A public consultation on plans to scrap the prescription charge in Scotland has been launched by an MSP.
Prescriptions cost £6.40 a time
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.
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.
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Mr Fox described the current system as "outdated, arbitrary and entirely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.
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
MSPs backing Mr Fox's plans include the Greens and Independent Lothians list member
Green health spokeswoman Dr Eleanor Scott said the present system had "many
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.