SCRAP Prescription Charges
The weblog of the Scottish Campaign to Remove All Prescription Charges. Keeping you updated on all the news about Colin Fox MSP's bill to the Scottish Parliament.
Tuesday, September 28, 2004
Prescription Charges – The case for Abolition
Prescription Charges – The case for Abolition
I was on Princes Street in Edinburgh on Saturday. The Scottish Campaign to Remove All Prescription Charges was conducting a street stall. The response from the public was fantastic. It always is. It is easy to see why the polls show support for scrapping this 'tax on the sick' running at 7 to 1. And can I say a big thank you to all the Scottish Mirror readers who stopped to sign our petition.
One senior citizen I met, a man called Tommy from Livingston, asked if I knew why the charges were introduced in the first place. I did but let him tell me anyway. 'To pay for Britains involvement in the Korean War.' He told me. And he was right, at least in part. 'Surely', he laughed, 'after 53 years we must have paid for it by now!'
Anuerin Bevan
One question I'm often asked, especially by older patients, is 'what makes you think you can succeed in getting rid of the charges when so many people have failed before? It is a fair point. After all even the man who brought in the NHS in the first place, Anuerin Bevan MP, failed to get rid of them.
There are important differences this time round however. First of all it is now a matter devolved to the Scottish parliament. So we can deal with it ourselves here in Scotland without waiting for Westminster. That’s why I put down a Members Bill last year. Dozens of MSP's from 4 different groups signed up to it. And I wrote this week to the SNP's new leaders Alex Salmond and Nicola Sturgeon asking them to add their party's backing too.
The second big change in the situation is that the Welsh Assembly has already decided to abolish charges there. So the time is surely ripe for the Scottish Parliament to follow suit.
Unhealthy charges
Thirdly the evidence which suggests that 'user charges' deter patients from getting the medicines they need is now overwhelming. The Citizens Advice Bureau, for example, recently produced a report entitled ‘Unhealthy Charges’ which suggest that 75,000 prescriptions were not picked up from chemists across Scotland last year because patients couldn’t afford the £6.40 charge. Similar health studies from around the world show that for every 10% increase in charges there is a 3% fall in the numbers taking up treatment. In the past few months even Chancellor Gordon Brown has spoken out. Making people pay for treatment, he told an audience of health professionals, in answer to Tory plans to charge patients for seeing a GP, leads to clear health inequalities. The facts and figures provide a very powerful case indeed for abolition.
Furthermore the cost of prescriptions has gone up 3,600 % since 1979. If they had simply risen in line with inflation they would be 64p today. I had a constituent John who came to my surgery last week. John has to take three different tablets to keep his mental health condition under control. He is on incapacity benefit and his fortnightly prescription costs him £19.20.
A false economy
There are unfortunately tens of thousands of people like John for whom vital health treatment isn't always affordable. Indeed John told me that in February he couldn't afford his prescription and went without. Unfortunately his condition deteriorated and he was admitted to hospital. He spent 4 weeks there recovering. According to figures provided by the NHS, it costs, on average £1,600 per week to keep a patient in hospital. You can see therefore what a false economy it is to deny patients free prescriptions. For the want of £19.20 the NHS was forced to spend £6,400 treating John in hospital! I know of hundreds of patients many of whom have been in touch with my office at the Scottish parliament relating similar very real hardships they face.
Charges undermine NHS.
I believe even in 1951 when the charge was just 1/-, it undermined the NHS ideal. How can you say it is free to use when you are sick if you are asking people to pay? The sick pay once via income taxes and National Insurance and then again when they fall ill. I object to the charges in principle.
Exemptions
The Scottish Executive is about to carry out their own review of prescription charges. Unfortunately they have ruled out complete abolition. They favour extending the exemptions. Currently youngsters under 16 and senior citizens are exempt, as are pregnant and new mums and people suffering from conditions such as diabetes. There are also exemptions for certain groups on low incomes - but by no means all. There are also discount schemes for those who must continuously pay, but these involve paying a lump sum up front. However it remains the case that 50% of the population are not exempt and must pay in full.
£45 million Cost
The cost of abolition would, according to the Executive, be £45million. This is based on current income from the charges. It does not include any savings from administration costs or savings from community pharmacist's time filling out forms [estimated by them at 10hours/ week].
This £45million figure is of course meaningless unless it is seen in the wider picture. The NHS in Scotland issues 7million prescriptions/year and its drug bill is £900m. Prescription charges now recover just 4.9% of the bill. We spend more than £8,000m annually on NHS in Scotland. Therefore as you can see the income from prescription charges makes up about one half of one percent of the total NHS budget in Scotland. Whilst the cost of abolition is negligible, the cost to those who go without their medicines and suffer real hardship is unfortunately significant.
SCRAP
The Scottish Campaign to Remove all Prescription Charges [SCRAP] will be campaigning on streets across Scotland in the coming months. We aim to persuade people to support abolition. I hope you will join with us. Together we can build a huge swathe of support and change Scotland for the better. I believe it is injustices like this we voted to end when we set up the Scottish parliament in the first place?
Colin Fox MSP
Scottish Daily Mirror article 27th September 2004
