Payment for prescriptions

Treetops05

Many would stop visiting Dr's and refusing to go to hospital, we'd go backwards on health care. As for paying for hospital food (having married a retired hospital chef) I'll get my family to bring food in every day. Better for me and cheaper

I think that's why there's an on-site M & S Simply Food at my local hospital!

I wonder if anybody has actually thought through charging for GP visits, hospital food and more prescriptions. There would have to be exemptions for people who simply couldn't afford to pay and others such as the terminally ill. The admin involved to collect it all and chase up the bills would be huge.

I don't think anybody is disputing that the NHS does far more than it did in 1948 - thank goodness! (I'd have died a few times by now).

However, what it comes down to is whether it should still be a national system of available healthcare for those who need it and paid for by those who can best afford to pay - or whether it's every man, woman and child for him/herself, with the wealthiest paying for the best treatment and the rest doing their best with quack remedies and (let's face it) dying or living a life in pain.

sazz1

Yes I would agree with pensioners paying for prescriptions if we had higher pensions. We have one of the lowest in Europe.
I don't agree with people paying if they have a long term condition eg diabetes, cancer, COPD, etc.
We shouldn't have to pay for GP visit, or hospital stays though.
Main problem is not enough people working and therefore not paying NI and tax. People should be forced to take any job if one is available. Too many people not interested in working below their qualification level. That's why we have rotting fruit, flowers and vegetables in the fields.

Some pensioners have low pensions, but many don't because they have additional pensions and/or additional sources of income. Comparing UK and other pensions is like comparing apples and pears. You can look this up for yourself, but the average pensioner household has a higher disposable income (after housing costs) than the average working age family.

Where's your evidence that people are unemployed because they're not interested in working below their qualification level? Fruit picking jobs in Kent aren't much good all year round to people living in an inner city in the North East (for example).

elleks

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.

And if there's a partner still at home, all the bills don't magically halve just because one of the pair is in hospital.

Just to reiterate that state pension does not stop after 4 weeks in hospital. Som benefits are, but SP is not one of them.

Problem is that means testing will almost certainly cost more than any money saved as will the admin involved in collecting fees in hospital for food etc.

I do wish people would read the thread.

I quoted someone who'd said that pensions had to be declared, saying that I hadn't heard that this was the case, and questioning the sense of such an arrangement. Someone posted to say that it is not the case very soon afterwards, but many pages later people are still quoting my post as though I am saying that you have to declare a pension if you go to hospital. This has been corrected more than once.

As for pensioners being well off because of occupational pensions - I don't see that as relevant. Someone with a high occupational pension (which I don't have, in case anyone assumes I am posting out of self-interest) will have paid a lot more NI than someone on a basic pension or pension credit, so there is no reason why they should also be singled out to pay again for medication.

Everyone has to feel that they are paying for the NHS if it is to work. If those on higher incomes are charged more for treatment as well as paying more tax they may as well go private and leave the NHS even more unfunded than it is already. By all means increase taxation to pay for it, but the NHS has to remain free at point of need, or if it is not it has to cost the same for everyone, if we are not to end up with even more of a two-tier system than we have now.

No, Doodledog, that's not necessarily true. Higher earners get tax relief on their pensions, so they actually receive a higher subsidy from the government than basic rate taxpayers. Not only that but there are pensioners who have another source of income and sometimes have hardly ever worked in their lives. I don't see that it matters whether people work in a traditional job for their money - it should be the income from all sources which is taxed, which should then be used for universal healthcare.

PS. NI is capped, so higher earners don't pay more.

Higher earners would have to pay their taxes (and for the NHS) anyway. If they choose to pay on top of that for private healthcare, that's their business.

Can I point out there is no such thing as a free prescription. It all has to paid from somewhere and in Scotland's case it's taxes. I live in Scotland, am over pensionable age and still working. I've said for years I would be happy to pay the prescription charge because I can afford it and have it free when I can't. Surely there has to be a simple way of managing free prescriptions for the people who need it. Not sure how it would work but what about anyone below the national average wage, as a starting point, gets free prescriptions and take it from there. I agree with a previous poster that means testing usually costs more than it saves.

growstuff

No, Doodledog, that's not necessarily true. Higher earners get tax relief on their pensions, so they actually receive a higher subsidy from the government than basic rate taxpayers. Not only that but there are pensioners who have another source of income and sometimes have hardly ever worked in their lives. I don't see that it matters whether people work in a traditional job for their money - it should be the income from all sources which is taxed, which should then be used for universal healthcare.

I'm not disagreeing with taxing all sources of income. The government can raise the cap on NI by all means, and reduce the tax relief on pensions while they are at it - you will hear no argument from me. But they are not measures that we were discussing. My point stands (regardless of caps and so on - it gets to feel like sitting exams in here sometimes).

If people paying up to the cap are then expected to pay again when they need treatment there is no incentive for them to stay in the NHS. I don't think for a minute that if they could get away with it the government wouldn't encourage people to leave - they already allow fee-paying patients to jump NHS queues.

My point was that if there is a two-tier system of paying for prescriptions too, the NHS will disappear. Also, not all drugs cost the price of a prescription. You can buy paracetamol over the counter, but there are other drugs that are cheap but prescription-only. We could easily end up with those who pay getting private prescriptions for cheaper drugs and using the NHS for expensive ones (on the same principle as seeing a consultant privately and using the NHS for the recommended treatment). This would reduce the money available to those who are on the lower tier of treatment, as currently the £9 paracetamol charges contribute to the expensive drugs for more serious illnesses) and ultimately more and more people would end up outside of the NHS, with only those with no alternative (including older people with existing conditions) staying for a lower level of service.

People should be careful what they wish for, IMO.

How about not charging anybody for prescriptions? Those who can afford to pay would pay through their taxes.

The majority of people spend most of their lives without ever needing a prescription. The most expensive groups are children, the elderly, pregnant women and those with chronic conditions, most of whom are currently exempt.

Healthcare charges should operate like a proper insurance scheme. Neither of my sisters nor my partner have ever been in hospital, although they probably will one day. They've paid all their lives for the time they need care - which is how insurance schemes work. People who don't need medical care are the lucky ones.

But they were part of your claim, when you claimed that people who earn more pay more - they don't necessarily. They do, however, have more spare cash to spend on superior health care.

But how would they leave the NHS? They can't stop paying for it. That's fine! If they don't want to use it, they're paying for a service they won't use.

I think there needs to be a change in mindset from some people who expect everything free on demand. I’m a nurse in the NHS and my daughter is a Podiatrist. When she first started working in the NHS, she had such a battle telling people what the service was commissioned to deliver (based on clinical need and evidence based), some older people expect to be able to book in every few weeks to have their toenails cut!
A colleague working in the complaints dept one day was preparing herself for a phone call with a man who she says she used to call Mr Podiatry, she now calls him Mr Aspirin. This is a man who has had more than his moneys worth out of the NHS, but is a serial complainer. Most recently his complaint is because GP’s in our are are no longer prescribing Aspirin. My colleague advised that this is a very cheap drug which can be bought for less than £1 at the supermarket. His response? Why should I buy it when I can get it free? ??‍♀️

PS. I don't think there should be any prescription charges.

I agree that many prescription drugs cost less than the prescription charge. I looked up the price to the NHS of the drugs I take regularly. One costs more than the prescription charge, but the rest cost peanuts. Unfortunately, they're not available without a prescription.

Pedwards

I think there needs to be a change in mindset from some people who expect everything free on demand. I’m a nurse in the NHS and my daughter is a Podiatrist. When she first started working in the NHS, she had such a battle telling people what the service was commissioned to deliver (based on clinical need and evidence based), some older people expect to be able to book in every few weeks to have their toenails cut!
A colleague working in the complaints dept one day was preparing herself for a phone call with a man who she says she used to call Mr Podiatry, she now calls him Mr Aspirin. This is a man who has had more than his moneys worth out of the NHS, but is a serial complainer. Most recently his complaint is because GP’s in our are are no longer prescribing Aspirin. My colleague advised that this is a very cheap drug which can be bought for less than £1 at the supermarket. His response? Why should I buy it when I can get it free? ??‍♀️

Hmm! Not sure where she works, but apparently my poor old diabetic feet aren't bad enough to be referred to a podiatrist - and I need more than my nails cutting. The GP said there's a really long waiting list anyway, so I pay for a private podiatrist, which I wouldn't do, if I didn't need treatment.

And what percentage of people are like that Pedwards? As a former teacher, I could tell a few stories about awkward parents, but they were a tiny fraction of the total. Every organisation has "awkward" customers.

PS. I have aspirin on prescription because it's clinically useful. It doesn't really matter that it's cheap.

How about not charging anybody for prescriptions? Those who can afford to pay would pay through their taxes. . . . But they were part of your claim, when you claimed that people who earn more pay more - they don't necessarily. They do, however, have more spare cash to spend on superior health care.

That is exactly what I am arguing for. Are you playing devil's advocate again, as I have better things to do than explain myself again if so? I have already said that I was not talking about above the cap - until that point it is true that higher earners pay more than lower ones.

But how would they leave the NHS? They can't stop paying for it. That's fine! If they don't want to use it, they're paying for a service they won't use.
People can't leave the NHS now, but as I said, there is no saying that that will not be an option if the government is able to separate those who pay and those who don't, as a means test will require a change of system. There are already ways of staying in the NHS but paying to get better (or faster) treatment, and these could easily be extended into a 2 tier system, as has happened with dentistry. If higher earners have to pay the top rate of NI (regardless of whether or not the current contributions are high enough) as well as pay for prescriptions they might decide that they would be better off taking advantage of private schemes that would prescribe certain drugs but refer them to the NHS for more expensive ones. There are already 'half way house' schemes like that - cheaper than fully private, but offering access to a GP and (I assume limited) access to prescriptions.

Anyway, I've already said all of this. There's not much point in repeating myself.

Can someone tell me where the promised £350 million per week for the NHS that was promised by the pro brexiteer brigade on the side of their big bus once we came out of the EU has gone? That would surely solve the issues of no money in the NHS. Oh dear, cynical me. I guess we were lied to.

Ultimately as some have posted already the current set up is not fit for purpose and needs changing.
There is wastage that needs proper oversight, it also needs funding properly and that means not just the medications but the staff all need properly paying. We are at an all time low in the NHS with so many leaving. A lot of that is related to funding. You can plough in money to medications and services but if you don’t have the backbone infrastructure in place it won’t work.
Premises are often outdated as well.
Either way change is coming as it is collapsing we just have to watch and see how it evolves!

Doodledog I have been consistent throughout. I don't think there should be any charges for prescriptions and they should be paid for through the tax system. Maybe you just liking arguing for the sake of it.

Mapleleaf

Can someone tell me where the promised £350 million per week for the NHS that was promised by the pro brexiteer brigade on the side of their big bus once we came out of the EU has gone? That would surely solve the issues of no money in the NHS. Oh dear, cynical me. I guess we were lied to.

I'll answer that, if you can tell me anything about the new 40 hospitals we were promised. I guess they both belong in the "pie in the sky" category.

LadyWee

Ultimately as some have posted already the current set up is not fit for purpose and needs changing.
There is wastage that needs proper oversight, it also needs funding properly and that means not just the medications but the staff all need properly paying. We are at an all time low in the NHS with so many leaving. A lot of that is related to funding. You can plough in money to medications and services but if you don’t have the backbone infrastructure in place it won’t work.
Premises are often outdated as well.
Either way change is coming as it is collapsing we just have to watch and see how it evolves!

I'm sure there is wastage, as there is in any large organisation, although nobody seems to know how much.

The issue is that, compared with other first world countries, the NHS is underfunded. It needs more money (yes, for staff and infrastructure) and the question is whether that's paid to maintain a service for everybody through a progressive tax system or just for those who can afford to pay individually.

I’m happy to pay for my prescriptions until I officially retire. No one has to pay more than ten pounds a month for prescriptions as you can buy a certificate which allows all prescriptions for ten pounds a month. I resent though, that it’s only the English that pay for prescriptions. Why can’t we all pay, and pay less? Also, why do I pay for my asthma inhalers while someone with a thyroid condition gets all their meds free?