were free, while those who paid were charged £7.65 per prescription, a fee that has risen to £8.05.

This raised £450m, it found, but a change to the exemption status of some groups would allow the Government to reduce the charge to £2.50 per prescription, while also bringing in an extra £2bn.

It also floated ideas about how to pay for the NHS, including through increased National Insurance charges for over-45s earning more than £42,000 a year.

The report said: ‘Some 40% of the population are liable to pay prescription charges. But not only are exemptions from the charge extensive, but they also cover those groups – people aged over 60, children, and some with specified medical conditions – who are the heaviest users of prescription medicines. As a result, while 40% of the population are liable to pay the charge, in practice 90.6% of prescriptions are dispensed free.

‘However, the current charging regime makes little sense.’

It concluded that the exemption age should increase from 60 to 65, the same as the state pension age.

The report added: ‘We believe there is a way to reform these charges that would, at the same time, raise some additional money.

The King’s Fund calculated that the prescription charge could be lowered to 45p with no exemptions and bring in the same money - £450m - that it currently brings in, while every extra pound would raise an additional £1bn.

It concluded: ‘On that basis, a £2.50 charge – a near 70% reduction in the existing charge, and less than the price of a pint of beer or about that for a posh coffee – would raise around £2bn a year. That sum would be reduced if the pre-payment certificates, or some other form of cap, were left in place – and the commission does favour the retention of a cap so that those on lower incomes do not face excessive costs.

‘We recommend that the government launch a review of prescription charges on these lines with a view to raising approximately an additional £1 billion a year.’

Authors also explored the idea of a tax on affluent citizens over the age of 45, and charging for GP appointments or DNAs as well as a variety of different financial scenarios.

However, they concluded that any cost benefits would not outweigh drawbacks of such plans.

The King’s Fund exercise also concluded that there should be a single commissioner for health and social care and the final report suggested health and wellbeing boards should be explored as the potential commissioner.

Readers' comments (10)

  • The slippery slope to privatisation. Just like the dental service in the long run. CO -pay anyone. something needs to be done.

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  • It amazes me how short sighted some of my patients are - today alone I had patients req antihistamines, paracetamol, ibuprofen, gaviscon etc all of which can b bought OTC but "cheaper" for them to get it on NHS for free.

    Except it is not "cheaper". The nation is paying for the cost price + admin fee + pharmacy charge to have it prescribed. It's madness.

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  • Do what the Germans do; If it can be bought over the counter then GPs cannot prescribe it whatever the patients circumstances.

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  • I have thought for years the charge should be a low one per item but apply to everyone, this would bring in more money for the NHS and encourage patients to take responsibility for their own care and cut down on waste medication...

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  • what about vulnerable patients - there will be some who will decline medication who might have clinical need for medication.

    why not have a list of meds which are free on sensible and clear clinical grounds eg medicine necessary to prevent premature death or serious harm eg thyorid treatment (i know already free) etc. It would exclude paracetamol etc and would be fairer. i.e. have an NHS 'free' formulary and for the rest charge. It means vulnerable groups will get their medications.

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  • Here in the Socialist Republic Of Wales we already have free prescriptions which makes life mostly easier for us as GPs. However, the health boards are pretty strict about us not prescribing things that can be purchased over the counter so in fact, the more vulnerable punters who would previously have been exempt actually end up paying more.

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  • Not really addressing fundamental and worsening imbalances in the system.Too many talking shops I'm afraid.

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  • I agree that OTC available should not be prescribable by Doctors.

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  • Agree with OTC medicines not being available on script. But there are many other barmy items available on script that should be removed.
    Stoma patients, who get all scripts free regardless of the health issue, can also can order pants and vest costing £30 per item and usually ordered in three's! Why?
    A patient with an artificial leg does get free shoes, you have to adapt.
    Stoma patients need to pay fro general medicines and many items on script need to be removed ... look on eBay and see these items for sale!

    Time the system was looked at, long overdue.

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  • The most logical thing to do would be to scrap costs for medicines that keep people out of hospital such as cardiac medicines and inhailers and charge for those that don't such as analgesics and antidepressants. However it is done there are always winners and losers but the main goal of prescription rationing should be to keep people away from increasingly expensive hospital care.

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