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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.