The report is the first in a series related to prescribing that the committee expects to issue. It says that the Auditor General for Wales estimates that around £15m a year may be lost to the National Health Service in Wales due to inappropriate exemptions being claimed. Prescription charge income for 2000–01 is expected to be £23m.

The report says that even simple errors, such as men claiming maternity exemption, are not being picked up, and that some pharmacists are not carrying out the checks as carefully or consistently as they should. This could stem from an unwillingness to damage relationships with customers and the complicated criteria relating to exemption status. The report also calls for better incentives to encourage pharmacists and tougher sanctions for those consistently failing to meet expected standards. The report accepts the argument put forward by Community Pharmacy Wales (formerly the Welsh Central Pharmaceutical Committee) that "a busy pharmacy is a difficult environment in which to carry out point of dispensing checks, particularly where a patient is not prepared to co-operate with the pharmacist".

Several steps could be taken to reduce the problem, the report says. The first is for all prescriptions to carry a patient's age or date of birth. Other measures, suggested by the Royal Pharmaceutical Society and Community Pharmacy Wales, are for discreet exemption cards and more involvement of pharmacists in issuing prepayment certificates.

Other recommendations made by the report include better checking and monitoring arrangements, greater pursuit of those fraudulently claiming exemption and clarification of the roles and responsibilities of all those involved in the checking process.

"Maximising income from prescription charges", National Assembly for Wales, Audit Committee report 06-01, presented 29 November (www.wales.gov.uk).