Consultation on Proposal to abolish NHS Prescription Charges

2 History of prescription charges

2.1 The NHS was created in 1948, by the pioneering post-war Labour government, to provide free healthcare for everyone regardless of income. It was, and remains, largely funded through general taxation and National Insurance contributions. Before the NHS’ foundation healthcare was rationed to those that could afford to pay for it or who were lucky enough to receive charitable assistance.

2.2 Aneurin Bevan, the Welsh socialist and Health Secretary in the Labour Government, was given the job of piloting the legislation through Parliament. The NHS was a hugely popular reform but Bevan saw the introduction of charges for health care as a betrayal of the “universally free” principle that the NHS was founded on. Therefore when his colleagues in the Government forced through a proposal to introduce prescription charges he and several colleagues (including later Prime Minister Harold Wilson) resigned.

“I consider the imposition of charges on any part of the health service (an issue) … I could never agree to. If the government impose them my resignation would automatically follow” - Nye Bevan, Health Minister in the post-war Labour Government.

2.3 However before they could introduce the charges Labour lost the election of 1951. Instead the new Tory government introduced the charges as a way of raising revenue and preventing “frivolous use of the health service”. Prescription charges represented a breach of the NHS’ most fundamental ethos.

2.4 As medicines became more expensive and NHS budgets were squeezed so prescription charges were seen as an easy source of additional revenue by successive Governments. Thus the original 1952 charge of 1 shilling (5p), per prescription form, has risen to £6.30, per item prescribed, today.

Prescription Charges Notable Changes
Year	Amount	Change	Government in power at time
1952	1 shilling (5p) per form	Prescription charges introduced	Conservatives
1956	1shilling (5p) per item	Each item on prescription liable for charge	Conservatives
1961	2 shillings (10p)	Increase in charge	Conservatives
1965	NIL Charges	Abolished	Labour
1968	Half crown (12.5p)	Charges re-introduced and increased	Labour
1971	20p	Charge increased	Conservatives
1979	45p	Charge increased	Conservatives
1980 to 1997/td>	70p to £5.65	Charges increased yearly	Conservatives
1997 to 2003	£5.80 to £6.30	Charges increased yearly	New Labour

2.5 The idea of getting rid of prescription charges is not new. From the outset they were opposed by large sections of the Labour Party. Thus in 1965 the Labour government abolished prescription charges, seemingly for good, and promised to do the same for dental and ophthalmic charges. That unfortunately did not occur and in 1968 prescription charges were reintroduced, and the charge increased, when Labour faced a “balance of payments” crisis.

2.6 The charge was increased again in 1971 but then remained static for 8 years. So in 25 years the charge increased from 5p to 20p. A similar increase over the next 25 years would have seen the charge rise to just 80p instead of the £6.30 it is today.

2.7 It was the Conservative Government of Margaret Thatcher in the 1980s which first introduced the concept of increasing the prescription charge annually. Between 1980 and 1998 the charge per prescription item increased by 355% in real terms, that is over and above the effects of inflation. This process has continued under New Labour with prescription charges increasing year on year though the rate of increase has slowed.

“There’s a danger that patients who genuinely need medicine are not getting it because of the cost” – John Appleby, chief economist, the King’s Fund