We need to reform prescription charges


Over the last few years, we’ve seen rise after rise in English prescription charges.

Yet the list of illnesses giving you free prescriptions was set in the 1960s, with cancer being the only recent addition.  Shockingly, it excludes mental health outright.

At this autumn’s South Central Regional Conference, a motion by the author was passed calling for reforms to remove the inequities of the current charging regime.

Take two hypothetical examples.

Jon is 40 and has a weak thyroid. Although he has a well paid job, Jon does not have to pay for his thyroid medication, or for any other medication, no matter what it’s for.

25-year-old Samantha works part time, with an income of £17,000. This takes her over the financial thresholds for free prescriptions. She has asthma, but often cannot afford to fill her prescriptions. Samantha ends up in hospital with asthma several times a year, with frequent GP visits too.

As a doctor, I know that there are many real patients like this.

Samantha is one of an estimated 800,000 people for whom charges mean they who go without the medication they need, and end up not only risking their health but also costing the NHS more as they become more unwell.

A key reform should be widening exempt conditions to include all long-term physical and mental illnesses, as recommended by the 2009 Gilmore Prescription Charges Review. The Prescription Charges Coalition noted two thirds of GPs, community nurses and pharmacists surveyed think the current exemptions should be widened to include anyone with a long term condition.

Possible savings to help fund this could be achieved by only making certain medication free for specific conditions, rather than giving free prescriptions for all of the medications taken by patients with an exempted conditions.

Where medications are not exempt, a per-patient annual cost ‘cap’ should replace the current annual £104 pre-payment certificate.

The current certificate requires you to predict in advance how many prescriptions you will need over an entire year, and buy it first. If doctors can’t predict how many drugs you might need in a year, how can patients be expected to?

Lastly, there should be more user-friendly application process with simpler means-testing where necessary.

A petition calling for some of these recommendations can be signed here.

* Dr Mohsin Khan is an NHS psychiatrist. He is Vice-Chair of both Oxford East Liberal Democrats and Liberal Democrat Mental Health Association. He sits on the Sex Work Working Group and is South Central’s Regional Policy Chair. He is co-founder of NHS Survival. He has commented on healthcare for BBC Breakfast, ITV Good Morning Britain, Sky News, and London Live.