The Pharmaceutical Journal
Vol 271 No 7269 p446
4 October 2003

This page
Reprint
Photocopy

PDF* 90K

  Prescription charges
  Community pharmacy
  Medical research
  Remuneration
  Advertising
  Primary care
  Fluoridation
  The Society

Letters to the Editor

Prescription charges

I suspect that the status quo will remain

From Mr A. J. Marshall, MRPharmS

I have to comment on Noel Baumber’s noble but unlikely vision on prescription charges (PJ, 13 September, p320). I have to agree wholeheartedly that the current system is unfair and unreasonably expensive to run for both the Government and contractors but making all prescriptions free will cause many problems in itself.

Doctors will be over-run with people wanting paracetamol, cough mixtures, antacids, etc. The public will not want to pay for what they can get for free. As such, the profit margin for the contractor will be heavily reduced and may even put some pharmacies out of business given that the National Health Service margin is rarely sufficient on its own. The NHS drugs bill will shoot through the roof because people will reorder prescriptions whenever they feel like it, whether they need them or not. You only have to see the number of unused medicines returned to pharmacies by the older population to realise the wastage abolishing prescription levies could cause.

One possible alternative is to charge everyone £1 per item dispensed. That way the cost to the Government can be dramatically reduced. If contractors could be allowed to retain this £1 as their dispensing fee, the Prescription Pricing Authority could simply reimburse the cost of the medicines dispensed plus any out-of-pocket expenses and additional fees such as extemporaneous preparations, expensive items and Controlled Drugs fees.

This would be considered a small cost by most parties and would also act as a deterrent to ordering items that are not required.

Obviously this option is also not ideal and, as always, there will be winners and losers. I would be concerned for several of our older patients who often have multiple items on their prescriptions. In theory pharmacists could decide to forgo their fee in these cases — but why should we work for free? It would not be impossible for the Government to give an “excess item” fee to the pharmacist (if the doctor endorses the prescription with the total number of items and forms issued) so that the patient is not charged a large some of money in these situations.

Another possible alternative is for the NHS to fund only prescription-only medicines, but to supply these free of charge. But this too would not be ideal.

My suspicion is that the status quo will remain for some time, unfair or not.

Antony Marshall
Stafford

How to save money for the NHS

From Mr U. A. Patel, MRPharmS

Noel Baumber advocates the abolition of prescription charges (PJ, 13 September, p320). Generally people only appreciate a service if they have to pay at the point of delivery, and what is not paid for at the point of delivery is widely abused. To save the National Health Service more charges have to be introduced.

I suggest there should be no exemptions and a £1 charge for every prescription item, £5 for every visit to a general practitioner and £10 for every visit to a hospital.

Everyone would be given a receipt and those who are on financial support from the state could reclaim the payment with a bonus of 10 per cent for the inconvenience. The Government would certainly lose the next election but the NHS would be safe.

U. A. Patel
Northwood, Middlesex

Send your letter to The Editor

Next Topic (Community pharmacy)