Key Summary
- Wales had scrapped prescription charges in 2007, Northern Ireland in 2010 and Scotland in 2011.
- The NPA survey found that 12 per cent were delaying getting a medicine due to concerns about the prescription charge.
- 41 per cent were worried about being unable to afford their NHS prescriptions.
A new poll by the National Pharmacy Association (NPA) found that last year one in 10 patients in England went without a medicine they needed due to concerns about prescription charge.
Interestingly, Wales had scrapped prescription charges in 2007, Northern Ireland in 2010 and Scotland in 2011.
Pharmacy leaders have urged the Chancellor John Healey to use the Budget next week to scrap the ‘cruel tax on illness’.
It may be recalled that during the last Budget the former chancellor Rachel Reeves had frozen the single NHS prescription charge at £9.90.
Patients between 18 and 59 years have to pay the prescription charge, unless they have a specific medical exemption, are on qualifying benefits or are very low incomes and have had this verified by the NHS.
Terming it a 'national scandal', the NPA said the charges ‘undermined the fundamental founding principles of the NHS’.
During a survey of adults across England, 12 per cent said they delayed getting a medicine last year due to concerns about the prescription charge, while 41 per cent were worried about being unable to afford their NHS prescriptions.
During the poll 8 in 10 (80 per cent) of respondents thought it was unfair that patients in England were charged a prescription fee whilst the rest of the UK were exempt.
An estimated 11.6 million patients paid prescription charges last year, with an additional 3.3 million patients who have multiple repeat medicines paying through pre-payment certificates (PPC).
Patients with a PPC paid £114 a year or up to £480 a year if they had at least four prescription items to collect in a month and did not use a PPC.
The prescriptions charges have swelled Treasury coffers by £732 million last year, up £80 million from 2021.
But none of the revenue from prescription charges goes to pharmacists, who are forced to act as tax collectors for the government.
Patients who are forced to pay the charge include some university students and those with potentially serious long term health conditions including Parkinsons, Asthma, multiple sclerosis, Chron’s or Kidney disease.
The NPA, which represents around 6,000 pharmacies across the UK, said pharmacists are often left in an ‘impossible position’.
Patients with multiple, one-off, medicines ask for advice about which one is the most important to take.
The prescription charge also creates significant administrative burdens on pharmacies who are under unprecedented workload pressures, preventing them from providing care to patients.
The NPA also wants the Treasury to provide business rates relief. Unlike GPs, pharmacies pay business rates, despite 90 per cent of their income coming from the NHS.
Deeply unfair cost
NPA Chair Olivier Picard said: “No patient should ever see cost as being a barrier to accessing the medicines they need but this polling shows an alarming number do.
“It is a national scandal and deeply unfair that anyone could consider stopping vital medicines because of cost.
“This cruel tax on illness, where some patients are exempt but others are forced to pay simply because they have the wrong kind of illness, undermines the founding principles of the NHS.
“If the Chancellor wants to tackle the rising cost of living and health inequalities, he should bring England into line with the rest of the UK and scrap this unfair and complex prescription tax.
“Pharmacists are health professionals, not tax collectors. They should spend their time helping patients, not administering an unfair tax on illness.
“Pharmacists do their best to support patients to bring down the cost of prescriptions but are in an impossible position. They should never have to answer questions about which medicines a patient should go without.”
Remove the barrier
Dr James Davies, Director of Research and Insights at Community Pharmacy England, said: “The Chancellor has an opportunity in this Budget to remove one of the most unfair costs facing patients.
"No one should be forced to choose between paying for essential medicines and making ends meet, yet these figures show that too many people are doing exactly that. Prescription charges also add to the workload of already stretched community pharmacy teams who have to collect those charges and check for exemptions.
"With four in ten patients worried about affording their prescriptions and one in ten going without medicines because of cost, scrapping prescription charges would remove a barrier to essential medicines while also simplifying the system for both patients and pharmacy teams. Healthcare should be based on clinical need, not ability to pay.”
Unfair tax on health
Commenting on the NPA survey findings, Director for England at the Royal College of Pharmacy Amandeep Doll said: “These findings are worrying and reflect what pharmacists know all too well. Every day, pharmacists are asked by patients who cannot afford all the medicines on their prescription which ones they could ‘do without’. Patients should not have to make choices which involve rationing their medicines.
“Prescription charges are an unfair tax on health. They risk exacerbating health inequalities by creating financial barriers to accessing essential medicines, particularly for people on lower incomes and those managing long-term conditions.
“There is no good reason why patients in England should face this barrier when prescriptions are already free in Scotland, Wales and Northern Ireland. With the Budget next week, the Government has an opportunity to put an end to this outdated and complex system and abolish prescription charges in England.”
Update exemption list
Asthma + Lung UK Chief Executive Sarah Sleet said: “It’s alarming that people are being forced to go without vital medicines.
"For people with lung conditions like asthma and chronic obstructive pulmonary disease (COPD), being able to take medication shouldn’t come down to whether or not you can afford it. But because respiratory conditions aren’t included on the prescription charges exemptions list, people are left essentially paying for their right to breathe.
“Lung conditions hit deprived communities the hardest and as winter approaches, people living with respiratory conditions – who are at a higher risk of ending up seriously unwell in winter – face the double blow of unaffordable prescription charges alongside increased heating bills."
Marianne Radcliffe, Chief Executive Officer at Crohn’s & Colitis UK said: “We know prescription costs are a major concern for many people in our community, many of whom rely on medication every day to manage their condition. No one should have to make difficult choices between paying their bills and getting the treatment they need to stay well. Life with a chronic illness is challenging enough without the added burden of financial pressure.
"The list of conditions exempt from prescription charges is outdated and urgently needs reviewing to include Crohn’s, Colitis and other life-changing long-term conditions.
"We support calls to scrap prescription charges in England. People with long-term conditions should not be forced to choose between their health and their finances simply because they need medication every day.”
Unfair towards dialysis patients
Fiona Loud, Policy Director at Kidney Care UK, said: “The current system is unfair for people with kidney disease, many of whom need to take powerful medication for the rest of their lives. Dialysis patients (over 30,000 people) are particularly disadvantaged as they are at the mercy of whether their GP classes their dialysis access as a medical exemption to qualify for free prescriptions, and they need dialysis to stay alive.
"People who have had a kidney transplant - a treatment, not a cure for kidney disease - are not exempt despite the fact they have to take an average of 10-15 different medications (between 20-30 tablets) every day including those that stop their body rejecting the transplanted kidney. It’s simply not a fair system because it penalises ill health; everyone should be able to access the medication they need to stay well for free, without worrying about whether or not they can afford it.
"That’s why we support the NPAs call for the Chancellor to bring the unfair and unjust system in England in line with the rest of the UK.”
Parkinsons, MS patients hit
Laura Cockram, Head of Campaigns at Parkinson’s UK said: “People with Parkinson’s rely on medication to manage their symptoms, yet many struggle to afford the prescriptions they need. A missed, reduced or delayed dose can cause their health to seriously deteriorate. This can lead to greater reliance on NHS services and hospital care, which costs a lot more than £9.90 to deliver.
“Freezing prescription charges is a short-term measure for a long-standing problem. With the current freeze due to end in 2027, the upcoming Budget is an opportunity for the government to take meaningful action. If they are serious about tackling the cost of living crisis and preventing avoidable ill health, the government must scrap prescription charges in England, bringing us in line with the rest of the UK.”
Peter Lloyd, Senior Policy Manager at the MS Society, said: “It’s outrageous that anyone should face the choice between financial sacrifice and going without essential medicines.
“MS is a debilitating, exhausting and unpredictable lifelong condition. Many people with MS need to take several medications to manage symptoms like pain, spasticity and bladder problems, but MS is not on the medical exemption list.
"This means someone with the condition in England can be charged for medicines that are free in Wales, Northern Ireland and Scotland. We support the NPA’s call to end this injustice, and we urge the government to reconsider who is exempt from prescription charges.”
