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A dose of medicine

Betsan Powys | 11:42 UK time, Wednesday, 17 June 2009

"Let us remember" said Jonathan Morgan in a speech last week "that the majority of people who support Welsh Conservatives are not millionaires. They are not landed gentry with moats and duck houses. They are hard working men and women living in terraced streets and on housing estates. They want a good, gritty, no-nonsense Welsh Conservative party to stick up for them".

He was pretty clear about something else too: that if the Welsh Conservatives are to break through in Assembly election terms, they need to be seen as "a truly Welsh party". It is, he says, "time to be purposeful in motive".

I think the former Shadow Health Minister would consider scrapping free prescriptions as "purposeful".

Yes, the Conservatives here - as in Scotland - have consistently rejected and voted against the introduction of free prescriptions. But telling people who currently don't pay that under a future Conservative Assembly Government they would have to reach for their purses in the supermarket pharmacy queue once again is quite another matter.

Scrapping prescription charges was never, in their view, the best use of NHS funds nor the fairest way of doing things. Welsh Conservatives were never inclined to accept the Assembly Government argument that free prescriptions are a long-term investment, a freebie - yes - but one with a purpose. It was designed to encourage those who were deterred from coming off benefits and taking a job to get back to work because prescriptions, at least, would still be free. They would not lose out. It was designed to improve the long-term health of the nation.

What the Conservatives called it was "an expensive con trick". This policy meant millionaires were let off paying for prescriptions and that was plain daft, especially at a time when money is tight and the NHS needs every penny spent in the right place.

Just look at Wales said the Scottish Conservatives back in April. Abolishing prescription charges there has led to a seven fold increase in the use of antibiotics! (Not a figure an Assembly Government spokesman recognises, incidentally.) Don't go there!

Why, counters the Welsh Assembly Government, should people with heart disease, high blood pressure, those who've had an organ transplant have had to pay in the past? This way, the unfairness is removed. The system is fair.

Both sides claim then, that 'fairness' is on their side.

So who would pay if charges were reintroduced?

Well ... 93% of prescriptions were free before the charge was scrapped .If you were exempt then, you'll probably be exempt if charges are reintroduced in future.

Young people, in other words those under 25, pensioners, those on income support, those with "certain medical conditions" and - added to the list of exemptions by the Welsh Conservatives already - those facing cancer treatment would not pay. There is also "a grey area" into which the party now intends to delve more deeply. In other words that list may well grow as past unfairnesses thrown up by the system are thrown at the architects of this policy change.

How much would "those who can afford to pay", as the Shadow Health Minister Andrew RT Davies put it this morning, have to pay per prescription? "A modest fee" of between £3 - £5. Prescription charges in England now are £7.20. In Scotland they're £4, though the plan there too is to move towards abolishing them by 2011.

If you plump for £4, then how much would the NHS save? Somewhere in the region of £30million per year is the figure the Conservatives have put on it. Given that when charges were abolished in 2007, the cost to the Government was put at £29.5 million in the first year, the maths seems to make sense.

Any money saved would be ring-fenced and spent in areas like palliative care and improving the care of stroke patients. That would be fairer, say the Conservatives. How can the same old Tory agenda of slashing public spending be seen as fairer, comes the response?

But add those "grey areas" and precise figures become rather imprecise.

And what about the cost of re-establishing the mechanism around administrating the charges, means-testing, checking against fraud (how many 'pregnant men' used to be exempt?) All that will cost.

What about the bigger picture, ask fans of free prescriptions? What about those asthma sufferers who don't want to shell out £8 for two inhalers so go for the blue one that makes them feel better rather than the brown one that actually treats their condition. Their health gets worse. They end up in A+E. Look at the global picture and the £30m starts to look like ... well, an expensive con trick perhaps.

"It's not a vote winner "says one Plaid AM. But it certainly does what it says on the tin, the one with the label that says Welsh Conservatives - distinct policies - use by 2011.


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