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Prominent GP calls for end to prescribing charges

The NHS’s prescription charging system should be ditched in England because it is unfair and out of date, an editorial appearing in the BMJ has argued.

Dr James Cave, the GP who edits the Drug and Therapeutics Bulletin (DTB) journal, which is part of the BMJ group, said that exemptions linked to features such as age and pregnancy seem arbitrary, and some qualifying patients are allowed free prescriptions for illnesses that are unrelated to their main condition.

In his editorial, Dr Cave said: ‘Many such exemptions appear illogical and unfair, adding to our belief that the prescription charge is a poorly conceived, manifestly unfair tax.’

According to the editorial, NHS figures show that 90% of all medicines dispensed outside hospital in 2012 had no fee attached, and most were for patients aged 60 and above. About 80% of people aged 18-59 had to pay for their medicines, however.

Another discrepancy is that trusts have to pay the full 20% VAT levy on medicines dispensed from a hospital pharmacy, although VAT is not paid on prescriptions dispensed in the community, Dr Cave argues.

‘As a cost-saving measure, many hospitals discourage doctors in outpatient departments from prescribing medicines to patients sitting in front of them in their clinic. Instead, they are asked to write to the patient’s GP recommending the prescription.’

Dr Cave said that the £8.05 charge per is far higher than costs for off-patent drugs. A pack of 28 aspirin is 74p and the same sized pack of atorvastatin is £1.26.

The follows a Pulse investigation this week that showed CCGs are struggling with prescribing budgets.

Readers' comments (8)

  • Cant wait to spend the rest of my GP life writing prescriptions for Paracetamol, Ibuprofen and Canesten etc etc etc because it is now 'free'.....Prescription charges put a (small) cap on demand.

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  • Vinci Ho

    What about switching this prescription fee into the consultation charge (so patients supplement cost of consultation instead of prescription)people having been talking about? Am I crazy to suggest that ???

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  • It would make sense to end charges for treatment that stabilises long term conditions and keeps people away from hospitals (eg inhailers and statins)whilst increasing charges for minor or short lived problems (minor fungal infections) that could be dealt with by a trip to the pharmacy. This would also help reduce the unsustainable demand for GP appointments. GPs should never be forced into prescribing one off treatments for hospital doctors, this is an absurd waste of precious resources.

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  • Prescription charge is free in Scotland and Wales but not in England. I think the whole point of the article is that it is not fair to the taxpayers. Most people who attend GP's surgery for "paracetamol, ibuprofen, and canesten etc etc etc" are already getting them free of charge. The other day I brought two items on prescription for my wife and it cost £16. As a salaried GP working in England I am already being taxed about 50% when income tax, NI tax, and pension are taken into account. I seriously think prescription charge in England is another form of stealth tax!

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  • AH, but you forget, the English have to pay more taxes in order that Jock and his chums can have free prescriptions, free university education and free nursing home care.

    DOI- Englishman who joined the SNP some while ago as it seemed the only viable way of getting rid of Scotland to me.

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  • I agree with the author that as the majority of prescriptions are 'free' it is absurd that just 10% of English pts have to pay, whereas everywhere else in the UK it is free.
    I also agree with 3.26, if there needs to be a small cap on demand, can we not do this by charging a small fee to everyone for all appointments. That is the only way to make the population more healthy. If they go to the dr often, they pay more, if they make healthy choices and go less they pay less, and if they dont go they are even better off!

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  • Long ago I proposed a simple system whereby £1 per FP10 was charged for all prescriptions if scrapping charges altogether was deemed unaffordable. This would be deducted from the payment made to chemists or dispensing doctors and there would be no exemptions. This would eliminate the whole raft of administration needed by the present system and abolish any fraud. Simples!

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  • As a stoma patient in my early 30's (1976) I qualified for free prescriptions no matter what my problem.
    I was recently denied micropore tape, which I had always used in place of the more expensive colloid rings.
    Strangely though, stoma patients allowed to have underwear (pants and vests) on prescription costing £30 per item ordered in three's! Why?
    I have been an ostomist for 36 years and worn ordinary high wasted clothing with no problem and at no extra cost to myself! I was denied rolls of 'mircropore tape' at 88p per roll on script (8 rolls per quarter) but could have ordered expensive underwear that is so unnecessary ... but still available today on script! I did raise my concerns with NHSe with no response.

    If medicines are POM but cheaper than the cost of a £8 script, issue the script with a basic charge of £1.
    If patients want a branded drug in place of other options, allow them to pay the difference in cost.
    If someone needs cough syrup, advice them to buy a bottle in the local pharmacy. Why is it every cough and sniffle requires a GP visit and a script?
    If you cut your finger, you don't expect a box of plasters on script so it is time what is available should be reviewed and many items removed.
    So much money could be saved it common sense prevailed .. not much hope of that with this government! .

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