In 1948 the leaflet distributed to every household about the forthcoming NHS said “Your doctor will give you a prescription for any medicines and drugs you need.”

In 2018 NHS England is conducting a consultation which proposes to restrict prescriptions of over-the-counter medicines for 33 minor, short-term health concerns. About £569 million is spent each year on these items and these proposals could save about £136 million.  That sounds a lot, but as a proportion of the £124.7 billion English NHS budget it isn’t a lot.

For most of us that is not a big problem.  Most of this stuff isn’t very expensive.    The recommended Chemists’ Own Head Lice Spray is £5.90, and that is one of the more expensive items involved.  We mostly don’t take headlice as seriously as we used to either.  But do we expect poor people to leave headlice untreated?  That seems a really good way of stigmatising them.  That is why we used to employ nurses specially to deal with headlice.

Nit nurses

But single people under 25  on Universal Credit are expected to live on £251.77 a month.  Once you reach 25 it goes up to the princely sum of £317.82  a month with £231.67  a month for a child. Some of the people to whom this applies are likely to have other problems. For example young pregnant women, who barely have enough money to eat properly.   It doesn’t seem sensible to put them in a position of choosing between food and medication.

There are also problems for people in residential and nursing homes.  Many of them will have difficulty in caring for themselves, won’t be able to buy items over any counter, and have no disposable income at all.   The consultation document says that all care homes should be encouraged to adopt a Homely Remedies Policy, which would enable them to administer these low risk treatments.  It also appears to imply that the home should pay for them.  Given the financial situation of many care homes – and the medical condition of many of their residents, who are very likely to be suffering from minor pain, constipation, diarrhoea and the like – this seems unreasonable.

The system of free prescriptions in England is a complete mess.  There is a list of illnesses which qualify you for free prescriptions. These are conditions for which there was life saving medication in 1968.   Cancer patients were added by Gordon Brown in 2009.   Everyone over 60 gets free prescription but younger people more than a couple of pounds over the means test limit (£57.90 for people under 25) have to pay £8.60 per item unless they can find £104 for a season ticket.

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3 Comments

  1. Dave Johnson says:

    Times change and society’s circumstances change. The range of services from and demands made on the NHS also change. This situation dictates that the NHS must adapt itself to match – BUT…the one thing it must always hold as its first priority is that it does no harm to the people who need its services.
    Each time a “review” or a “consultation” is held it’s clear that the primary objective is to cut costs – regardless of the effect. It seems that no matter what sound and fair arguments are put to ensure people are not harmed, these alarm bells are (and will always be) disregarded if they thwart the key aim of slashing costs.
    With Tory austerity and the Tories long-term aim of ridding government of any direct responsibility for the nation’s health care, we’re all in for a rough ride.
    As Neil Kinnock once said about the then-real dangers of Margaret Thatcher winning power: “…I warn you not to be young … not to fall ill … not to be old.” Those warnings still apply with this and any Tory government.

  2. Linda Szaroleta says:

    This issue is a real dilemma. One off prescriptions don’t seem to me to be the issue.
    It’s repeat prescriptions without adequate medication review which seem to be problematic. Patients who get these medications on repeat prescription will often continue to re order when they no longer require them. Regular medication reviews are essential, these reviews also are key to patient safety

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