Government review on prescription charges

In October the government announced two concessions in relation to NHS prescription charges:

  • the exemption of cancer patients from charges from April of 2009 and

  • the exemption from charges for people with “long term conditions”, sometime “over the next few years”.

The latter concession was dependent on savings in the NHS drugs budget which the government was hoping to make from negotiations with the big drugs companies.

Swindon TUC asked our local MP’s whether or not all people with chronic conditions would be exempted. Courtesy of Michael Wills we received a letter from Health Minister Dawn Primarola which explained the review in this way:

This review will seek the views of the public, clinicians and patient representative bodies and will consider how to define the range of long term conditions which should be exempted from prescription charges and how exemption from prescription charges can best be phased in.”

This seemed to imply that some ‘long term conditions’ might not be included in the exemptions. This we tried to clarify with Ian Gilmore. We received this response from the Department of Health Customer Services Department, not from Mr Gilmore.

Professor Ian Gilmore will undertake a review of prescription charges to report back to Ministers next summer. The review will seek the views of the public, clinicians and patient representative bodies on how exemption for people with long-term conditions should be phased in. The Department expects charges to be phased out progressively as savings in the drugs budget allow.”

This seems a little different to the Minister’s response: how the exemption will be introduced rather than “the range of long term conditions which should be exempted”. Surely Mr Gilmore would have been given a remit, or terms of reference on exactly what he was reviewing. We shall seek further clarification.

Swindon TUC will write to Mr Gilmore’ review on two points.

  • All people with long term (or chronic) conditions should be exempted. We do not wanted a revamped exemption list which includes some conditions and excludes others.

  • Secondly, we will reassert the need for all patients in England to be exempted in line with the situation in Wales (where charges have been abolished), in Scotland and Northern Ireland (where they are being phased out).

Mr Gilmore may well say the second of these is beyond his remit. Nevertheless we should continue to drive home the case for abolition in all of the UK, for all patients.

If his remit is as described by the Department of Health above, it only underlines the stupidity of the government’s approach. If charges for “long term conditions” are to be phased out, as money becomes available from savings on the drugs budget, how do you determine a hierarchy of conditions which will be phased out? Which disease do you chose above another to exclude first? Moreover, if the further exemptions are dependent on savings then the current crisis may well extend the time scale beyond “the next few years”.

Given the fact that the government receives only £430 million a year from prescription charges it is the worst sort of penny pinching to dogmatically insist that a shrinking number of people in England alone, continue to pay. Money has been no object when it comes to bailing out the banks and financial institutions responsible for the global financial crisis, yet such a minor sum is apparently an obstacle to abolishing prescription charges for everybody.

As we have said before, whilst charges remain in place the government’s assertion that treatment in the NHS is “free at the point of need” cannot be true. Whilst the concessions are a victory of sorts, we should recognise that the government did not concede them out of compassion. They were the result of its political crisis. The abandonment of the privatisation of pensioners payment cards (at the Post Office) was the result of a high level of opposition all over the UK. Likewise we need to persevere with the demand for abolition because it is the only means of ensuring that treatment in the NHS is genuinely “free at the point of need”; that patients are treated equally regardless of their financial circumstances.

Individuals and organisations can write to Ian Gilmore at:

Prof Ian Gilmore, DH Mail, Richmond House, 79 Whitehall, London SW1 2NS

Or email (for his attention): DHmail@dh.gsi.gov.uk

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