Ending free prescriptions for people over 60

[Fiz]

April 1st was going to be when the age for free prescriptions was due to be raised from 60 to 65 to match "when most people retire" but it is widely reported in hundreds of newspapers, all but the broadsheets, that free prescriptions will be scrapped for all. So only pensioners receiving pension credit or being exempt due to a medical condition won't have to pay for their prescriptions.


I actually approve of this as many pensioners are very wealthy. And prepayment certificates are affordable for those on lower incomes. I just hope all the money gained by this, goes to the NHS.

[Sunny Clouds]

I have three concerns about this sort of thing:-

1. I'm suspicious as to the cost of administering exemption schemes and applications for benefits that give rise to eligibility for exemption.  I note that just as withdrawing various other sources of support for disabled people prompted a spreading of the information that what was DLA was an alternative, e.g. where my local council day centre was run when central government funding to councils were slashed, people found the way to meet other people with mental health problems and have a meal meant hiring a taxi and going to a  pub.  Ah, but how to afford that?  Apply for DLA leading to a boom in applications from people already eligible but not claiming, giving the government an excuse to replace DLA with PIP.

2. Time-wise this increase in what health services you have to pay for will fit in very neatly with government privatisation of NHS, so even if I thought it was good for other reasons, I'd be unhappy because of further normalisation of paying for services.

3. There are many people who'd be entitled to pension credit but who don't know about it or don't know how to apply for it.  Based on people I've helped or referred to others for help, people who are in with a low likelihood of applying for benefits such as pension credit would include those with low IQ, low literacy, no internet connection (taking into account closure of libraries where formerly people could use the computers), homeless people (yes, where I live, as elsewhere, we have homeless in their sixties and even seventies) etc. 

4. In particular, I'm concerned about those I'd describe as 'mentally dysfunctional and unsupported' who can be difficult to persuade to take their pills, e.g. thiamine supplements for alcoholics to significantly reduce the risk of Korsakoff's dementia.

5. The more 'benefits' that are means-tested, the less support there is from those that don't get them for their availability for others.

6. I already object to people subject to Community Treatment Orders being obliged to take medication, and consider it a further insult when they are obliged to pay for medication they are only taking under threat of being sectioned if they don't.  That already applies to some people and would now apply to more.

7. This brings me full circle to a belief that medications should be free on the NHS.  If the government wants to cut the drugs bill, let it get tough with bigpharma over their prices.

[Fiz]

The people in in your groups 3 and 4 are likely to be entitled to free prescriptions before they reach 60 unless they are in full time employment so will already be receiving them so that will continue for them. And people under a CTO have previously been detained under S3 of the MHA which entitles them to section 117 aftercare with CCG funding for anything that keeps them well which includes their medication.

[Sunny Clouds]

Thanks for reminding me about s117 aftercare.

I'd forgotten, since no one bothered to tell me about s117 aftercare when I needed it years ago.

As for groups 3 and 4, I'm not talking about people that are entitled and claim, I'm talking about people that are entitled but can't manage to claim.  The more people that have to go through bureaucratic form-filling to claim a benefit in order to get other things, the fewer get them.  Two wrongs don't make a right, so having lots of people that already have to claim something else to get free scrips doesn't make it ok to increase the numbers.

That being said, over the years, I've given quite a few bottles of vitamins to local homeless people where I live (there are quite a few that camp out in the graveyards and car parks etc.) who can't get it together over that sort of thing, and I know there's an underground market in other basic medicines.  Yes, the stereotype is people trading in 'street drugs', but I've seen people passing on basic meds.

Where I live, there have been cuts to advice services, closure of libararies i.e. loss of access to computers with help to use them, cuts, cuts, cuts.

And if you're on benefits, mess up your paperwork or put a foot wrong and get sanctioned, you've just denied yourself a lot of basics. 

I suppose I'm just edgy because I've known so many people that have fallen through the net over the years.  In reality, what we need where I live in addition to foodbanks and other resources like places we can donate bedding and warm clothes, is a medicine & vitamin bank.  Then that would help those already struggling and adding more to their number would be less disastrous.

[Sunny Clouds]

I suppose it's only a half-way step anyway.  I think it'll be ten years at most, and probably nearer five when we'll need private insurance with a very basic and inadequate state safety net.

I lost a friendship a couple of years back when an older friend took exception to official figures published, I think, in the context of taxation, putting pensions and other benefits such as sickness and unemployment benefits into the same category.

"But I paid for my pension!" My friend said.  "No, I said, state pensions are a ponzi scheme.  You paid for the previous generation's pensions and today's younger people are paying for yours.  Also, many people on benefits have either paid national insurance for years or been unable, through no fault of their own, to do so. 

(It didn't stop me offering, via a third party so she didn't know it had come from me, some practical help not long after.)

I feel the same way about imposing greater and greater limits on eligibility for things like free (at the point of need) healthcare, education, legal representation, disability care and support etc.

It's the same reason I increasingly come close to blowing my top over the 'two child rule' which limits which children our society deems entitled to food, heat, clothing, toiletries etc. based on the foresight, luck and judgement of their parents.  My question is what next - only the first two children get free education?  Only the first two children get free healthcare?

So I suppose that with views like mine, I wasn't going to be in favour of any steps, however small, towards reducing healthcare on the NHS free at the point of access.  I just wish I thought it would be more than an intermediate step towards a totally Americanised healthcare system.  Bankruptcy for an ambulance, here we come.

Maybe I'm wrong.  Time will tell.

[ditchdwellers]

I remember reading somewhere, I can't remember where and it was a few years ago, that it was more cost effective to give free TV licences to all those of qualifying age rather than means testing it. The administration costs far out weighed any financial benefits.
Perhaps it will be a similar situation with the prescriptions. We all know how well the NHS and DWP like paperwork!

[Sunny Clouds]

Costs of handling cuts versus not cutting - an aside on legal costs...

I had a head-shaking moment when I read how one calculation (and I don't have a source for it) concluded that the project to deny certain benefits was costing more in legal costs than it was saving in reduced benefit payments. Well, since I don't have the evidence, and I can't cite which benefit(s), so let's take it not as a fact but as reasoning.

But I mapped it onto something I read from some prominent lawyers (and again I don't have a source for it) that the government's attempt to achieve a win-win for their political views by cutting legal aid had increased court costs in a variety of courts.  This doesn't just affect benefits.  Again, feel free to take it as reasoning not fact.

If a judge or magistrate or tribunal chair is honest (even if not intrinsically, just wishing to maintain reputation by minimising successful appeals against their decisions) and therefore seeks to get all the relevant evidence, an unrepresented applicant or appellant or defendant can take a lot longer to present their case, to give evidence etc. 

Let us say that you don't get your benefit and you appeal to a tribunal.  Let's say that where you live, there's either no free help to be had or very little.  Even in places with a range of free advice services, they may be overwhelmed, and what if you live in a village or small town, are so short of money you can't afford enough food, much less much time online or the bus fare to the nearest big town.

So you turn up at the tribunal, with an imprecise knowledge of the relevant law, no idea what the case precedents say, no idea what the judge is going to ask etc.  You may take literally hours to bombard the court with a range of information, perhaps with a couple of adjournments, that a lawyer or adviser could have done in well under half the time.

Is that extra court time, not just the judge's pay, but the pay of the other staff, cheaper than the saving in the claimant's benefits?

And if an appellant pushes the matter up to appeal, what then of all the administrative costs if a precedent is set?

Hidden costs.

[Monic1511]

This is an English problem as all prescriptions are free in Scotland,  making them even more means tested is wrong and will lead to an even bigger burden on the NHS as folk will be more unwell by the time they access help.  I looked at the nhs website and this is the information

I know pensioners get more £ than working age people but they are also most likely NOT to claim means tested benefits.  We should be encouraging all of them to claim attendance allowance as it could get them pension credit and then their free tv license 






Who can get free prescriptionsYou can get free NHS prescriptions if, at the time the prescription is dispensed, you:
are 60 or over

• are under 16

• are 16 to 18 and in full-time education

• are pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx)

• have a specified medical condition and have a valid medical exemption certificate (MedEx)

• have a continuing physical disability that prevents you going out without help from another person and have a valid medical exemption certificate (MedEx)

• hold a valid war pension exemption certificate and the prescription is for your accepted disability

• are an NHS inpatient

• You're also entitled to free prescriptions if you or your partner (including civil partner) receive, or you're under the age of 20 and the dependant of someone receiving:

• income-based Jobseeker's Allowance

• income-related Employment and Support Allowance

• Pension Credit Guarantee Credit

• Universal Credit and meet the criteria

• If you're entitled to or named on:a valid NHS tax credit exemption certificate – if you do not have a certificate, you can show your award notice. You qualify if you get Child Tax Credits, Working Tax Credits with a disability element (or both), and have income for tax credit purposes of £15,276 or less

• a valid NHS certificate for full help with health costs (HC2)

• People named on an NHS certificate for partial help with health costs (HC3) may also get help.Read more about who can get free NHS prescriptions.Check you're eligible for free prescriptions There's a simple way to find out if you're eligible for free NHS prescriptions and any help with other NHS costs.  Use the eligibility checker.Free prescriptions for certain medical conditions. People with certain medical conditions can get free NHS prescriptions.
• Medical exemption certificates are credit-card-size cards. They are issued if you have:cancer, including the effects of cancer or the effects of current or previous cancer treatment

• a permanent fistula (for example, a laryngostomy, colostomy, ileostomy or some renal dialysis fistulas) requiring continuous surgical dressing or an appliance

• a form of hypoadrenalism (for example, Addison's disease) for which specific substitution therapy is essential

• diabetes insipidus or other forms of hypopituitarism

• diabetes mellitus, except where treatment is by diet alone

• hypoparathyroidism

• myasthenia gravis

• myxoedema (hypothyroidism requiring thyroid hormone replacement)

• epilepsy requiring continuous anticonvulsive therapy

• a continuing physical disability that means you cannot go out without the help of another person (temporary disabilities do not count, even if they last for several months)

• Find out more about medical exemption certificates.How to apply for a medical exemption certificate
• Ask your doctor for an FP92A form to apply for a medical exemption certificate.
• Your GP will sign the form to confirm that your statement is correct. At your GP's discretion, a member of the practice who has access to your medical records can also sign the form.
• Your certificate will be valid from 1 month before the date the NHS Business Services Authority receives the application form.
• If you have a low income, you may be eligible to receive financial help through the NHS Low Income Scheme.  To apply for an HC2 certificate, complete form HC1, which is available from Jobcentre Plus offices or most NHS hospitals. You might also be able to get an HC1 form from your doctor, dentist or optician.  You can also get an HC1 form by calling 0300 123 0849.  You qualify for a full help HC2 certificate (which includes free NHS prescriptions) if your income is less than or equal to your requirements, or your income is greater than your requirements by no more than half the current English prescription charge.  You qualify for a limited help HC3 certificate if your income is greater than your requirements by more than half the current English prescription charge.  The HC3 certificate shows how much you have to pay towards your health costs. Certificates are usually valid for between 6 months and 5 years, depending on your circumstances.

[Sunny Clouds]

Looking at that list reminds me how utterly bonkers it all is.

I have two conditions I take pills for.  The one entitles me to them for free, but the pills only cost a few quid a year anyway, besides which, if I didn't take them, I'd feel rough but nothing dire would happen.  (Pituitary and thyroid aren't on talking terms, just random slanging matches, so the pharmacist acts as a go-between.)

The other doesn't entitle me to free prescriptions.  I've checked NHS prices (the pills not the scrips) and the pills themselves cost the NHS about £120 year (plus the costs involved in repeating the scrips, dispensing etc.)  If I had to pay for scrips for them, it wouldn't cost me a lot, but let's say I was younger, in work, didn't get free scrips, but was on a fairly low income, I might find myself prioritising other things such as food, fuel, rent, sanitary towels, travel costs to work etc. and skipping the pills.  You could say buy a pre-payment certificate, but you have to be able to afford it up-front.

How much does it cost to keep the likes of me in the loony bin for a fortnight if I go mad or seriously crash moodwise?  Around £3,500 a week, plus the costs involved in spotting I've a problem and getting me there.  In all seriousness, depending on who spotted there was a problem, whom they told etc., that could involve anything from police to councillors to social services to - well, whichever public service people thought to phone or knock on the door of.  Then there'd be some follow-up care.  So we're probably talking at least £10,000. 

Hmm.  Somehow I don't find the sums add up right in terms of what it makes sense for the state to fund.  Still, I didn't get a brilliant grade on my A-level maths, so maybe I missed the lessons on "How to do the sums on spending a bit to save a lot."

[Monic1511]

Hi


If you’re exempt for 1 condition you get all your meds free in England, I agree some of the exemptions are stupid after all GP’s don’t prescribe meds if we don’t need them.

[Sunny Clouds]

Hi


If you’re exempt for 1 condition you get all your meds free in England, I agree some of the exemptions are stupid after all GP’s don’t prescribe meds if we don’t need them.

Yes, it's mad that with two conditions, one of which could kill me if I don't taper my meds very carefully and get alternative non-med support (which the NHS is unlikely to provide), and the other of which makes life rather  less pleasant but isn't likely to kill me, I get free scrips for the potentially deadly one on the basis of having the non-deadly condition.

And I'm the one that's supposed to be mad, not the people in positions of seniority who decide these things.

Oh well, maybe time to make sure my doom and gloom hat's on, consider that we'll probably all need private insurance soon anyway, and consider that the rules will all change again then, and who knows what, if anything, will or won't be covered.

Medication, in particular insulin, symbolises the NHS for me.  One relative got diabetes after insulin became commercially available, but before the NHS.  Bye, bye, cash-strapped diabetic relative. Another relative got diabetes after the NHS, lived for a fair few more decades.  I bet most UK families have some sort of story like that to tell relating to what care their relatives/ancestors could or couldn't get.

On the other hand, insulin symbolises what gives me hope if the NHS is privatised.  You can't patent insulin, only the means of production.  In America, there's a team working with help over the internet from people around the world to come up with a means of producing insulin (including the whole injectable product, not just the insulin itself) that can be done on a small scale in what I'll call community labs/factories.  Their declared plan is to make the method available via free software.

Things like meds can make the likes of me fume over daft rules, but also give me hope about how people are fighting back in countries with nasty, unaffordable health systems.

[Sunshine Meadows]

My brain did that sliding across text thing so I have not gotten all the good information posted on this thread but wanted to say 


In particular I had not thought of how free prescriptions are the first level of healthcare that often prevents further more expensive treatment being needed.

[Sunny Clouds]

Are you telling us you didn't read and digest every single word?  I suppose you expect us to make some of those ridiculous 'reasonable adjustments' that disabled people keep demanding?  Why shouldn't you read and contemplate absolutely every point everyone makes even if you don't have the spoons for it?  Huh, these disabled people!  The next thing you'll be saying is that just because it's your site doesn't mean you have to be on full-time duty here?

 

[Sunshine Meadows]