Payment for prescriptions

What an informative thread this is. The combined experience of Gransnetters could provide an excellent Board of Trustees for the charitable trust that someone proposed to run the NHS.

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".

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

Me neither.

And I think there should be good, free school meals for all children at State schools. No discrimination.
It could save the NHS money in the future too.

Yes, fair point. I still think that when everyone contributes there should not be a situation where those with poor health should be impoverished by charges when those lucky enough not to need prescriptions should profit from it, though.

Doodledog

*I would get rid of free prescriptions, the various winter fuel payments, free bus passes and all the other bells and whistles of dribbles of little bits of money here and there that those over retirement age get.*
I can see the thinking behind this except that free prescriptions for older people are in recognition of the fact that older people are more likely to need more treatment than younger ones.

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.

The reason these are 'free' and separate and the money not included as part of the State Pension is so that they can be taken away again if the government of the day so decides. This has just happened with the TV licence.

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!

Since when has anything in the UK been ‘efficiently means tested’ ? Unfortunately arbitrary thresholds are set so low as to leave people who genuinely struggle, without support. No reason to think it would be any different with prescription charges. And free prescriptions for pensioners is because in the main, as you get to pension age you have more health issues and not as much income. Do we really want to get to the stage where people can’t afford essential medication ? Means testing doesn’t work - it gives authorities the tool to screen out vast swathes of people who struggle and just miss the cut off point.

Witzend

*Callistemon21*, I’m not surprised at the number of no-shows. Dh was not,long ago given an appt.for a minor procedure - at the wrong clinic. He turned up on time for it, only to be turned away. So that surgeon’s time - at the right clinic - was wasted.

And a BiL with cancer who was having regular appts. recently had an appt. letter sent to the address he’d moved from 17 years previously! Just as well the residents knew where to forward the letter to - in time.
It would seem that all too often, NHS admin is chaotic.

Plus I’ve heard of so many cases where relatives of people with dementia have repeatedly told the hospital not to send appt letters to the dementia sufferer - or at least to copy a relative in - because even if the person doesn’t throw the letter away, they will never remember.
But the same thing happens again and again - ‘Oh, we can’t do that - patient confidentiality….’
Yes, but what’s the point, if they’re just going to miss appt. after appt and waste everybody’s time?

I was called for a colonoscopy as a result of the bowel cancer screening test a few years ago. I was given preliminary results afterwards and told I would get a follow up outpatient appointment in about 8 weeks. I got the letter, followed by a cancellation letter the next day. The re-arranged appointment was also cancelled and when I finally got an appointment when I turned up the appointment had been cancelled again and the letter informing me was ‘lost’. I never got any more, despite trying my best via the hospital and GP. When this years’ screening test turned up I got the all clear. It’s no surprise to me that the early cancer diagnosis figures are so bad for the UK if this is anything like typical.

My mum, who lives with us has had dementia for three years. I have her power of attorney and have exhausted myself pleading with both GP and hospital clinics to address all correspondence to me, as mum hides or bins anything addressed to her. They have taken absolutely no notice and we have been contacted several times by both to find out why we have missed appointments.

Mum has recently been diagnosed with breast cancer and despite informing the breast care clinic that she has advanced dementia and to address everything to me, they too are ignoring me in favour of patient confidentiality. So now, we’re running the risk of missing appointments for a life threatening disease. In addition, despite me clearly stating that I have mums’ LPA and that I did not want her told she has cancer, they did exactly that at our last clinic visit. Power of attorney and the wishes of those living with the patient in difficult circumstances don’t seem to count for much.

The, seldom mentioned, main idea behind the 'free prescriptions for all' legislation in Scotland, is that it has been proved to be cost neutral. The huge sum saved by closing down a whole department whose sole purpose was to check that only the groups who were entitled to free prescriptions got them. Add to that the cost of extra checking work foisted on to pharmacies and Surprise, Surprise, these savings equal the cost of Free For ALL. I suspect that the same equation would apply to charging for missed appointments, hospital food.

PS - when DH was on end of life care in Hospital, all he could manage to eat was yoghurt and ice crème. I was amazed to learn that the abundant supplies of tubs of ice-cream & Yoghurt (also offered to family keeping vigil) came free, courtesy of a generous, local manufacturer/supplier

M0nica

And how about consulting patients when making appointments , so that they can have an appointment that fits in with buses, or the availability of lifts, or the need to take medication so that appointments are not cancelled and patients do not have to go back into a lottery for another appointment.

DD turned up at the hospital at 7.00am for a major op, to discover that her surgeons operating session had been cancelled and they had forgotten to tell her.

Yes - 'no shows' would be reduced if patients weren't sent letters with 'An appointment has been made for you at X time', which may or may not be possible for them to attend.

Sorry to hear about your daughter's cancelled op - I hope it has been rescheduled and that it went well if so.

And how about consulting patients when making appointments , so that they can have an appointment that fits in with buses, or the availability of lifts, or the need to take medication so that appointments are not cancelled and patients do not have to go back into a lottery for another appointment.

DD turned up at the hospital at 7.00am for a major op, to discover that her surgeons operating session had been cancelled and they had forgotten to tell her.

I don't agree with suggestions of £4 per night or whatever for food, bed and lodgings, apart from being the first step away from universal health care free at the point of delivery, can you imagine the number of staff involved? Fussing around patients' beds waving a card machine/producing spreadsheets of number of patients per ward and funds collected, then said spreadsheets being discussed in meetings with managers? Nope.

Nagmad2016

I have long thought that prescriptions should not be free. I have seen many cases of people re-ordering a full sheet of prescription medication, even if they do not need it. There seems little management of repeat prescriptions by GPs. Anything that is offered free, will invariably be abused by some. Just a nominal fee (not suggesting the full price of drugs), would, in my opinion, deter people from re-ordering drugs they no longer need. I think this should apply to everyone, except perhaps. those dependent on life saving drug regimes for chronic illnesses.

Also a consideration is that people who have a stoma of any kind get their supplies on prescription and these would need to be exempted, so if the fee were levied as a proportion of the full cost it would probably still be unaffordable for most as stoma products cost a fortune. The problem with charging even a nominal fee for prescriptions is that it will disproportionately affect the vulnerable. I think a better idea would be to more vigorously implement the system of GP medication reviews. Ours have been farmed out to the pharmacist who doesn’t seem to have much idea as to whether meds are still needed or not.

I would get rid of free prescriptions, the various winter fuel payments, free bus passes and all the other bells and whistles of dribbles of little bits of money here and there that those over retirement age get.
I can see the thinking behind this except that free prescriptions for older people are in recognition of the fact that older people are more likely to need more treatment than younger ones.

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.

Callistemon21, I’m not surprised at the number of no-shows. Dh was not,long ago given an appt.for a minor procedure - at the wrong clinic. He turned up on time for it, only to be turned away. So that surgeon’s time - at the right clinic - was wasted.

And a BiL with cancer who was having regular appts. recently had an appt. letter sent to the address he’d moved from 17 years previously! Just as well the residents knew where to forward the letter to - in time.
It would seem that all too often, NHS admin is chaotic.

Plus I’ve heard of so many cases where relatives of people with dementia have repeatedly told the hospital not to send appt letters to the dementia sufferer - or at least to copy a relative in - because even if the person doesn’t throw the letter away, they will never remember.
But the same thing happens again and again - ‘Oh, we can’t do that - patient confidentiality….’
Yes, but what’s the point, if they’re just going to miss appt. after appt and waste everybody’s time?

I would get rid of free prescriptions, the various winter fuel payments, free bus passes and all the other bells and whistles of dribbles of little bits of money here and there that those over retirement aage get.

It is treating us like children, who cannot be trusted with money unless it is carefully ring fenced so we do not spend it in sweets, wine or cigarettes.

Replace them all by a cross-the-board pension increase that costs the same as these extras and save on all the civil servants and costs of administration of all these extras and leave us to decide how to spend our money.

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.

Only just read this thread and want to endorse Volver's response, apart from moving to Scotland.

Hi Pammie1
My post was in response to another that said you had to declare it, which was corrected later.

I agree that it would be wrong to stop or reduce pensions for people in hospital, as even things like broadband charges and mobile phones are on contracts that have to be paid whether you use them or not.

Doodledog

*If you have a State pension and in Hospital for more that 4 weeks you are supposed to declare it, as you not "entitled" to it. How many do that?*
I don't have a state pension yet, but I didn't know you were supposed to declare it if you are in hospital. Probably a lot of people are also unaware of that. I suppose there is a certain logic in that the State is 'keeping you' when you are in hospital; but how do people pay the rent or other commitments if their income is stopped - outgoings are not restricted to food and/or other things that would be covered in a hospital stay.

Hi Doodledog. I’m having a senior moment and couldn’t find the post that mentioned the State Pension, but the information is wrong. For most state benefits anything over 28 days in hospital has to be declared, but not so for State Pension - payment is not affected by hospital stays or going into care.

Benefits like PIP, DLA and AA stop after 28 days, rent contributions are stopped after 26 weeks and council tax benefits stop after 52 weeks. All other benefits are subject to various limits depending on whether they are contribution or income based (means tested).

I think going down the road of charging for being an in patient is a minefield and it will involve redrawing benefit rules and the dreaded means test a lot more - not a fan of it as I think it’s a race to the bottom.

I understood the Government were considering raising free prescription age to state pension age, which seems reasonable if some people are paying for prescriptions.
There is a much bigger issue about whether the NHS should be free at the point of contact or whether people should pay something. The difficulty is, if we pay, who should get it free? The current system of free prescriptions seems quite random. Some well off people get them free and some on quite low incomes pay. Some people with chronic conditions get them free and some have to pay.

I am also unable to order repeat prescriptions ahead of time, which can be annoying if we are going away, but makes sense (although why anyone would want to stockpile inhalers is beyond me). Also, they are reviewed regularly - I can see my records online and the reviews show up on there. If I don't order as regularly as usual (eg if my asthma is better controlled and I don't use an inhaler as often as I might) I am asked if I still need the repeats.

I doubt if many drugs with a street value are put on repeat, so there is no incentive there to over-order, but maybe people with Dementia or similar forgetting to take tablets explains stockpiles? It is concerning that they aren't taking their medication as prescribed - presumably there are fewer check-ups with a GP than there used to be, and things are being allowed to build up, which can't be good for people with long-term conditions.

Means testing for anything is expensive, degrading and discriminatory and just fuels the flames of the intentionally divisive tabloid tales of people supposedly abusing the system. The first thing which would make sense though, is to raise the free prescription age in England in line with retirement age; I know plenty of people still working, at the top of their game financially, and getting free prescriptions because they are over 60. It is not as if you can redistribute it as can be done with the winter fuel allowance. A fairer scheme would be an annual pass, free to those in certain categories such as in receipt of pension credit or UC, thus the hated means testing part would already be done, and costing say £10 a month to everyone else.

rosie1959

Perhaps they should realign free prescriptions for pensioners to the age that you receive your pension. My DH was amazed that he no longer had to pay for his regular prescription at 60 what had changed he was still earning as much money as when he was 59 and certainly not a pensioner

That was so the age for men and women could be equalised. I think the government does want to increase the age to state pension age.

Perhaps they should realign free prescriptions for pensioners to the age that you receive your pension. My DH was amazed that he no longer had to pay for his regular prescription at 60 what had changed he was still earning as much money as when he was 59 and certainly not a pensioner

Nagmad2016

I have long thought that prescriptions should not be free. I have seen many cases of people re-ordering a full sheet of prescription medication, even if they do not need it. There seems little management of repeat prescriptions by GPs. Anything that is offered free, will invariably be abused by some. Just a nominal fee (not suggesting the full price of drugs), would, in my opinion, deter people from re-ordering drugs they no longer need. I think this should apply to everyone, except perhaps. those dependent on life saving drug regimes for chronic illnesses.

Who's to say that private insurers wouldn't continue to issue unnecessary repeat prescriptions?

I confess that I have hardly ever paid for prescriptions in my life. I was diagnosed with diabetes in my mid 30s, prescriptions are free for expectant mothers and for a year after the birth and now I'm over 60, I don't pay anyway. There have been times in my life when I could have ticked three exemption boxes. I don't stockpile, by the way, and my medication is reviewed annually.