Prescription charge plea by MSP

Prescriptions cost £6.40 a time

A public consultation on plans to scrap the prescription charge in Scotland has been launched by an MSP.

Lothians Socialist MSP Colin Fox said the cost forces many patients to go without vital treatment.

He said it also undermines the NHS's founding principle of free health care at the point of need.

Mr Fox now wants MSPs to follow the Welsh Assembly, which will phase out charges by 2007 at an estimated cost of £31m a year.

Scotland's largest public services union, many pharmacists and various campaign groups also want the Scottish Executive to follow Wales.

Scottish ministers do not back abolition, but plan to review charges, focusing on chronic health conditions that are not yet exempt as well as young people in full time education or training.

About 91% of items dispensed in Scotland are already supplied to patients free of charge, according to the executive, which raised £46.3m of the NHS's £733m drugs bill in 2001-02 through prescription payments.

Vital medicines

Mr Fox said that simply extending exemptions, perhaps to about 95%-96% of items, would make the whole prescriptions regime less financially viable, while still leaving some Scots with long term illness having to pay.

He said: "Rather than adding to the groups who are exempt from paying the charge, we should abolish charges completely.

"The overwhelming reason for that is that all the evidence now shows that there's a significant number of patients in Scotland who cannot afford to pay the £6.40 charge per item and are consequently going without vital medicines their GP says that they need."

Three-quarters of prescriptions are repeat prescriptions, and about 80% of 18 to 60-year-olds still face paying prescription charges when they fall ill, according to the consultation paper.

We are opposed to prescription charges because they are a tax on those who are ill Bob Cuddihy Scottish Pharmaceutical Federation

While under-16s, over-60s and people with certain recurrent illnesses are among thousands of people north of the border who do not pay for their regular medication, some chronic medical conditions including cancer, HIV/Aids and multiple sclerosis are not exempt.

Mr Fox described the current system as "outdated, arbitrary and entirely contradictory", and at odds with the founding principle of the NHS of free universal access to health care at the point of need by asking many people to pay twice for health care.

Mr Fox conceded that the initial cost of abolition could be more than £46m, since the 70,000 people said by abolitionists to decline medical treatment due to the charge would then take up their prescribed treatment.

But he insisted the move could also save the NHS millions by ensuring poorer Scots no longer face costly hospital admissions after failing to get the right medicine and also removing administration costs.

Scottish public health expert Dr David Player and other campaigners were due to address a public meeting in Edinburgh to coincide with the consultation launch.

Unison Scotland health officer Jim Devine welcomed the move, describing prescription charges as a "tax on the sick".

A 2001 poll of GPs found one in five admitting they broke the rules to make sure poorer patients received the medicine they needed.

Eight out of 10 doctors told the same survey they had patients who missed out on drugs because they could not afford to pay for them, while 6% said they had actually paid the prescription costs themselves.

'Refuse treatment'

Bob Cuddihy, of the Scottish Pharmaceutical Federation, said some of his 1,100 members had been asked by patients which medicines were most necessary as they could not afford all those prescribed.

He said: "I've been told be individual pharmacists that they face these choices and they do not want to, it puts them in a terrible situation.

"We are opposed to prescription charges because they are a tax on those who are ill."

MSPs backing Mr Fox's plans include the Greens and Independent Lothians list member Margo MacDonald.

Green health spokeswoman Dr Eleanor Scott said the present system had "many anomalies".

She said: "Given that many medicines are already free, the bureaucracy needed to run the system and also the risk that some of those facing charges may refuse treatments, I think it would be simpler and fairer, and not hugely more expensive, to abolish charges altogether."

A health department spokeswoman said the executive's own review would begin within the next few months.