Petition for Free Prescriptions for All

On the 04 February 2011 Hayley Bate launched a petition on the 10 Downing Street site to lobby for free prescriptions for all.

"Recent studies have shown that 800,000 people have had to give up their much needed medication as they can longer afford to take it! This leaves no question as to why 20% of GPs break the law to ensure that their patients can have their prescriptions and 6% of GPs have paid for their patients prescriptions themselves! The NHS was funded on the principle that healthcare is free at the point of use- not free if you have your £7.20per item. It has been evidenced that it will cost £46m to scrap the scheme but this would be offset by savings in emergency care and admissions! I am sure that it Wales and Scotland can do this successfully there is no reason why England cannot follow suit!"

We would ask people to please sign the petition at -

http://petitions.number10.gov.uk/prescription1/

Free Prescriptions Petition Facebook Group

Petition FAQs and Views from Colitis UK

1) Why do you think prescriptions should be free for Sufferers of Chronic Illness

The underlying principle of the NHS is that treatment should be free at the point of use. The fact is that many chronic illnesses are treated by the lifelong use of medications. This effectively means that patients suffering from these diseases only get free diagnosis - and not free treatment.
If the same principle were applied fairly across the NHS then this would be the end result - Take for example that you went to casualty with a leg injury. You had some gashes and a fracture. Applying the same principles -

1) They would diagnose your injury for free - including the X-Ray and doctors consultation.
2) They would charge you a fee for each treatment you needed -

• £7.10 for the bandages under the plaster
• £7.10 for the plaster
• £7.10 to remove the plaster at the end
• £7.10 for your tetanus
• £7.10 for the stitches

Unfortunately people with Chronic Illnesses face this type of bill as not just a one off cost - but as a life long drain on their finances. Many end up skipping vital medication or "Stretching" their medication to make ends meet. Often this adds an extra burden to the NHS when the same patients end up requiring acute treatment in hospital.

2) Do sufferers of other diseases get free prescriptions

Yes the sufferers of the following conditions get free prescriptions -

• A permanent fistula requiring dressing.
• Forms of hypoadrenalism such as Addison's Disease.
• Diabetes insipidus and other forms of hypopituitarism.
• Diabetes mellitus except where treatment is by diet alone.
• Hypoparathyroidism.
• Myasthenia gravis.
• Myxoedema (underactive thyroid) or other conditions where supplemental thyroid hormone is necessary.
• Epilepsy requiring regular anti-epilepsy medication.
• If, because of a permanent disability, you cannot leave your home without help.

On the other hand sufferers of the following life threatening chronic conditions don't -

• Asthma (http://petitions.pm.gov.uk/Asthma/)
• Those requiring lifelong immunosuppressants following transplant surgery (http://petitions.pm.gov.uk/Transplantees/)
• Those suffering from Colitis, Chrons and other auto-immune diseases (http://petitions.pm.gov.uk/IBDPrescriptions/), (http://petitions.pm.gov.uk/freemeds/)
• Those suffering from Cystic Fibrosis

The list appears to be wholly arbitrary

3) Should any chronic conditions be excluded

We believe that those conditions primarily caused by lifestyle and that can be treated by lifestyle changes should be excluded.

4) Don't those on low income get free prescriptions anyway

Technically yes - but in reality no. The governments definition of low income is far below what most people would consider low income. This is also a means tested benefit - and most people choose not to apply for means tested benefits.
The reality is that if your income is about £3-6 more per week than you would receive in unemployment benefits then you probably don't qualify. For example most single people earning the national minimum wage wouldn't qualify.
In addition to this people on low income quite often can't afford to pay £100 up front for an annual pre-payment - and can't pay by direct debit as they only have basic bank accounts.

5) Won't the costs bankrupt the NHS

Whilst it is hard to prove we expect that making prescriptions free for life threatening diseases would produce a net saving for the NHS. There is a tendency with such diseases for patients to be in denial when the disease is well controlled. They often then cease using the medication - partly to save costs of the prescriptions.
This results in extra consultant visits (about £100 each), hospital stays (About £200 per night - or about £2,000 per episode) and can also result in major surgery (J-Pouch £8,000 to £15,000). These costs probably far outweigh the extra £100 of revenue from each sufferer.

6) How could this be administered

The current list based system of exemptions is cumbersome to administer and over burocratic. In reality most medication used to treat serious chronic illnesses are specialised - and have little or no use in treating acute illness. Based upon the use of computer systems to create prescriptions then a fairly simple approach could be taken

Primary Exempted Medications

Certain drugs such as azathioprine, asacol, asthma inhalers etc are only used for conditions that meet our proposed criteria. These would automatically be marked on printed prescriptions as exempt of fees.

Secondary Exempt Medications

These would be drugs such as steroids which may also have other uses. They would be marked as exempt on the prescription if the person was also receiving a Primary Exempted medication (not necessarily on the same prescription.)

There may be still a need to have a list/exemption based system for certain conditions - but I believe this would be rare.

Colitis sufferers would still have to pay for drugs not directly related to their illness - which I believe is only fair and proper.

7) Who would administer the scheme

The decision for which drugs would receive primary exemption and which would receive secondary exemption would lie with the National Institute for Clinical Excellency (NICE).

8) Why not have free prescriptions for all

There are good reasons why a prescription charge is desirable. The main one is to stop patients going to GPs to obtain medication for minor ailments that could be treated by a pharmacist. For example one would not want people seeing their GP for prescriptions for paracetamol.
I would therefore propose that free prescriptions should be limited to conditions meeting the following criteria.

• The condition must be either -
  • Life threatening if not treated by medication or -
  • Highly likely to require hospital treatment if not treated by medication or -
  • Severely debilitating or distressing if not treated by medication
• The condition requires ongoing medication - I would define this as medication being required for a period exceeding 12 months.
• The condition must be one treated mainly by the use of medication. Conditions caused by lifestyle and that can be treated through changes in lifestyle should be excluded.

9) Should changes be made to prescription charges in general

We believe the prescription charge should be treated as a per month charge or per-episode charge - and not a per-item charge. As a very minumum the charge should be changed immediately to a per-presciption charge rather than per-item.

I think this would be fair and stop the following anomalies

• Currently if a doctor prescribes a medication - and it doesn't work as the diagnosis was incorrect then the patient has to pay a new charge for the medication that will (or may) work. This is common in medicine as treatment is often a process of elimination/trial and error.
• If a condition requires multiple medications then the patient has to pay multiple charges. This is unfair as it reflects only the current type of preparations available to treat the condition. It doesn't relate to the cost of the drugs - as they may all be inexpensive. For example a skin infection may be best treated by a combination of a topical cream and oral anti-biotics.

And most of all - no one should have to make a choice between which medication they will get because they are unable to avoid all the items prescribed to them. If a GP thinks someone needs medication then they should be able to obtain it without excessive cost.