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Prescription charges adversely impact on patient care, say 40% of GPs



Two out of five GPs think prescription charges are having an adverse effect on patient care, with some patients having to choose between food and medication, Pulse has found.

GPs say they are told of patients ‘all the time’, particularly those with long-term conditions, who are not collecting their prescriptions because they can’t afford them, with 39% of respondents to a Pulse survey saying that the cost is adversely impacting on patient care.

Some GPs reported they are ‘reluctant’ to prescribe certain medications because of the cost of the prescription, although the majority – 52% of the 425 GPs surveyed – argued the charges are not having an adverse effect.

Meanwhile 27% of GP respondents said they want to see prescription charges scrapped, with 65% opposing the move saying it is a necessary cap on demand.

Pulse reported earlier this year that Dr James Cave, editor of the BMJ Group’s Drugs and Therapeutics Bulletin, had called for an end to all prescribing charges, saying they were a ‘poorly conceived, manifestly unfair tax’.

The Prescription Charges Coalition, a group of 30 organisations, including the British Heart Foundation and the Royal Pharmaceutical Society, are currently campaigning for prescription charges to be scrapped for people with long-term conditions.

But the likelihood of charges being lifted seems remote in light of the 40p price hike for the single prescription charge, which the Government announced in March, and CCGs saying they will crack down on GP prescribing to curtail millions of pound overspends.

Responding to Pulse’s survey, Dr Lucy Marchand a GP in Milton Keynes said: ‘I see patients all the time who haven’t been able to get prescription meds they need for hypertension and blood pressure etc that aren’t picking them up because they say they haven’t enough money to get them.’

While Dr Yera Shah, a GP in Hemel Hempstead said: ‘I am reluctant to prescribe several meds due to the cost of the scripts sometimes. Other times, patients are reluctant to cash scripts in as they can’t afford them.’

Dr Sarah Nelson, a GP in Worthing, West Sussex said that she was unsure whether charges should be dropped entirely, suggesting: ‘It might be more appropriate to extend them to more patient groups, but drastically lower the amount per item.’

However she did recognise the impact that charges could have on patients: ‘With multiple drugs for long term conditions such as asthma and hypertension, some low income patients do need to decide whether to eat or take their meds.’

She added: ‘Since wealth versus poverty is one of the biggest determinants of life expectancy, who are we to say that patients that prioritise food and fuel over medications are wrong?’

Dr Bill Beeby, deputy chair of the GPC prescribing subcommittee and a GP in Middlesbrough told Pulse that the current system, which has been in place for more than 40 years, was ‘grossly unfair’.

He suggested the NHS should look to harness more technological solutions, and suggested patient prescription charges could be tracked to trigger a cap when they have paid the equivalent of a prescriptions prepayment certificate.

Dr Beeby told Pulse: ‘There are a whole host of ways that they could make it fairer, I don’t know whether I’m of the “make it free” or “keep some charges” camp, it depends on my mood because there are arguments for and against.’

‘However, the current system is grossly unfair, it doesn’t in anyway relate to the cost of the drugs, it doesn’t relate to any sort of real need, it’s just quite random.’

He added: ‘But it’s not up for debate because the Government isn’t interested in changing it. Talking about things that might disadvantage many people, definitely isn’t going to be on the agenda.’

Survey results

Question: Do prescription charges adversely affect patient care?

Yes – 164 (39%)

No – 220 (52%)

Don’t know – 41 (9%)

 

Question: Should prescription charges be abolished?

Yes – 113 (27%)

No – 277 (65%)

Don’t know – 35 (8%)

 

About the survey: Pulse launched this survey of readers on 30 June 2014, collating responses using the SurveyMonkey tool. The 29 questions asked covered a wide range of GP topics, to avoid selection bias on any one issue. The survey was advertised to readers via our website and email newsletters, with a prize draw for a Samsung HD TV as an incentive to complete the survey. As part of the survey, respondents were asked to specify their job title. A small number of non-GPs were screened out to analyse the results for this question. Both question were answered by 425 GPs.