DARREN ALDRICH, from corporate affairs at the NHS Counter Fraud and Security Management Service, responds:

The purpose of the penalty charge is to deter the incorrect or deliberate evasion of prescription charges by patients, which costs the NHS some £47m each year. The penalty charge is one of a series of measures that the NHS Counter Fraud and Security Management Service introduced to tackle patient evasion of NHS costs. This has contributed towards a reduction in losses to pharmaceutical fraud of approximately £70m per year — money that otherwise would have been lost and is now being used for the benefit of the NHS.

The process is governed by the NHS (Penalty Charge) Regulations 1999 and has been the responsibility of primary care trusts since 1 April 2005. NHS CFSMS has issued guidance to PCTs on managing the penalty charge process and this explains valid defenses and easements that can be applied.

The regulations clearly state that a patient is not liable to pay a penalty charge if they can show that they did not act wrongfully or with any lack of care in respect to the payment in question and that a lack of understanding of the law is not sufficient on its own to provide a valid defence.

Although we appreciate honest errors can take place in completing a prescription, it remains the responsibility of the patient to complete the prescription correctly and ascertain whether they should or should not pay the charge.

Further information and a copy of the guidance can be found at www.cfsms.nhs.uk