Re-introducing prescription charges is like paying twice for your shopping


Current First Minister of Scotland, Nicola Sturgeon, was Health Secretary when prescription charges were abolished in Scotland in 2011 (picture from the Scottish Government’s Flickr page)
 I watched an intriguing news report from STV News this evening which focused on the idea of re-introducing prescription charges. The Scottish Conservatives are making the call for “modest” charges to be brought back and it is not the first time that the party under Ruth Davidson’s leadership have made the call for the current policy of free prescriptions to be brought to an end.

Alan Jenkins who reported on this story today provided a concise and quality insight as I would expect him to do (I’ve shadowed him twice on work placements with STV and he is a star already, let alone a star in the making) so any harsh critcism I make on the issue itself is by no means a reflection on his excellent journalistic capabilities. Rather, it is a good thing that this issue has been highlighted today as the potent counter argument needs to be made as to why bringing back prescription charges will be disastrous for patients in Scotland. And I have no doubt that the issue will be debated fiercely on this evening’s Scotland Tonight on STV at 10:30pm (they should make me a guest presenter of that show one day at the very least, haha).

The whole reason that the Scottish Government got rid of the two tier system that discriminated on the basis of who fell under a certain set of exemptions and who didn’t in terms of who pays for prescriptions was to improve access to medicines for patients. Clinical need is the priority over affordability to pay. Why should a patient suffering from asthma have to be hit in the pocket, because they don’t qualify for exemption under an outdated and incoherent list of specific reasons at the back of a prescription form? And why should a pharmacist and/or pharmacy team have to lose valuable time in their day to administer and experience the whole bureuacratic pain over having to confirm who is eligible and who isn’t eligible for free prescriptions? The fact is that prescription charges, especially on a “modest” fee, would bring little into the coffers in comparison to the total amount of money spent on medicines on NHS Scotland which was nearly £1.2 billion in 2014/15 (ISD Scotland). You would probably and hardly bring in around £80 million in prescription charges and what would that bring you? Not very much – much of that money would have to be invested into NHS Counter Fraud Services and the remaining amount wouldn’t really go far in addressing the need for more investment in more NHS frontline staff. Rather, the chances of admissions going up would rise if the two tier discriminatory system of who pays and who doesn’t pay is re-introduced.

And what’s more, why on earth should the democratic wishes of the Scottish electorate be dismissed? In 2011, Scotland returned an SNP led Scottish Government to Holyrood and backed the policy of free prescriptions. It is also worth remembering that many of the patients who use NHS Scotland to access medicines have paid for the medicines that they have been prescribed with. Are you really going to hit Scottish taxpayers with a second bill for their healthcare? And even if some patient weren’t contributing any money in taxation due to their circumstances regarding their welfare, then what will bringing back prescription charges say about us as a country and as a society? Our values of compassion, egalitarianism and cohesiveness would diminish if we take a divisive approach.

Re-introducing prescription charges is like paying twice for your weekly shopping at your local supermarket. Re-introducing prescription charges is like paying twice for your bus fare home. And re-introducing prescription charges is like paying for a parking ticket twice – twice the punishment. Prescription charges are punitive, especially when taxpayers have paid for medicines to be prescribed on the NHS and when much of the Scottish electorate have backed a political party or a set of political parties that pledge to keep prescriptions free at the point of the need of medicines and healthcare. 

It is an emotive argument that I am making, but unapologetically so. And it is a simple yet perfectly logical argument as well. I spent a time working south of the border when I was training to become a pharmacist and I saw first hand the utter obscenity of having to watch a patient choose between which medicines they were going to pay for that was prescribed to them. Charging for NHS prescriptions is madness – what is honestly the point of a prescriber writing a full prescription based on full clinical need when affordability becomes an issue? Let’s get our priorities correct and always.

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