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.

Thursday, January 26, 2006

Colin Fox's Speech to the Parliament

Colin Fox (Lothians) (SSP): Today, I have great pleasure in introducing this stage 1 debate on the Abolition of NHS Prescription Charges (Scotland) Bill. It is a proud moment for me and for the Scottish Socialist Party. I thank those MSPs, particularly in the Green party and the independent group, who were the original sponsors of the bill. I am grateful for the support of all my colleagues in the SSP and the SSP team in Parliament. I am also grateful for the support outside Parliament of the Scottish campaign to remove all prescription charges, whose members are in the public gallery today. I particularly thank David Cullum and Claire Menzies Smith from the non-Executive bills unit, whose efforts have been immense. I express my gratitude for the work of the clerking teams on the Health Committee and the Finance Committee in bringing those committees' reports on the bill before the Parliament. I am particularly pleased that my bill comes before members on the anniversary of Robert Burns's death. It is a significant day.

I am disappointed however that the speech that I prepared yesterday has had to be substantially rewritten in the light of this morning's announcement that the Scottish Executive has conceded many of the arguments that it previously used in the debate about the bill and has announced a raft of new proposals to go out to consultation. It appears to me that, with its new propositions, the Executive has conceded entirely two lines of argument. The first is that only the rich currently pay prescription charges; the second is that the £44.4 million income from prescription charges is vital for the funding of the national health service in Scotland.

In trying to pull a rabbit out of a hat this morning, the Executive has presented us with another rabbit—one that is half-cooked and inedible. In my view, the Executive has shown in its announcement disdain for the Parliament. The bill has been before the Parliament for nearly two and a half years and before the Health Committee for a year, but the Executive waited until just three hours before this debate started to come forward with its proposals. I think that that shows disdain for the Parliament and the Health Committee. In addition, as the sponsor of the bill, I did not get to see the Executive's report until two hours ago.

So what is in the report? I must say that it appears to me to be a proposal/consultation document that has been put together very quickly. It tries to replace one dog's dinner with another, with the ability-to-pay approach contradicted throughout. The Executive puts in question the continuing exemption of the over-60s, which it says is anomalous with its proposals. In effect, the Executive proposes to consult exactly the same people who were consulted on my bill and exactly the same people who were consulted on the Health Committee's proposals. The Executive gives with one hand and takes away with the other.

I will focus my remarks on the case for the abolition of prescription charges in principle. Martin Luther King was fond of borrowing a saying of the Scottish author, Thomas Carlyle:

"No lie can last forever."

King used that in the context of the civil rights struggle in America to highlight the way in which millions of African-Americans were denied equality under the law.

For me, prescription charges are a lie that will not last forever. They show that medical justice and equal access to health care are denied to people in Scotland today, irrespective of their class, background or income. The founding principle of the national health service was universal free health care, paid for out of people's taxes. The NHS's high ideals have been compromised by prescription charges.

The Deputy Minister for Health and Community Care told us at the Health Committee that prescription charges represented a co-payment contract between patients and the NHS. I have to say that there is no concept of co-payment in the founding principles of the NHS—that should be made clear. The Parliament has the opportunity today to make a profound and very welcome difference to the lives of the 2.5 million Scots who currently do not qualify for free prescriptions. That statistic alone should lay to rest any claims that members would like to make in this debate that the rich alone pay for prescriptions.

The bill concerns the kind of improvement that the people of Scotland wanted from the Parliament when they set it up. In the most recent test of public opinion, 82 per cent of Scots supported the abolition of prescription charges because they see that the charges deny poor people the medicines that they need. That conclusion is based not on sentiment but on hard facts and sound reason. The Wanless report, which was commissioned by Her Majesty's Treasury to consider all the available international evidence, concluded that every 10 per cent increase in health charges leads to a 3 per cent fall in the numbers taking up that care.

It is telling that, as the first part of its consultation, the Scottish Executive's review examined all the available international research literature. That review was completed seven months ago, yet the Executive still refuses to publish it. Why could that be? Could it possibly be because all the studies conclude that the charges act as a disincentive to those accessing health care and the Scottish Executive wants to avoid the conclusion that the Health Committee and others have drawn? The evidence from the National Consumer Council, Citizens Advice Scotland, the Social Market Foundation and the King's Fund is that the current system of prescription charges is a complete dog's dinner and lacks any basis in fairness or logic.

The bill that is before the Parliament today has the backing of the Health Committee. That committee heard not one piece of evidence backing the status quo. However, the Executive has rejected the committee's working conclusions. I have to say that the Executive gave a slap in the face to the committee system of this Parliament when it delivered its verdict. For the first time, it has rejected the positive recommendation of a lead committee.

The Health Committee recommended the bill because it accepts that the current system is an indefensible dog's dinner. Everyone over 60 is exempt because of their age, irrespective of income. Every pregnant woman, new mother and patient with diabetes, epilepsy or an underactive thyroid gets free prescriptions, regardless of income. At the same time, however, only some people on state benefits qualify for free prescriptions.

The reality is that the Queen gets free prescriptions while people on disability living allowance do not. Some 30 members of this Parliament get free prescriptions but people on incapacity benefit do not. J K Rowling, as a new mum, gets free prescriptions, but a low-paid woman worker in the Scottish Parliament must pay in full. That is the reality of the dog's dinner of a system that currently exists.

The Scottish Executive argues that, since 92 per cent of prescriptions go to people who are exempt, only the well-off pay. Unfortunately, however, that picture is simply not supported by the facts. Some 75 per cent of all prescriptions are repeat prescriptions, mostly for people over 60. The reality is that half the population of this country are not entitled to free prescriptions at the moment. That means that the exemption could be extended to 2.5 million people for a small sum of money. We might expect the Executive to say, "Never look a gift horse in the mouth," yet it looks the other way and decides that it does not want 100 per cent exemption, saying that it prefers to target the benefit. The Deputy Minister for Health and Community Care is nodding. He is quite right to nod. However, all the evidence shows that the system is about as effective at targeting as poor old Charlie Kennedy was when he tried to bowl those balls in that old people's home. It is precisely the abject failure of targeting that means that those who need the benefit the most—such as 300,000 people on disability living allowance, 219,000 people on incapacity benefit and 850,000 low-paid people—are left behind. That is the reality of targeting and it is why the current system of targeting was not attractive to any of the witnesses who came before the Health Committee.

However, the Executive goes further and says, "We want to bring forward proposals to increase the number of sufferers of chronic conditions who will be exempt," and that it intends to introduce exemptions for as yet unspecified chronic conditions, pointing out that the list of chronic conditions has not been changed since 1968 and is, therefore, worthy of review.

The fact of the matter is that the list of chronic conditions has been looked at 13 times since 1968. Every review concluded that we should leave well alone, because it is a Pandora's box. The National Assembly for Wales decided that it was

"not practically possible to rank chronic conditions in terms of clinical need for medication."

In other words, all chronic conditions should be covered, or none. That is the reality of the sheer folly of the Executive's suggestion of ranking the suffering of cancer patients against that of asthmatics, or the suffering of people with Parkinson's disease against that of people with cystic fibrosis or Crohn's disease. What an unattractive proposition.

The second, and perhaps weakest, argument from the Scottish Executive is that abolition of prescription charges would lose the national health service £45 million of vital income and lead to cuts elsewhere. That raises two questions. Who pays the £45 million and where does it come from? As I have already illustrated, it comes from people who can ill afford to pay those charges. It comes from the 300,000 people who are on disability living allowance, from people on incapacity benefit and from the 850,000 people who are on low pay. They are the people who run the risk of not getting the treatment that they need.

The Executive says that the £45 million could not be absorbed into the budget and would lead to cuts elsewhere. Let us look at the evidence: £45 million represents 0.5 per cent of the national health service budget in Scotland. In Scotland, 99.5 per cent of the NHS's income comes from taxes, but it is the 0.5 per cent that comes from prescription charges that we cannot do without. The NHS's income is £9,000 million a year, but £45 million cannot be absorbed. I remind the minister of the background: the United Kingdom Department of Health at Westminster pledged a 7 per cent increase in health expenditure year by year until 2009. That gives the real context of the £45 million.

Two years ago, the former Secretary of State for Health, John Reid, renegotiated—to his credit, and I applaud him for it—the contract between the drugs companies and the national health service to the advantage of the service of £1.8 billion over the next five years. The financial claims of the Scottish Executive in the matter are just not credible.

The evidence in front of us today makes it absolutely clear that there would be savings for the national health service from the abolition of prescription charges: the £2 million that it costs to run the system. I see that the minister is now nodding in agreement after shaking his head; it always pays to listen to the end of a sentence. It is also clear that other parts of the national health service must pick up the tab for those who are denied their prescriptions. If they present themselves at hospital, the cost is £1,800 a week for a stay in a general hospital or £7,000 a week for a stay in a high-dependency or intensive care unit. That is the reality of people going without prescriptions. Considerable savings are to be made from the £45 million.

Finally, I want to touch on the party politicking that is going on in the chamber on the question of prescription charges. Scottish Socialist Party policy is to support the abolition of prescription charges and to support the bill, and that is the position of the Greens and the Scottish National Party. The Liberal Democrats will go into the 2007 Holyrood election calling for the abolition of prescription charges, but they will not vote for it today. The Labour Party policy in Wales was to abolish prescription charges, which, much to its credit, it did in 2003. However, the Labour Party in Scotland refuses to abolish charges—it hasnae got the bottle.

Some cynics have suggested that Labour would back the bill if it had come from a Labour member, but I could not possibly comment. Labour MSPs intend to vote against the bill, while the Labour Party in Wales championed the abolition of prescription charges. The Scottish Executive offers vague propositions in a consultation that begins today, yet there is a bill before the Parliament that would abolish prescription charges and introduce fairness and equality in the national health service. That is the choice for Labour back benchers. Members should support the bill, which I have pleasure in commending to the Parliament.

I move,

That the Parliament agrees to the general principles of the Abolition of NHS Prescription Charges (Scotland) Bill.

posted by Alister at 11:02 am

Parliament Rejects Scrapping Charges

You can find the official parliament report of the debate on the Scottish Parliament Website.

Herald Report

The Herald Editorial

If it's broke, fix it. That would be a useful adage to apply to the prescription charge regime in Scotland. It is outdated, anomalous, unfair and crying out for reform. MSPs had the chance yesterday to do something bold about it when the bill promoted by Colin Fox, the Scottish Socialist Party leader, to abolish these charges came before the Scottish Parliament. In the event, they voted by a large majority (77 to 40 with one abstention) against the really radical solution. The vote pleased Scottish Executive ministers, who argued that universal free prescriptions would cost the NHS many millions of pounds a year to benefit the better-off, who can afford to pay the charge.

posted by Alister at 11:00 am

Wednesday, January 25, 2006

MSPs vote on prescription charges

Press Association

MSPs are to be asked to vote on proposed legislation scrapping prescription charges, as ministers unveil plans to reform the current system.

Socialist proposals to scrap the £6.50 charge will face their first parliamentary hurdle, but Jack McConnell said the move was "misguided".

The First Minister said the Executive's planned reforms would aim to help those who struggled to pay for multiple prescriptions or regular ones for particular conditions.

Earlier this year, Holyrood's Health Committee endorsed - by five votes to four - the general principles of the Bill, brought forward by Scottish Socialist Party leader Colin Fox.

Mr McConnell said: "I think Colin Fox's proposal, which would mean people like him and I would not pay prescription charges and would do nothing to help ensure that the balance of provision in the health service is directed to those who need it most, is misguided, it's wrong in principle and it would be damaging in practice."

Mr McConnell said Parliament had to devise a new prescription system that better met the needs of the health service and users. He said any reforms should also help young people and those in education.

Mr Fox claimed his party had won the argument over prescription charges, irrespective of whether MSPs backed it, saying: "The abolition of NHS prescription charges is universally popular among the public."

"Support in the country for the abolition of this despised tax on the sick is absolutely overwhelming and MSPs should reflect on that before the vote."

The Bill was kept alive after Health Committee member and Labour MSP Kate Maclean voted for Mr Fox's proposal along with the Liberal Democrats' Mike Rumbles. Three Labour MSPs, Helen Eadie, Janis Hughes, and Duncan McNeil, and Tory MSP Nanette Milne dissented from the report's recommendation.

About half the Scottish population is eligible to pay charges. But the half that are exempt require many more prescriptions and in 2004 only 8% of prescriptions had to be paid for. The Executive has acknowledged there are "anomalies and inconsistencies" in the current system.

posted by Alister at 10:49 am

Thursday, January 19, 2006

NHS principles dictate that prescriptions should be free to all

Colin Fox MSP has an article in today's Scotsman putting the case for his bill to scrap prescription charges. Unfortunately this content is only available online for subscribers. So get down to the newsagent!

posted by Alister at 11:01 am

Wednesday, January 18, 2006

Students press case for free prescriptions

Scotsman: "SCOTTISH students have renewed their campaign to scrap prescription charges for those in full-time education.

The National Union of Students (NUS) Scotland said it had recently met Deputy First Minister Nicol Stephen and Health Minister Andy Kerr to press the issue.

The NUS has long argued students should be exempt from the £6.50 per item charges.

But the organisation has not taken a position for or against the Bill being promoted in the Scottish Parliament by Scottish Socialist Party leader and Lothians MSP Colin Fox to abolish prescription charges altogether.

NUS Scotland president Melanie Ward said: 'Many students find that they have to forego other essential items in order to pay the cost of a prescription.

'Students are finding it harder and harder to make ends meet and they are forced into high levels of debt. We are calling for the Scottish Executive to make students exempt from prescription charges, recognising that essential services, such as access to healthcare, should be provided free of charge as part of the government support package.'"

posted by Alister at 11:32 am

Tuesday, January 17, 2006

Lobby Parliament, Wednesday 25th January!

The debate on the Abolition of Prescription Charges will now take place on Wednesday 25th January at 2.15pm. We intend to have a lobby at 12 noon outside the public entrance to the parliament building. We would be grateful if you could encourage as many people as you can to give support. Please bring banners, placards, wear uniforms - anything you can think of to highlight the lobby.

We look forward to seeing you there.

Once again, many thanks for your help and support throughout the campaign.

Kind regards.

Lorna Bett
SCRAP Committee

posted by Alister at 8:21 pm

Saturday, January 14, 2006

Campaigning for an End to Prescription Charges

Edinburgh Evening News - Politics - 'Sick tax' MSP tests opinion: "Sick tax' MSP tests opinion

SCOTTISH Socialist leader Colin Fox will take to Princes Street tomorrow to test public opinion on his Bill to scrap prescription charges.

The Scottish Parliament's health committee this week gave its backing to the Lothian MSP's proposal. He has branded the charges a 'tax on the sick'.

The Executive has made clear it will continue to resist the move, arguing instead for a revision of the list of exemptions.

But Mr Fox said he now had 54 MSPs ready to vote for his Bill, including Labour and Liberal Democrat rebels. He said: 'The momentum is in our direction. The most recent poll shows 81 per cent support for abolition.'"

posted by Alister at 4:07 pm

Dundee appeal over prescriptions

Evening Telegraph: News

Dundee appeal over prescriptions

Dundee’s Anti Poverty Forum is calling for local MSPs to back the Scottish Socialist campaign to abolish NHS prescription charges.
In a bulletin sent to their members and local MSPs today, the forum said they believe the argument for abolition has been convincingly won and applaud MSPs Kate MacLean and Shona Robison for supporting it.

Jim MacLean, from the Dundee Anti Poverty Forum, said, “We are urging the other list MSPs to follow the example of their colleagues and support the abolition of prescription charges.”

In Dundee there are 10,000 people suffering long-term sickness and in receipt of incapacity benefit or severe disability allowance, and the Anti Poverty Forum believes that thousands of Dundonians would benefit from the abolition.

The SSP claims that 75,000 Scots go without some or all of the medicine they require because of the cost of prescriptions, currently £6.50 each.

The party believes prescription charges undermine the core principal of the NHS — a service free to all in need.

At Holyrood on Wednesday, the health committee endorsed the general principles of the Bill brought forward by SSP leader Colin Fox

posted by Alister at 4:06 pm

Thursday, January 12, 2006

Tell Your MSP: Scrap Prescription Charges

There has been widespread discussion in the media of the decision of the Scottish Parliament Health Committee to back Colin Fox's bill to scrap prescription charges.

We urge all supporters of the bill to contact their MSP's and let them know how you feel. Write to the newspapers, call the discussion programmes. We need to let the politicians in Holyrood know how strongly this bill is supported in Scotland.

Here is a selection of some of the commentary.

The Herald

A prescription for change
Editorial Comment January 12 2006

To join up with Wales, or stay with England? That is the question confronting Scotland's political class on the thorny issue of prescription charges. Colin Fox, the Scottish Socialist Party leader, has promoted a bill to abolish these charges. These will be phased out by the Welsh Assembly in 2007. The Scottish Executive is against abolition on grounds of cost, £45.4m a year and rising, and that those who can afford the £6.50 fee for each subscription should continue to pay (pre-payment is cheaper). One route out of this political impasse would be for the Scottish Parliament to debate and vote on Mr Fox's bill.

The Scotsman

ANDY Kerr, the health minister, was accused of "political expediency" last night after he rejected a cross-party attempt to get prescription charges scrapped for everyone in Scotland.

A Scottish Socialist Party bill to abolish the £6.50 prescription charge was backed by Holyrood's health committee yesterday, raising hopes among campaigners that Scotland would follow the lead set by Wales and abolish the charge.

But Mr Kerr said it would be wrong for the state to pay for a universal benefit for all and cover the costs of those who could afford to pay, arguing that it would be better to target money at those most in need.

Colin Fox, the SSP MSP who introduced the bill, said: "The health minister cannot have his cake and eat it. Recently we have seen the introduction of free care for the elderly along with eye and dental checks, all provided regardless of income.

"For Andy Kerr to then turn round and oppose abolishing NHS prescription charges because it would be a universal measure is a complete nonsense."

Daily Record

Fox said: "There is now unanimous agreement that the current system makes absolutely no sense.

"The question now is, do we tinker at the edges of a discredited exemption scheme or do we abolish it and go back to first principles?"

His party claim 75,000 Scots go without some or all of the medicine they need because of the cost.

Evening Times

LABOUR MSPs in Glasgow were today challenged to throw their weight behind abolishing prescription charges after the move was backed by Holyrood's health committee.
In a new report, the Parliament's influential health committee recommended the £6.50 charge should be ditched and replaced with free medicines.

SSP leader Colin Fox said scrapping prescription charges would be of particular benefit to people in Glasgow.
He issued this challenge: "Will Labour MSPs in Glasgow, the city with the highest levels of disability allowance and incapacity benefits in Britain, vote to deny their constituents free prescriptions?"
He urged them to follow their party colleagues in the Welsh Assembly who abolished prescription charges three years ago.
Mr Fox said: "The level of need in Glasgow and the west of Scotland means thousands of people are going without their prescription because they can't afford it."
He claimed 75,000 Scots were going without some or all of their medicines because they could not afford the £6.50 charges and an "overwhelming" proportion of them were in Glasgow.

posted by Alister at 9:08 am

Wednesday, January 11, 2006

Parliament Health Committee backs Scrapping Prescription Charges

Abolition of NHS Prescription Charges (Scotland) Bill

Full Health Committee Report at the Scottish Parliament Website.

Scottish Parliament Research Briefing (PDF)

Scottish Parliament News Report

The Health Committee today published its report on the Abolition of NHS Prescription Charges Bill, and has come down narrowly in favour of the Bill.

The Member's Bill which is being promoted by Colin Fox MSP seeks to remove the need to pay a prescription charge from those who currently do.

Committee Convener, Roseanna Cunningham MSP said:

”Our Committee was unanimous in agreeing that the status quo on prescription charges is not an option.

“We believe that the current prescription charging regime is inequitable. It exempts individuals suffering from some chronic illnesses, but not others, and it exempts some people on low incomes, but not others. There are too many inconsistencies and anomalies in the current system.

“The Deputy Minister's suggestion that the Executive may extend the remit of the review of the prescription charging scheme is welcomed, but there are concerns that the Executive appeared to be making very slow progress with this important work.”

BBC News

Prescription campaign gets boost

A campaign by the Scottish Socialists to abolish NHS prescription charges has received a significant boost.

Holyrood's health committee has given its backing to MSP Colin Fox's bill.

Ministers remain totally opposed to the idea but have accepted that they will have to address flaws in the present set-up.

The SSP claims 75,000 Scots go without some or all of the medicine they require because of the cost of prescriptions, currently £6.50 each.

The party believes prescription charges undermine the core principal of the NHS - a service free to all in need.

However, it is known that 92% of Scottish prescriptions are already free.

On Wednesday, the health committee voted narrowly in favour of the abolition of charges.

Scottish National Party MSP Roseanna Cunningham said all members agreed that the status quo on prescription charges was not an option.

They believed there were too many inconsistencies and anomalies, with some people suffering from chronic illnesses and on low incomes eligible for free prescriptions, while others were not.

However, in its report, the committee criticised some of the financial evidence offered by SSP leader Mr Fox, claiming he had overestimated savings and underestimated costs.

As ministers have rejected the idea of abolishing charges it is thought to be unlikely that the bill will reach the statute book.

The Scotsman

"The Welsh Assembly voted in 2003 to phase out charges, and they will finally disappear in Wales next year.

The verdict is expected at the very least to put pressure on ministers to widen the scope of a review of prescription charge exemptions. The committee's convener, SNP MSP Roseanna Cunningham, said: "Our committee was unanimous in agreeing that the status quo on prescription charges is not an option."

The embarrassment for the Executive was compounded by the fact that Labour's Kate Maclean, MSP for Dundee West, and the Liberal Democrats' Mike Rumbles, MSP for West Aberdeenshire and Kincardine, voted for Mr Fox's bill. Three Labour MSPs, Helen Eadie, Janis Hughes, and Duncan McNeil, and Tory MSP Nanette Milne dissented from the report's recommendation."

posted by Alister at 10:01 am

Monday, January 09, 2006

Committee backs Fox bill to scrap prescription charges

Sunday Herald

THE abolition of prescription charges in Scotland will move a step closer this week when an influential group of MSPs backs the measure.

The Scottish parliament’s health committee has endorsed plans to scrap the £6.50 charge that critics say is a tax on the poor.

Ministers have so far opposed the move but the cross-party support will put pressure on the Executive to adopt a policy costed at £40 million.

The committee report, expected within days, follows scrutiny of Scottish Socialist Party leader Colin Fox’s bill to end prescription charges.

He argued that the £6.50 charge penalised people on low incomes and those with conditions such as asthma, and cited research showing that 75,000 Scots go without medicines because they can’t afford them.

Prescription charges are to be abolished in Wales from 2007.

But opponents argue that the bill fails to target scarce resources at Scotland’s needy and is expensive. They say that vulnerable groups, such as pensioners and children, already receive free drugs, a flexibility that the bill’s supporters fail to recognise.

Now the health committee, after evidence from health professionals and other interest groups, has backed the “general principles” of Fox’s bill.

The nine-member group voted to back the move by a narrow majority. It is understood Labour members, with the exception of one rebel, were unmoved. One committee source said: “There was a debate on whether to delay supporting the bill, or to push ahead. The people who argued for pushing ahead were in the majority.”

Their endorsement will put pressure on the Executive to respond to a bill that ministers privately concede is popular.

posted by Alister at 1:38 pm