Payment for prescriptions

M0nica

Doodledog Leaving them free means that people don't have to choose between treating one condition or another, or just not taking the treatment at all. It's not a level playing field if everyone gets an extra £10 a week but some have to spend £20 (or more) to stay alive and others nothing.

No, everyone's pension would be increased by the cost of an annual prescription prepayment certficate, similarly winter fuelpayments, cost of free bus passes. We would just get a larger weekly pension and then be free to spend the money as we wished. If someone chose not to buy a cheap prescription 'season ticket' that would be their decision and they would need to pay for each prescription they required - assuming of course that they were on any medication.

I see what you mean; but that extra money would soon be absorbed into the pension, and people with no other source of income would inevitably end up skipping the certificate, which would rise in cost, I'm sure.

Medical care being free at point of need for older people means that nobody needs to ration their healthcare, and balances out the cost. Giving everyone the same whether they are going to spend it on health or not means that money has to be found for those needing expensive drugs, which in turn means that something else will get cut, whilst money meant for prescribed drugs will go to those who aren't ill.

I also feel that such a scheme would have overtures of the views of Americans who oppose Obamacare - 'I am healthy, so why should I subsidise other people's sickness?' The principle of 'all pay in/all take out when we need it' is fairer, doesn't penalise anyone for being ill and is an easier principle to hold on to - once it gets eroded it will disappear.

Still agree with you Doodledog. Great posts.

maddyone

Still agree with you Doodledog. Great posts.

Jaxjacky

I have wondered for some time why actual letters are posted out from the NHS, my bank, insurance, utilities and many other services I use have given me the option to go paperless, I emphasise ‘option’. We have the NHS app, so why isn’t this extended and used more? Contact by email, text or via the app must be a time and money saver why not NHS?

We have appointments sent by all three.

If the NHS decides to change the date of the appointment, firstly a letter arrives saying an appointment has been cancelled. Then another letter is sent out with the new date a day or so later.
Followed, of course, by two text messages and two emails..

It all seems very clumsy. I am 'seeing' a consultant for Graves disease (a thyroid complaint) and get a letter to say when the next telephone consultation will be, followed by recorded 'press 1 to confirm' type calls and texted reminders.

Sometimes the letters give 6 weeks' notice of the call, and sometimes it's less than a week. It would be so much easier if the secretary could call me and set up something that actually works for me. Pre Covid the appointments and blood tests were at the GP surgery up the road, but now it's all on the phone and bloods are taken at the hospital miles away. I work, so it's not always possible to get there at the time they arrange, and I have to ring the secretary anyway.

I don't think I'm a demanding patient - I keep every appointment I can, and reschedule in plenty of time if I can't make it - but everyone has other commitments, and I don't drive, so it's a lot easier if Mr Dog is also free to give me a lift. A quick call would take less time than typing out a letter, and would save a lot of faffing about.

Doodledog- yes -in a lot of NHS departments the tasks seem to be self driven rather than overall efficient which is the main reason that before any more money is put into NHS, a full review must take place to get rid of these gross inefficiencies plus hundreds more like them. On the whole, its not patients who are ruining the NHS and there is no point in chucking more good money in after bad.

Witzend

As long as it’s efficiently means tested, I honestly don’t see why not. It’s often said how much better healthcare is in other European countries - but many do charge for various things.

According to my Swedish friend, everyone there pays something for prescriptions (with an annual cap), for visits to GP and A&E, and the ‘board’ element of hospital stays.
And Sweden is popularly supposed to be some sort of socialist Utopia.

As for pensioners’ free prescriptions, it used to infuriate me to see how a friend of ours stockpiled masses of various items - only for them all to be periodically thrown away. I once counted over 60 items in his bathroom - half a dozen each of this and that. When he died he left 2 houses paid for and well over £1m cash. But he was as tight as they come - if he’d had to pay even £2-3 each I bet he’d never have taken so many things he evidently didn’t need. He was even getting paracetamol on prescription, FGS - it costs pennies in supermarkets.

And I bet he’s not the only such case, far from it.

What government will ever have the guts to introduce any such thing, though? They’ll all be terrified of losing votes.
People moan about creeping privatisation, but unless we start paying a bit more, that’s going to be the alternative.

A bit off topic, but I for one would like to see charges for people who end up in A&E purely because they’ve had far too much to drink!

Witzend

^According to my Swedish friend, everyone there pays something for prescriptions (with an annual cap), for visits to GP and A&E, and the ‘board’ element of hospital stays.
And Sweden is popularly supposed to be some sort of socialist Utopia.^

It's identical to the system in Norway.

When I lived there you had to pay for GP appointments, and yes, there is an annual cap - but that also includes appointments with specialists and consultants, etc, which also have to be paid for.

A GP appointment was roughly £10 and an appointment with a consultant ranged between £12-£25 (you also get a full refund if you are kept waiting for more than 40 minutes!). The cap was around £115.

The thing is, most Norwegians are well paid - they don't have the low-wage economy of the UK, and the majority are able to absorb these costs without any real hardship.

Nothing is free. Someone pays for it. Here in Oz concession card holders only pay $6.80 per prescription. I pay $120 to see my gp, our Medicare system pays $37.10, I pay the balance. And we can always get an appointment, we are lucky.

Doodledog Patients in my GP practice all received a message a few days ago that the practice would no longer carry out tests on behalf of a hospital consultant. Their argument is that they take up too much time, they don't get paid for them and they don't always know how to interpret the results. I understand from a GP friend that there's tension between GPs and hospitals about who does what. It could be the reason you now have to travel to a hospital for your tests.

Jaxjacky

I have wondered for some time why actual letters are posted out from the NHS, my bank, insurance, utilities and many other services I use have given me the option to go paperless, I emphasise ‘option’. We have the NHS app, so why isn’t this extended and used more? Contact by email, text or via the app must be a time and money saver why not NHS?

I think it depends on your hospital. My local hospital has a system which is almost paperless. I get appointments, test results and copies of messages to the GP online and there's a "messages" facility.

... He was even getting paracetamol on prescription, FGS - it costs pennies in supermarkets.

Just to point out that paracetamol is no longer on prescription - generally - but if you have a condition which requires you to take them daily on a regular basis, GPs will prescribe them because it is impractical to buy them over the counter due to the restrictions on the amount of tablets that can be purchased in any one transaction. If you were to obtain a month's supply, you'd have to make several frequent trips to the chemist and explain why you needed so many (assuming the pharmacy would accept such an explanation) or drive / bus around to various other chemists to get the amount needed.

I asked my GP if he could issue a note which I could present to our local pharmacy when I needed paracetamol on a regular basis - I wouldn't object to paying for them (they really are cheap if you buy own-brand), but he explained that "it doesn't work like that". Maybe it should! It could even be done electronically, each prescription has a unique bar code which can be translated, written down, and presented to your local pharmacy who could then check / verify its validity. I've no idea how many people use paracetamol - quite a few I imagine - but if the principle of "every little helps" really does work, then this is another area in which money could be saved within the NHS.

I've had a 'medication review' and told my doctor that I don't need this drug any longer on a regular basis - but it's still on my 'regular' medication list, so if I was that way inclined, I could stock-up 'just-in-case'... but as I greatly value the NHS I'm not inclined to abuse it.

Yes Dickens, the problem with paracetamol.
When I was on 2 4x per day, that was one pack every 2 days and I was only allowed to buy 2 packs per time. At B&M they cost me 29p per pack + parking+petrol. At the nearest walkable shop they cost around 45p.
I used to get 100 on prescription (12 1/2) days and buy the rest as and when I was at the supermarket or in town.

When I had to pay for prescriptions my GP would often say, particularly if it was Paracetemol, that it was cheaper for me to get it direct from the chemist rather than pay prescription charges so she would not issue one.

kittylester

Millie22

Not again ☹

Not everyone is a wealthy pensioner and can afford over £100 for a yearly charge. People will not get essential medicine or have to choose which to have if they have more than one prescription.

Not all pensioners just the ones who can afford it.

I don't see why means testing is such a thing. Surely, people in receipt of certain benefits would qualify.

Means testing doesn’t work, it’s a race to the bottom. Thresholds are set very low and ‘screen out’ people genuinely struggle and who miss the cut off, in some cases by only a pound or two. It’s also expensive to administer and in a lot of cases badly targeted - in the case of pensioners exemption to the yearly charge would almost certainly be tied to those in receipt of pension credit, which would leave others struggling.

Means testing doesn’t work, it’s a race to the bottom. Thresholds are set very low and ‘screen out’ people genuinely struggle and who miss the cut off, in some cases by only a pound or two. It’s also expensive to administer and in a lot of cases badly targeted - in the case of pensioners exemption to the yearly charge would almost certainly be tied to those in receipt of pension credit, which would leave others struggling.
I agree 100%

Doodledog

*Means testing doesn’t work, it’s a race to the bottom. Thresholds are set very low and ‘screen out’ people genuinely struggle and who miss the cut off, in some cases by only a pound or two. It’s also expensive to administer and in a lot of cases badly targeted - in the case of pensioners exemption to the yearly charge would almost certainly be tied to those in receipt of pension credit, which would leave others struggling.*
I agree 100%

Yes

Do you have to pay for each drug or per prescription?

Since DH retired he has suffered heart problems and has about 6 (I think) pills a day.

That would be a huge cost for the poorer pensioner. If it is per prescription.

And if people are forced to make a choice, that must make it well nigh impossible for the doctor, and cost far more in the long run I would have thought.

Dickens

... He was even getting paracetamol on prescription, FGS - it costs pennies in supermarkets.

Just to point out that paracetamol is no longer on prescription - generally - but if you have a condition which requires you to take them daily on a regular basis, GPs will prescribe them because it is impractical to buy them over the counter due to the restrictions on the amount of tablets that can be purchased in any one transaction. If you were to obtain a month's supply, you'd have to make several frequent trips to the chemist and explain why you needed so many (assuming the pharmacy would accept such an explanation) or drive / bus around to various other chemists to get the amount needed.

I asked my GP if he could issue a note which I could present to our local pharmacy when I needed paracetamol on a regular basis - I wouldn't object to paying for them (they really are cheap if you buy own-brand), but he explained that "it doesn't work like that". Maybe it should! It could even be done electronically, each prescription has a unique bar code which can be translated, written down, and presented to your local pharmacy who could then check / verify its validity. I've no idea how many people use paracetamol - quite a few I imagine - but if the principle of "every little helps" really does work, then this is another area in which money could be saved within the NHS.

I've had a 'medication review' and told my doctor that I don't need this drug any longer on a regular basis - but it's still on my 'regular' medication list, so if I was that way inclined, I could stock-up 'just-in-case'... but as I greatly value the NHS I'm not inclined to abuse it.

There’s something called prescription strength paracetamol but pharmacists can dispense this, so it’s a misnomer. When my partner required pain relief for a hairline fracture the hospital he had to keep going back to the pharmacist because it was limited to three days supply at any one time.

Conversely, my mum has prescriptions for Co-Codamol and Zopiclone (think they used to be called Mogadon) and the pharmacy keep sending a big box of each, every time they deliver her various monthly meds. The system run by our surgery is that regular meds are ordered/delivered automatically by the nominated pharmacy and I’ve contacted them several times to say she only takes them when she needs to, and we’ll order them if and when needed, but they keep on coming. When I mentioned it to the surgery they said that the only alternative would be to take them off the repeat prescription list at the next meds review, but that if she needed them in the future, she would have to have a consultation with the GP first. I wonder how many other non essential meds are being wasted in this way.

Sorry, that first paragraph doesn’t make sense. What I meant to say was that when he was treated at the hospital they told him to see his local pharmacist for paracetamol 500 and they would only dispense three days supply at any one time.

Whitewavemark2

Do you have to pay for each drug or per prescription?

Since DH retired he has suffered heart problems and has about 6 (I think) pills a day.

That would be a huge cost for the poorer pensioner. If it is per prescription.

And if people are forced to make a choice, that must make it well nigh impossible for the doctor, and cost far more in the long run I would have thought.

It’s so short sighted isn’t it ? If we introduce more prescription charging - and especially if it’s means tested - it means that the people who can’t afford the meds to treat their condition will inevitably get worse and end up costing the NHS far more in hospital admissions and more complicated treatments. As I said, it’s a race to the bottom.

Whitewavemark2

Do you have to pay for each drug or per prescription?

Since DH retired he has suffered heart problems and has about 6 (I think) pills a day.

That would be a huge cost for the poorer pensioner. If it is per prescription.

And if people are forced to make a choice, that must make it well nigh impossible for the doctor, and cost far more in the long run I would have thought.

You pay per item on the prescription so four types of medications is four prescription charges.

I must have been lucky with my mums various hospital treatments, she had dementia but sill lived alone so any appointments sent by letters were a nightmare. However, as she had stopped driving, I had to take her so if we were booking the next appointment with the receptionist, I simply stood there with my diary to check the date.

If a letter was being sent, I asked for either a copy of the letter, am email or text to be sent to me and as far as I remember, I always got one. The receptionists would take my details and make a note on the computer. It might have helped because mum would be stood next to me telling the receptionist that my daughter will sort it out.

The only time it went wrong was during Covid when mum was living at a care home and a breast cancer review letter went direct to her care home, organised through her new GP. Luckily the care home let us know and we were able to take her.

We still had to keep a close eye on her post during our daily visits to find any important letters, a snoop through the recycling was sometimes fruitful!

Kittylester - Did you say only £105? My mother only has a State Pension on which to survive. DS and I are both retired. I know who would have to pay the £105. And what about the pensioners - or other people not flush with money - who have no relatives to help them?

Sorry - want to add that my dad was in the army for the whole of WWII and my mother worked in a munitions factory putting the tail fins on bombs.

I wonder of the constant 'discussions' about whether to charge for prescriptions is responsible for any of the stockpiling?

I take three inhalers, and they each last a month. I have until recently also been on two lots of thyroid medication, so that would be around £50 a month without a pre-pay certificate. I'd rather exclude those from the discussion, as a lot of people would find paying £100+ upfront impossible, and there is almost a guarantee that they would rise in price quickly if we allowed the principle of 'free at the point of need' to be eroded.

A lot of older people take medication for blood pressure too, as well as statins and so on, so we can see how expensive it would be to pay for that on top of existing conditions like mine. Many people would have to start rationing their medication and missing some off the prescription.

We already pay ££££ for dentistry - I have just been given a treatment plan that will cost £3000 for remedial treatment (ie not cosmetic) - and with that in the mix even poor old Mick Jagger, who always gets a mention in discussions about means testing, might feel the pinch. It would be understandable if people started to think about getting as many drugs in as possible ahead of any detrimental changes, so that they have a bit of 'wriggle room' and can spread the cost of their treatment a bit if they do start to be charged for.