Posted by: Nicholas Swetenham | February 12, 2009

The prescription charges maze

Currently, NHS patients in England, Scotland and Northern Ireland pay a small fee when they collect a prescription, £7.10 at the time of writing. Wales recently phased them out, and Scotland and NI are in the process of doing so. It looks like by 2011, only NHS patients in England will have to pay these.

The situation has been further complicated by Prime Minister Gordon Brown’s announcement on 23 September 2008 at the Labour Party conference:

“I can announce today for those in our nation battling cancer from next year you will not pay prescription charges.………….and this is not the limit of our commitment to a fair NHS in a fair society. As over the next few years the NHS generates cash savings in its drugs budget we will plough savings back into abolishing charges for all patients with long-term conditions”


People already exempt include the following: People age 60 or over, 15 or under, or 16-8 and in full time education., pregnant women and new mothers, families receiving Jobseekers Allowance, Employment and Support Allowance, Income Support, or Tax credit. People on the NHS Low Income Support (LIS) scheme receive help with the charges and other expense. The following conditions are also exempt in a list unchanged since 1968: Permanent fistulae, some forms of hypoadrenalism incl. Addison’s disease, diabetes insipidus and mellitus, hypoparathyroidism, myasthenia gravis, myxoedema, epilepsy, and continuing physical disability that prevents the patient from independently leaving their place of residence.

The vast majority of long-term illnesses affect those over 60 in any case. Essentially, if implemented this move would mean that only patients with short-term, non-debilitating illnesses in England would have to pay prescription charges.

***Edit 17/08/2009***

Here is a summary of the comments I sent:

1. The financial burden of prescription charges is directly proportional to the duration of the illness, and the amount of treatment, and these should be the primary considerations; it is difficult or even impossible to quantify suffering and may not be fair to do so.

2. A broad definition would be more useful; the idea that it will only be applied to ‘long term’ diseases means some will have to be excluded, and difficulties will arise if people contest the reasons for their condition being excluded. A clear, simple, compassionate definition would be ideal.
e.g. ‘NHS patients in England are exempt from prescription charges if the condition is expected to last for more than 6 months and/or result in death’.

3. Besides the conditions listed in 1968 and cancer, we should include:
HIV and Hepatitis C infection, Tuberculosis and other long-term/lifelong infectious diseases.
Neurodegenerative disorders including Alzheimer’s disease, Huntington’s Disease, Parkinson’s.
Genetic disorders such as Cystic Fibrosis and Sickle-Cell Anaemia.
Any autoimmune disorder not already listed.

This list is by no means comprehensive.


  1. […] maze – 2 I wrote about the confusion and complexity of prescription charges across the UK last month. Since then, the BMA has issued a press release stating its position that it would be much simpler […]

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