Prescription charges for long-term conditions are unfair and out-of-date

Thanks to ever-increasing prescription costs for the essential medication people with long-term conditions need to keep them well, or even alive, many are facing the stark choice between food, clothing, bills or their prescriptions.

Leo Watson is a member of the Prescription Charges Coalition

“The squeezed middle has never been so squeezed.”

Those were the words of Ed Miliband in his speech on living standards last month. With austerity beginning to bite owing to deep cuts, rising inflation and stagnant wages, the reality of this phrase has rarely been so apparent.

But for those of working age living with long-term conditions such as rheumatoid arthritis, cardiovascular disease, asthma or crohn’s disease, the squeeze is even tighter and more suffocating.

Thanks to ever-increasing prescription costs for the essential medication people with long-term conditions need to keep them well, or even alive, many are facing the stark choice between food, clothing, bills or their prescriptions.

This situation has been worsened further still this month with the price of a prescription being increased by 20p to an eye-watering £7.85 per item.

It may not sound like much but this cumulative cost soon stacks up and can easily amount to hundreds of extra pounds a year for people unfortunate enough to be diagnosed and living with a long-term condition.

These are people that already pay their national insurance contributions and now suddenly and unexpectedly need help from the NHS only to find that popular NHS mantras of ‘free at the point of delivery’, ‘available to all’ and ‘based on clinical need rather than ability to pay’ do not apply to them.

Prescription charges today are eight times higher, in real terms, than they were 30 years ago. The latest rise is up from £7.65 last year and is in keeping with a tradition that has seen charges rise every year since 1979.

With Labour having recently taken its first few steps towards its 2015 election manifesto through the publication and subsequent consultation on its Challenge Paper, ‘21st Century NHS and social care: Delivering integration’, now is an opportune moment to remind Labour of the argument for introducing free prescriptions for people with long-term conditions.

The Prescription Charges Coalition – a group of 20 leading charities and organisations – has today published a new report, Paying the Price, which makes a powerful case for reform.

We surveyed almost 4,000 people with long-term conditions who are not exempt from prescription charges, and found that of those who paid for their prescriptions but did not have a Prescription Prepayment Certificate (a pre-pay card which provides free prescriptions for an up-front charge of around £100 a year) 35 per cent had not collected a prescription medicine from the pharmacy because of the cost.

Among these respondents, 72 per cent reported their health deteriorated as a result of failing to take medicine as prescribed, and of these, 40 per cent were forced to go back to their doctor and ten per cent ended up in hospital.

The fact that some people have been admitted to hospital as a result of the current prescription charging regime should particularly worry policymakers, as unplanned hospital admissions are generally regarded as a sign of failure.

Long-term conditions are also a key source of health inequalities. The government’s own analysis shows that they disproportionately hit poorer members of society.

And not only do people with long-term conditions have a lower quality of life overall, but a regional analysis of long-term conditions shows that average quality of life scores are worse in poorer areas.

Ed Miliband made a speech on the future of the NHS to the RSA in 2011 in which he said, “it is essential to tackl[e] the gross health inequalities we still face in Britain”.

If the party is serious about taking action then this is one area that demands attention.

It goes without saying that introducing a manifesto pledge to give people with long-term conditions free prescriptions would be in keeping with Labour’s NHS heritage.

The introduction of prescription charges in 1952 actually resulted in the resignation of Aneurin Bevan and other ministers because of beliefs that it undermined the principle of the NHS being free at the point of delivery on the basis of need rather than ability to pay.

The coalition argues that 80 per cent of prescriptions are dispensed at no charge, as prescriptions are free for those who are under 16 and over 60, have certain medical conditions or are in receipt of benefits.

While this is welcomed, it still leaves another kind of ‘squeezed middle’, including students and new graduates, those saving for a deposit on their first house, people looking to start a family and even those sending their own children to university.

The last Labour government, under Gordon Brown, acknowledged the strong case for removing prescription charges for people with long-term conditions and indeed pledged to remove them in 2008.

Despite asking professor Sir Ian Gilmore to undertake a review on how to implement his pledge, and the fact Scotland, Wales and Northern Ireland all decided to abolish prescription charges, the policy was sadly never implemented in England.

With Labour now in the process of renewing its thinking on health policy. we have good reason to hope this situation will change under a future Labour government.

You can download Paying the Price at: www.prescriptionchargescoalition.org.uk.

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