C+D Snapshot: Is it time to remove script charges in England?

England is the only remaining country in the UK to levy prescription charges from patients.

People over the age of 60 are exempt from prescription charges in England, while no prescription charges are levied in Scotland, Wales or Northern Ireland.

But a C+D snapshot poll conducted last week, which garnered 319 votes, found that the majority of respondents believe the charges should be scrapped altogether.

Less than a third (30%) of respondents said they should be kept in place, while 57% said they should be removed and 13% said they weren’t sure.

“Sickness levy”

Director and superintendent pharmacist of the M J Williams Pharmacy Group Ade Williams told C+D this week (October 23) that he believes “it is not in our patient's interest to be paying prescription charges at a pharmacy”.

The charges “can amount to a sickness levy, creating a barrier that robs them of their dignity, not to mention their health”, he said.

And he added that even with schemes designed to provide “equity” in place, evidence shows that the most vulnerable are “less likely to access” them, especially “where there is also a history of marginalisation”.

“We have to consider if this charge sits well with the values of the NHS,” Mr Williams told C+D.

“The cost of living pressures mean that we are creating an indefensible choice for some: your medicines or your food,” he said. “We can and must do better.”

Waging war on waste

But contractor Rob Pitt told C+D this week (October 25) that he thinks a prescription charge “should still be levied” because it helps people understand the cost of their medicines.

Mr Pitt, who owns Bewick Pharmacy in Darlington, said that his three pharmacies dispense around 60,000 items a month and “see a staggering amount of waste that comes back in”.

“We've tried to wage war in our area in County Durham around medicines wastage and how much it actually costs the NHS [because] I don't think people really understand that”, he told C+D.

But he stressed that he is “completely against” community pharmacy contractors collecting the levy because they are “effectively collecting tax on behalf of [the] government”.

He said that making pharmacies collect it “for free” is “completely and utterly unfair”, while the system is also unfair on patients who “might be under the illusion that they're receiving a benefit that gets the prescription charges exempt and then they’re hit with a huge fine”.

“I hate April 1, because that's when it's generally prescription charge increase and you just get a ton of abuse from customers who paid £9.65 last week and are now going to be paying probably upwards of £10 this April that's coming in,” he added.

But while the “current system is broken”, it is “really difficult” to find an alternative way to collect the charge because it has been “embedded for so long”, Mr Pitt told C+D.

NHSE prescription savings campaign

It comes as the Pharmacists’ Defence Association (PDA) reminded its members to flag prescription charge exemptions to patients in England earlier this month.

It called on its members to “alert” patients to an NHS England (NHSE) campaign that raises awareness about possible savings from prescription charges.

The campaign highlighted two schemes that could help people who struggle to afford their prescriptions - the prescription prepayment certificate (PPC) and the low income scheme.

NHSE “urged” healthcare staff to “remind their patients about these schemes – particularly those living with long-term conditions and people living in deprived areas where data shows people receive significantly more prescription items than those living in less deprived areas”.

The PDA is one of a number of pharmacy organisations that oppose the prescription charge levy – currently £9.65 per item, raised by 30p in April.

In February, C+D reported that half of all pharmacists surveyed by the Royal Pharmaceutical Society (RPS) had reported a rise in patients asking which of their prescription medicines they could “do without” as the cost-of-living crisis bore down.

And in April 2020, C+D launched a campaign calling for prescription charges to be scrapped in England during the COVID-19 pandemic. Despite support across the sector, in June 2020 the government announced that it had “no plans” to end prescription charges.