Do prescription charges make us sick?
It goes down very well with voters, but are free NHS prescriptions such an obvious boon?
I ask because this week it became clear that, within a couple of years, only patients in England will have to pay for their medicines after Northern Ireland's decision to follow Wales and Scotland and abolish prescription charges altogether
I can already hear the objections of English patients, furious at the unfairness of a supposedly national health service that is in UK terms, of course, nothing of the sort. But my question is not about British health equality. It is about the most effective use of limited public funds which, ultimately perhaps, should amount to the same thing.
Ask someone whether they would rather pay £7.10 or get something free and they will think it must be a trick question. But the problem with free stuff is that people don't value it. And the 'stuff' we are talking about in England alone is valued at £8.2 billion.
Let's look what has happened in Wales.They went first and abolished prescription charges in April 2007. A year on, an enterprising Liberal Democrat wrote to GPs to ask what they thought. It was a straw poll rather than anything you could hang your hat on, but almost two-thirds of 133 family doctors said they opposed free prescriptions.
Here are some of the responses;
"I think that patients frequently fail to value that which they receive cost free and I suspect this contributes to high levels of wastage of medicines."
"I'd much rather the money was used to reduce waiting list times which causes needless suffering and often worsening of conditions."
GPs revealed that patients were demanding prescriptions for what would normally be over-the-counter treatments. Among items they were asked to prescribe were "nit combs, vitamins, honey, aspirins, paracetamol, cough and cold remedies, antihistamines".
One respondent revealed how they were "inundated with requests for head lice preparations for whole families".
I am sure there are some people who are put off going to their GP for beneficial medicines because they are worried about the cost. But not many. Eighty-eight percent of prescriptions in England are free already. And that's before Gordon Brown's recent announcement that all cancer patients won't have to pay for their prescription drugs.
Income from prescriptions in England is expected to be about £435m this year - hardly peanuts but equally not a huge sum in the grand scheme of NHS finance.
The cost of administering the whole prescription system is only ten million quid so the bureaucracy is not really a factor.
You see, I wonder if it is the money that matters here. Is the relationship people have with their NHS more important? People abuse ambulance crews and A&E staff because they see themselves as disgruntled consumers rather than citizens with a shared responsibility for the system. They waste the valuable time of doctors and nurses by not bothering to turn up for appointments because there are no consequences.
As I was having a tooth drilled this morning, my NHS dentist told me that the patients who are most likely to miss their appointment are those who don't have to pay. Further journalistic inquiry was limited to dribbling I'm afraid, but she was convinced that if a service is free people don't respect it.
The NHS in England reckons patients waste prescriptions worth "at least £100m" a year. I suspect it is much more given Merseyside health trusts alone calculated the cost at £12 million.
Managers speculated as to whether putting the real prices of drugs on the packets would reduce wastage, make people think twice before they threw away valuable drugs. A focus group suggested this would have unintended consequences.
"If the cost of the medicine was very high, some people thought that they should not take it, because it was too expensive. If the cost was very low, people thought that they should have had a slightly more expensive drug" the NHS Chief Executive told MPs.
Prescription drugs have never been part of the "free at the point of delivery" contract that underpins the NHS, but one can see why abolishing charges appears to strengthen this principle. To some, the health service ideals are seen as a bulwark against the power of capitalist markets - a model for benign and universal state provision.
However, the NHS increasingly encourages patients to behave like customers. Internal markets designed to improve standards are driven by "patient choice".
The arguments over prescription charges quickly go to the heart of the relationship between citizen and state, patient and NHS. Would free medicines for all protect the health service? Or expose its weaknesses?
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I agree 100% that people should pay what they can afford for prescription drugs. The principle that a free thing is not valued is so true.
Also people need to be better educated in the need to take their drugs AS PRESCRIBED. I am a Scout leader and on a recent camp a parent gave me some prescription antibiotics for her son. She said "Give him one in the morning and one at night". But the prescription clearly printed on the label said "Take one, 4 times a day". Her excuse was that his school was reluctant to let pupils take medicines themselves, so she had decided that he could just take 2 a day, for twice as long.
PEOPLE - it doesn't work like that! ASK your doctor.
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HI
I feel that the charges are unfair.I have high blood pressure and Asthma both of which need regular daily medication which i need to take to keep me well. I am finding it very hard to pay for these items as i take and use so many different things and my GP will only prescribe 28 days supply each time its a nightmare in costs.People with long term illnesses should get free prescriptions but everyday illnesses we should all pay for the cost of the medication.All long term illnesses such as Astma,Heart problems,etc need to have free medication.
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Interesting article. I can understand the draw of free prescriptions - after all I used to have to pay for them myself before applying for a pre-payment card - to the genal public.
Because of my eczema and asthma, I was regularly paying anything upwards of £30 a time - and that was just on repeat prescriptions alone, never mind anti-biotics and one-off medicines.
Now I pay 98-odd quid for a 12 month pre-payment card, money which probably goes towards the £10m admin budget , and collect repart and one-off prescriptions as normal.
I can understand the concerns of some Welsh GPs who have seen an increase in the number of prescriptions issued - especially for the 'over-the-counter' medicines - following the abolishion of prescription charges, where the public would still have to pay for a packet of pain-killers. After all, why pay at your local chemist or supermarket, when you can get it free from your GP?
No doubt, free prescriptions will become the norm throughout the UK, with the NHS having to cover a rather lucrative shortfallbby other means. It would be akin to HM Treasury losing the revenue it currently recieves from tobacco products.
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I very much favour a capping system similar to the one we have here in Hungary. The law requires that medical professionals must prescribe the cheapest available brand of the required medication so the parma industries compete on price and generics are always given priority. This tends to keep the price down. Patients then pay a subsidised price for each drug but up to a ceiling so that patients on very expensive products are guaranteed that their bill will never exceed a specific amount. On the other hand, drugs which are very cheap such as asperin or paracetamol are sold are sold at the market price so you are not paying a minimum charge as with the UK system.
Chronically sick patients requiring regular medication can also buy bulk packs under the scheme so, for example, I take a drug not licenced in the UK but similar to Warfarin which is dirt cheap to produce and I can obtain bigger packs which are much cheaper. My monthly bill on prescription for this one drug would be 7.10 GBP. That is about six months supply here.
UK patients need to wake up to the idea - and pharmacies should promote this - that quite often, drugs for which a script is not required are actually cheaper over the counter in BPC packaging. Even basic multivitamins are way cheaper in this form when you are not paying for attractive packaging and costly ad campaigns.
Having said that, the English do have every right to complain if only they are paying the charge. Either it is a National Health Service or a regional one.
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You say:
"I am sure there are some people who are put off going to their GP for beneficial medicines because they are worried about the cost. But not many. Eighty-eight percent of prescriptions in England are free already."
That is a logical non-sequitur. You can't measure the proportion of people who don't seek prescriptions by reference to the statistics for those that do. What if 90% of those who would pay for prescriptions simply don't bother going to the doctor, due to the cost? How could you tell just by looking at current figures? Clearly, you can't.
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I also have controlled high blood pressure but I only need to see my doctor once a year for it, but again I can only get 28 days per prescription which means I have to pay out every month now. It would cost me more to get a prepay certificate. When I complained to the PCT all I got from them was most people get free prescriptions. Its enough to give you high blood pressure.
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I have recently moved to England from Wales, and first started paying £6.10 for my prescriptions. Within a few months I then found that I was, and still am paying £7.10 per item on a prescription! I am asthmatic and recently needed tablets due to severe chest problems. I am in a lower paying job and stuggled to find the spare money to pay for my tablets. I can't help feeling that due to eveywhere but england having free prescriptions, people in England are having to pay for their privalege.
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There`s a thriving street market in prescription drugs. Sleeping tablets (nitrazepam, temazepam etc) and tranquillisers (the benzodiazepine family etc) used by street drinkers to reduce their shakes, by crack users to bring them down, by heroin users to reduce the physical symptoms of withdrawal or just to simply get `off their heads`. Quite a few heroin addicts wean themselves off heroin only to become addicted to prescription drugs. Doctors seem to prescribe these simply when asked, and many people do. Once obtained they become means or barter or sale on the streets.
Drug addicts/alcoholics needless to say do have many physical and mental health issues (hence I guess many doctors can`t see a real reason not to prescribe); meaningful counselling or residential rehabilitation seems impossibly hard to obtain (pop stars can pay – that`s how they get immediate attention). Giving free prescription drugs on demand may create greater problems amongst some sections of society. Having to pay even a few pounds does create some barriers.
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I dunno what you are all complaining about! The prescription costs are a steal! I moved to Canada from Kent and the cost of medication here is insane. You have a average prescription FEE of around $12 per item + the actual cost of the medication. Example being anti-inflamatories for Rheumatiod Arthritis cost around $75/mth or Asthma Inhalers costing around $80-$100 each... and if you don't have health care benefits (Insurance) provided by your employer, which usually still requires you to pay at least 20% and/or part of the monthly cost of the Healthcare insurance - you have to pay the full amount yourself for all members of your family - yes thats right your children too, no matter how old they are.
I think the prescription costs in the UK are reasonable and the money should be spent elsewhere.
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The point about prescription charges is that they are an unfair tax that hits the less well off more than the well to do. I am aware that if you are unemployed,unable to work through illness a pensioner or receiving benefits then you do not have to pay. But there are a lot of people on very low incomes in the UK who do have to pay and paying for several prescriptions at once as is sometimes the case,can be a real drain on a very limited budget. You might care to ask doctors how many prescriptions are not filled because the patient is unable to afford them.That is a bigger waste of NHS resources in my view that they consulted a doctor then were unable to afford the cure.
People wasting the docs time demanding cheap stuff they would normally buy from the local chemists shelves should be sent away with a flea in their ear but there is an issue here about very poor people completely unable to afford even basic medicines.
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The whole point is and should always be .....fairness.If i have to pay for a course of treatment why should another person in the UK in similar circumstances not.
It is this splitting up and division within the UK that is causing resentment.
i personally think we should have to pay for prescriptions,all of us.....
But we have a government that is hell bent on splitting up and dividing the health service into packages...
There should be one set of people in the nhs that negiotiate with the drug companies not as at present every trust this duplication of effort should be stopped it would save billions,and we could all at least say we are being treat equally,which is not the case at present.
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I beleive there should be a token charge for prescriptions for one off medication - repeat prescriptions for long term/permanent illnesses should be free.
The big issue here, is why is there enough money in the budgets of Wales, N.I. and Scotland to allow the abolition of prescription charges yet us English are still having to pay? Are their PCTs more efficient than ours or are the English yet again being disadvantaged by unfair funding systems?
It seems to me that this is yet another example of countries that no longer want to be members of the UK having their cake and eating it.
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The doctors and your dentist are spot on, and the same rule applies to "free samples" given out by businesses.
I have no problem in principal with paying for prescriptions. What does get my goat is that I am always asked if I have to pay by the pharmacy (rather than do I get it free). It seems that the working person is paying too much per medicine, to pay for the can't works, the won't works, plus kids and pensioners in our society.
Surely if everyone had to pay something, then the charge per prescribed medicine would be much less than the £ 7 plus that it is now. If the majority of the population that gets the drugs free had to pay, perhaps they would be less keen on visiting the doctor and extracting from him / her medicines that they don't really need (e.g. antibiotics for the common cold).
I would also advocate a token charge for visiting the GP, which would probably cut down no-shows, and again, make the "slightly unwell" think twice before wasting the time of GPs, who could then concentrate on the "really ill" who often can't get to see their GP because he / she is booked solid for a week ahead.
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Nothing we get from the NHS is free, we actually pay quite a lot for the service. As for the argument that people are asking for ridiculous items on prescriptions just because they are free I think that:
1. This would be a tiny minority as most people are sensible (yes really) and
2. The doctors should just say no when asked to prescribe.
3. Some people are really struggling and the difference between a free item and a paid for one makes a god deal of difference on a low budget.
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I think the definition of 'life saving' medication should be reviewed and that is what should be prescribed free of charge (I think at the moment it is just 3 or 4 medical conditions). My husband has chronic asthma for which he has had inhalers since he was born. His mother actually died from a heart attack brought on by a chronic asthma attack almost 20 years ago. He has a pre-paid prescription, which does save him money, but, when he needs his medication to keep him alive, why should he have to pay for it?
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One thing that annoys people like me (i.e. those that have asthma) is that there is a list of chronic conditions whereby medication is free. However, this list (from what I remember of a radio interview a few months ago) has not been updated since the 60s when it was introduced. The reason it wasn't on the list then was because there was no treatment for asthma then so legislators couldn't see the point of putting asthma (and some other chronic conditions) on that list.
Whilst I can see the point of paying for one off things: If we're not going to get free prescriptions then how about updating that list?
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" He has a pre-paid prescription, which does save him money, but, when he needs his medication to keep him alive, why should he have to pay for it?"
I'm being devil's advocate, I know, but I could just as well say 'I need food to keep me alive, why should I have to pay for it?'. I agree that medication should be provided free for those who can't pay for it (and it is, prescriptions are free for those on very low income), just as we provide benefits so the poorest people can still feed and clothe themselves. And I do see your point that there's a seemingly unfair disparity where some chronic conditions qualify for free prescriptions and others don't. But there are not unlimited resources available, and the line has to be drawn somewhere.
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I would support you in questioning if this automatically the right thing to do.
Another way of looking at it is this. If you were to spend another x billion on the NHS, what could you spend it on that would save most lives or suffering? ...would the answer to that question be free prescriptions?
(Obvious exceptions for the elderly, serious/chronic illness etc of course)
Although you are raising a different issue here, I dont think we can ignore the Scottish issue. How come the scots can afford free prescriptions, free universities, free school meals, free hospital parking, free elderly care etc etc and England can't?
Lets even up the distribution of tax revenue then see what they can still afford.
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"How come the scots can afford free prescriptions, free universities, free school meals, free hospital parking, free elderly care etc etc?"
They can't. It's the English taxpayer that funds them.
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Anyone of whatever age, working or not, can buy a three-month prescription 'season ticket' for just £27.85. That covers all your prescriptions, and is worth the cost if you have four or more medicines in three months.
Just over £2 a week -- can any working person really not afford that? If you can manage £102.50, the season ticket lasts an entire year. And if you're on benefits they're all free anyway.
I am passionately opposed to the creeping privatisation of the NHS, and all other attempts to whittle it away. But offering free prescriptions to everyone is simply not justified when there are more important uses for that money.
Taking action against the many freeloaders who tick the box for free prescriptions to which they are not entitled would also help.
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being English I dont mind paying for prescriptions as long as everyone in the United Kingdom do the same . Why are we singled out to pay while everyone else gets free .
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There is another argument that drugs for chronic conditions should be free rather than all drugs for people with chronic conditions.
For example if you had high blood pressure your would get your blood pressure tablets free. This would be useful as it might encourage use of these drugs which have some side effects and are given for a condition that causes few symptoms. However well controlled blood pressure may prevent a stroke which as well as a personal disaster is very expensive for the NHS. The NHS may even save money in total.
The same may be true of cholesterol tablets etc.
There is little reason for free paracetamol, nit combs or whatever in these cases though and they could be charged normally.
Of course there will be debate about which drugs would be free but we are going to have a debate about which chronic conditions will count anyway.
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I lived in South Africa for 20 years and i can see where medical treatment has now become unfordable for many many people. i have asthma and would spend the equivalent of £180 a month for my prescriptions.
My friends in South Africa with two toddlers in one month paid £600 on doctors fees and prescriptions.
I agree free attaches no value, ability to pay comes into it but imagine the world without the NHS!!!
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The thing I've never understood is why patients with conditions that exempt them from prescription fees can then get free treatment for completely unrelated conditions. There has to be some sense - diabetic patients should receive antibiotic medicines free of charge because of the complications of their condition - but there has to be a limit. This could potentially fund free prescriptions for people with conditions like brittle or severe asthma.
I agree that the NHS fee does insulate the patient from the costs of their medicine. I work for a private healthcare group. I am constantly dealing with amazed patients who are surprised when they are handed a bill for the medicines that they receive. This morning I explained to a patient that the medicine cost me £60 to buy in and that there would be an on-cost on that and her response was that she would talk to her GP to get it for free on the NHS. I then tried to explain the top-up situation but she wasn't interested.
My grandmother has free prescriptions. She doesn't take the medicines but keeps putting her repeats in to keep her doctor happy. The cost price of her medicines are about £4 per month. The most expensive medicines for the NHS are the ones that get dispensed but are never taken.
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One thing which does need emphasising - particularly to those people with chronic conditions where GPs only prescribe on a monthly basis: Prepayment Certificates these work out at £2 a week for as many prescriptions as you might need or want and they can even be purchased by Direct Debit at £10 a month. Please, please, please! ask your Pharmacist for the details. It constantly amazes me that people will complain about paying for 2 or 3 prescriptions a month when a certificate would have reduced the cost to £2 a week.
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Frankly, I'm insulted by the claim that I wouldn't value medicine if I'm not charged for it. Mainly because I pay for it every single month - it's called national insurance and I'm more than happy for the money I've been paying in and not using for the last 12 years to be used for this. If there isn't enough cash, increase NI payments.
The prescriptions are a tool that the doctor uses and are therefore part of my healthcare. I don't get charged for wear and tear on the stethoscope.
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So, according to you "Eighty-eight percent of prescriptions in England are free already" but making the other 12% free will usher in a new era of profligacy? How does that make any sense at all?
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To those who are claiming that other parts of the United Kingdom, not including England, are getting perscriptions free at 'English taxpayers' (no such thing we are all British and pay tax) are quite wrong. Scotland, England, Wales and Northern Ireland are all incharge of their own healthcare, we spend our money in different ways that have allowed us different privilages.
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It will work well.
Free prescriptions, but you can not get an appointment.
I know when I try to make an appointment it is always at least 7 days to wait.
Until recently you could wait your turn and see a nurse, now you must make an appointment.
If you are very ill you can phone from 8.30 Mon.-Fri half day thursday. but it is nearly impossible to get through.
So if you eventually get an appointment and a prescription, believe me, it is not wasted. It is a miracle.
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I often wonder whether people actually read Mr Easton's great articles before commenting. To answer a few of the easy 'complaints'.
How can the devolved nations afford this? Well in the case of Wales it is clearly not because of extra money but because they are spending less on things like reducing waiting lists. England has shorter waiting times and Wales has free prescriptions. You can't have it all.
The health system should be "national" and access the same for everyone. Its funny because most people say that they should devolve decisions to doctors and nurses and have less "central interference" but at the same time want everything equal. Devoving health to the nations isn't quite as far as to individual doctors but it has the same effect: different areas take different priorities. The only way you get total uniformity is Stalinist central control and people always say they don't want that.
Bottom line: people need to learn that there are trade offs. The NHS has finite resources and different parts of the UK have set different priorities. As a Welshman living in England I think England's got it right. If you are "very poor" you don't have to pay and if you are on long term medication you can buy an annual card for about £100 which is £8 a month: money everyone can find if they have to by avoiding that take away or drinking a few less pints. We really don't realise how easy we have it.
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I know that prescription charges can be prepaid and that if a person needs a lot of regular medication it's possible to buy them at a reduced rate.
I also thought it was possible for those in financial need to get free prescriptions - which is why we were very surprised when our student offspring (who needs regular doses of antihistamine) tried to claim this 'benefit' now that they're living away from home and currently is solely reliant on our handouts and a hefty means-tested on parental income "student loan".
Unfortunately they aren't eligible because the whole family finances are inspected, yet again, which includes savings held by younger siblings which relate solely to birthday and Christmas gifts over the years.
This is iniquitous and unreasonable.
The majority of British, and indeed English, students study away from home. They are on the electoral register of the constituency in which they are studying and are unable to earn very much, (if at all in the present uncertain financial climate) because of the number of hours taken up by studying.
As a family we are not entitled to any support from the state. Child benefit, which is a meagre amount, is no longer paid even though they are in full time education and it's suddenly assumed that, because we have earned income and a few savings, we are instantly able to find spare capital to top up loans so that our children can live "independently" away from home - this really isn't the case at all. Whoever thought up the system certainly was creative in their expectations.
A simple offering of free prescriptions, dentistry and optical care would be something, better than the current situation of nothing at all. It would also help students gain independence from their parents, after all, should they always have to go running to their parents to pay their bills?
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As an expat in Canada I am amazed at the deal that is available in the UK. Here in Canada we pay full price for our prescribed meds. This is in a country famed for its' health care.
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I think the frustrating thing is the inequality. I don't mind paying something for my medicine but the fact that the English will be the only ones paying is blatently unfair. One NHS should mean one rule for all.
I do think that those who are on long term medication, asthmatics, heart patients, cancer patients etc, who take pills every day and need to for the rest of their lives should be given an exemption. But for the rest of us who have the odd ailment paying shouldn't be that big a deal. I also think that Doctors should be able to prescribe for more than a month at a time. E.g my spouse has hayfever which usually lasts about 3 months, so why not give enough to cater for that time frame?
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I think you are missing the unfairness of prescription charges and the admin costs of this system.
88% of prescriptions are free. they go to those with cronic illnesses, diabeties people who are pregnant, under 18 over 65, unemployed, students they also cover birth control etc etc...
Then there are the Welsh, Scotish and soon the Northern Irish.
The only people paying for the 12% of prescriptions are the English working taxpayers, who, by the way pay for the other 88% too.
It can hurt paying £14.20 for two prescriptions only to find they didnt work and you need to pay again for another script.
It is not how much you earn that counts rather thatn how much cash is left for food shopping and bills.
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Although not resident in the UK I was surprised to read that the levels of service vary to such an extent.
Here in Israel the members of the corresponding national health services (there are several to choose from) pay a token fee for listed prescriptions (about 2 pounds), with certain exceptions. Some medicines are more costly, but normally a cheaper alternative is available. The cost of new drugs and treatment is a major problem and a government appointed body decides which ones are to be included. Various categories of patients and population are exempt from payment and there is also a cap on how much a patient has to pay within a 90 day period.
A similar system applies to fees for visiting a specialist or consultant and also out-patient care.
Maurice
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My husband is on co-codomol, prescribed by the GP. If he had to pay over the counter for these he would be at the chemists every other week (which would be a 20 mile round trip). The doctor can prescribe amounts that you just cannot buy them in without visiting 4 or 5 different pharmacists. This way he uses the Dr. less and doesn't have to go out all the time which is hazardous to his health.
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A horrifying number of people with disabilities are living in poverty, unable to pay essential care costs let alone prescription costs. Free prescriptions are not in fact automatically available to "everyone on benefits", as only some benefits qualify. I have to skip medical appointments as I can't afford to keep paying for taxi costs (the ambulance service is appalling and I suffered a serious collapse due to their neglect) and for a carer to take me to the doctor in a wheelchair. Thankfully prepayment certificates in Scotland have dropped in price, otherwise I wouldn't be able to afford medication either. I can't afford dental treatment. To say that no one should get free healthcare or medication because some people abuse the system is an absolute insult.
As for people not using their medication correctly, I agree and I think that doctors and pharmacists should make more effort to make sure that the patients know what to do. For starters, if you're visually impaired then you're in trouble, as the font size used on medication bottles/boxes and leaflets is far too tiny for many people to be able to read. I've taken incorrect medication and not realised I'd done it for a month due to this problem, and with some medication a mix-up could literally be fatal.
Next you get to the problem that the doctor says no more than, "I'm prescribing you X drug," and the medication label will say, "Take as directed by your doctor." Plenty of medication is supplied with no leaflet at all, so that patients have been given no instructions as to how to take their medicine. Even if the doctor has given verbal instructions, many people forget what the doctor has said in the consultation, and that's before we get to people who have memory difficulties or are so stressed by seeing a doctor that they don't remember exactly what was said.
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The wastage just now is likely in the 'those who don't have to pay' category because of the lifestyles they lead. I worked with benefits recipients, the bulk of the 'don't have to pay' people, and their lives are unstructured and ruled by whims. They won't turn up for an appointment if it's raining, because they don't really care. There's no come-back, no loss to them. They need to have missed appointments or charges taken off their benefits - that's the only thing that would make them sit up and pay attention.
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I have a rare immune deficiency Primary immune deficiency that requires blood replacement therapy, antibiotics,asthmas drugs, antacids, and depressive anxiety disorder, that requires mood stabilizers, antidepressants, Valium type drugs... None are free luckily I can pay for a prepayment certificate, but I don't work myself and if i had epilepsy, diabetes or some other conditions known in 1968!! I would exempt....
Hoe can that be fair so 88% are free.... great what about the rest of us....
I complain too and was told the same thing....
But I am on incapacity benefit, but because its family income it doesn't count...
It seems we are all in competition to be the worse off....
that cannot be fair .....
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Like some of the posters I have a long term illness which necessitates 8 prescription items per month. If I paid the full amount that would be £56.80 per month, as it is I use the NHS pre payment system which costs me £102.50 per year. This facility is open to everyone so when I see people complaining about the cost of prescriptions I see a load of lazy wingers who cannot be bothered to make a simple phone call.
I did not even have to go looking for the information the pharmacist gave it to me without any prompting.
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#24
You don't have to. Much of the world doesn't have any form of national health service. People just die.
Look at pets.
I choose to have pets and I had to decide recently whether to pay around £350 every three months or have my dog put to sleep. I'm keeping him alive as long as I can. I had to make the choice - medicine or death.
That's the reality of the NHS - it saves us having to make that choice.
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I am a GP, and wish to respond to some of the comments above.
We DO NOT just prescribe sleeping tablets etc when asked ... we are under huge pressure from PCTs not to prescribe, and are all well aware of the potential addictive effects.
It is very difficult to "put a flea in the ear" of someone who comes asking for something they could buy over the counter in these days where part of our pay is based on a patient satsifaction survey, and complaints are rising - although I don't deny that its frustrating when appointments are wasted like this.
The prepayment system means that no-one should ever pay more than about £100 per year for prescription drugs (ie less than a TV licence).
I agree that some of the current exemptions / non-exemptions do seem inequitable ... but I don't think these unfairnesses necessarily mean we should abolish charges.
In many cases the true cost of buying the drug and dispensing it is higher than the prescription charge.
The 28 day supply issue referred to by many is NOT generally the choice of individual GPs (after all its far more work for us to generate and sign 12 repeat prescriptions for 28 tablets each year than to do four prescriptions for 84!), but is pushed on us by PCTs who cite genuine evidence that 28 day scripts minimise wastage. When I see figures about medicines wastage I can hardly blame them for this.
There's no easy answer ... but all would do well to heed the comments from Canada that remind us that there is no system like this in most of the world .... and I worry that universal free prescriptions would hasten the demise of the NHS as they may encourage people to expect that the NHS will deal with minor illnesses which most people are more than capable of sorting out for themselves. Any attempt to get round this (for example by exempting drugs legally sold over the counter from any free prescription scheme) would be likely to just create more anomalies I suspect.
With my citizen (rather than doctor) hat on, I must say that different regimes in different bits of the UK seriously undermine any pretence of a "national" service.
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I've been in the position of having to choose between two prescription items - antibiotics and painkillers - when I could only afford one. I would fully endorse free prescriptions to save anyone else being in the same position. It doesn't matter what people expect from their doctors, the choice is in the hands of the person writing the prescription, not the patient.
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As a paying customer I do believe that the system of paying for our prescriptions is fine. There are people who genuinely need the free medication but unlike the current emphasis on a free for all which possibly leads to unwanted prescriptions there needs to be a more controlled system.
G.P's should be able to make a decision on whether they will issue a prescription and should not do so if it is not really necessary. Any medication over the prescription charge should be made available free but everyone can and should pay the same prescription fee.
The only exceptions need to be people who have chronic medical needs, babies, pregnant women and older people.
There is absolutely no need for working age adults to use free prescriptions and should be able to pay for their prescriptions.
I personally know of a good neighbour who is chronically ill and is always on medication. There are indeed times when she wastes these as she does not religiously complete every course or have to as the doctors keep chopping and changing every regimen she is on with every new blood test they carry out - but indeed there is some wastage here and this could not necessarily be totally avoided.
There is however the possibility for such patients being able to return their unused medication to the pharmacy which can then be used up first for other patients without another prescription charge being made on another individual. Of course this is frugality however where my tax pound is being spent and I make every effort to save turning on my light switches, shutting my curtains, washing at 30 degrees why should I not expect the same of my society.
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