Payment for prescriptions

I live in Sweden and we have always paid co-pay contributions for healthcare for the almost 30 years I have lived here. However the contributions are limited by the so called "high cost protection" which limits the amount you pay to about £95 per year for medical appointments and £190 for medicines.

For prescriptions you pay full cost for a certain proportion then gradually with subsidy increases until you hit the maximum when you are issued with a free-card for the remaining portion of the 12 months. The same works for appointments. You can also opt to pay monthly.

Personally as a disability pensioner it is factored into the Swedish version of disability living allowance that I receive.

The costs for healthcare try to help steer people away from turning up at A&E, out of hours with minor complaints. The current costs in my region are:
GP in-person appointment - £15
Specialist appointment or A&E - £30
A&E outside 8am to 5pm - £32
Other medical practitioner (nurse, physio, dietician, occupational therapist, psychologist etc) £10
Telephone appointments for doctor follow up - £8

Teacheranne

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.

Bloody hell. So in my DHs case it’s 6 lots plus a spray when it runs out of date.

Ask any doctor, people are going to die.

It wasn't a leak Doodle it was an article written by Stephen Smith which appeared in the Times at the weekend and then, possibly, in The Mail.

Yes, I know. As I said, I was talking in general (this idea does come up every now and then) not about the incident that sparked this thread.

Doodledog

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.

This. Makes so much sense.

Humbertbear

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?

I was referring to someone who said that IF they had to pay, it would cost £72 pm. With a prepayment pass it would only be £108. As would WWM2's husband's prescription.

It wasn't a leak Doodle it was an article written by Stephen Smith which appeared in the Times at the weekend and then, possibly, in The Mail.

I’m not so sure.

Well of course growstuff we don’t know what the future will bring. Next year, or in the next decade, we don’t know what any government will decide to do. I meant that it was not suggested in the article that this is in any way future policy. As far as I understand it, these are the thoughts of Professor Stephen Smith.

You are right Doodledog about leaks, but I didn’t get any impression that this was a leak, rather that it is the opinion of one man. I just didn’t want anyone be be so scared by my thread that they rush out and stockpile their medicines. I can’t anyway, my GP Practice only allows you to reorder after a certain date, so I can’t stockpile. I’d quite like to actually, in order that I have enough of everything for our two month trip to New Zealand later this year.

I didn't think you were doing that, maddyone, which is why I posted the addendum.

Every now and then we get a 'leak' that the government is considering charges though, and it crossed my mind that a side effect of that may be that people get in as many supplies as possible, just in case.

maddyone

I’m sure there are no plans at present to introduce either prescription charges for the over sixties or hospital ‘board’ plans. As I said in the original post (I started the thread) a certain Professor Stephen Smith made these suggestions. He was an NHS chairman in Kent I think. These are his ideas and there are no suggestions that this government, or any political party are planning to bring in these charges. I thought I should make that clear before everyone starts to stockpile medications. I started the thread as a point for discussion, not as scaremongering.

I'm not so sure.

I think all prescriptions should be free. My reasoning is that medications are just as much part of the treatment process as visiting a doctor, having a diagnostic test or an operation or other procedure - and we don't charge for those - yet!

Of course, that would mean that reviews would have to be done efficiently. I must admit that mine are. I get a text when a review is due and the GP stops prescribing if the review is more than two months overdue. I guess if I really wanted to stockpile, I could lie, but why would I? Maybe it would be more valuable to target expensive drugs rather than finding out if people still need paracetamol or one of the cheap generic drugs.

I’m sure there are no plans at present to introduce either prescription charges for the over sixties or hospital ‘board’ plans. As I said in the original post (I started the thread) a certain Professor Stephen Smith made these suggestions. He was an NHS chairman in Kent I think. These are his ideas and there are no suggestions that this government, or any political party are planning to bring in these charges. I thought I should make that clear before everyone starts to stockpile medications. I started the thread as a point for discussion, not as scaremongering.

By 'discussions' in that post I meant the government leaks, not chats on places like this .

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.

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.

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?

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!

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.

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.

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.

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.

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.

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

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%

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.

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.

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.