Payment for prescriptions

... 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.

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.

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.

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.

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.

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.

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.

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..

maddyone

Still agree with you Doodledog. Great posts.

Still agree with you Doodledog. Great posts.

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.

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?

growstuff

Ladyleftfieldlover

Just skimmed through this - if I had to pay for my prescriptions, that would £72 ish per month.

No, it wouldn't because you could get an annual "season ticket".

IIRC, my Swedish friend said that their annual cap, no matter how many were needed, was no more than about £100.

Her dad, who was over 90 and not well off, still had to pay for his.

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’ve just checked to see if the rules have changed since I retired from DWP. And they haven’t. State Pension is not affected by a stay in hospital.

How about free prescriptions for people over state pension age, those with long term conditions or are on benefits? They're already known about/registered etc so no need for more admin.

I am against a small charge being levied on patients in hospital, because once that is accepted, it will almost certainly rapidly increase to a high charge.

Ladyleftfieldlover

Just skimmed through this - if I had to pay for my prescriptions, that would £72 ish per month.

It wouldn't - it would be £108 pa if you bought a prepaid prescription pass.

volver

There two kinds of people in the world.

Those that think the NHS should free at the point of use and that funding should be from the public purse whether you are the Queen or the person who cleans her toilets.

And those that think money is the answer to everything and people should be sanctioned for missing appointments, and that the cost of collecting £4 a day from an as-yet-undefined proportion of hospital residents is in any way a valid response, when what is actually required is an overhaul of the NHS.

Move to Scotland. Prescriptions free at point of need.

Couldn't agree more. Agree to the kind of charges being suggested as you are on the first step of a very slippery slope to privatisation of the NHS.

Ladyleftfieldlover You can get a Prescription Prepayment Certificate. £30.25 for 3 months, £108.10 for a year. That will cover all your prescriptions. You would not need to pay £72 a month, just £9 - £10 a month, depending on whether you bought a quarterly or annual Prepayment Certificate

The latest form of appointment, following a referral for a hospital appointment which I’d been told could take up to 3 months arrived after a week and went like this;
Hi Mxxxx we have developed a new online service that lets you choose and book an appointment on a date and a time that suits you - please try it out. You can book your appointment yourself within the next 48 hours by clicking this secure link.
That arrived on my phone(complete with a link) so I obediently looked at the appointments available and booked an appointment at a date and time that suited me.
Confirmation arrived. So exciting.

A few days later I got a follow up message to say that unfortunately that appointment wasn’t available due to changes in the system. The next day I got a text saying

Hi Mxxxx we have developed a new online service that lets you choose and book an appointment on a date and a time that suits you - please try it out. You can book your appointment yourself within the next 48 hours by clicking this secure link.
I did rebook, and asked for paper confirmation, which arrived, but I await further texts . . .

Zonne

We don’t have an equivalent healthcare system to Germany, and I don’t see that cherry picking bits of theirs and bolting them will help.

Means testing always costs more than it saves, anyway. Charging for GP visits will just stop ill people going, or delay them going until the cost of treatment is higher than it would have been.

And, of course, ‘paying a token amount’ to improve access has failed with dentistry, so I’d need to see very strong evidence that it wouldn’t do so for other parts of the NHS.

I am m all for having g a wide-ranging, citizen and expert (ie not politicians) led England and Wales wide conversation about the kind of healthcare we want and how it is to be funded, but reports produced in isolation like this aren’t helpful, imo.

I also agree with Zonne.

Anyway I meant you say it better than I could.

Oh no, it didn’t work, I wonder why.

Doodledog you so much better than I would, so I have quoted your post.