Consultation on Proposal to abolish NHS Prescription Charges

3 Current revenue and charges

3.1 The revenue raised in Scotland from prescription charges amounted to £46.3 million in 2002-03. The total Scottish NHS prescription drugs bill for the year was £773 million, up 10% on 2001. Thus the amount raised by charging is a very small part of the total NHS drugs bill.

3.2 As medicines became more expensive and NHS budgets were squeezed so the original 1952 charge, introduced at 1 shilling, has risen over the years to £6.30 today. The average weekly wage in 1952 was £7.11s the prescription charge was 1 shilling (for all items prescribed on form; increased to 1 shilling per item in 1956).

3.3 By 2003 the prescription charge had risen to £6.30 per item. The current charge is therefore 126 times the original cost. So the average wage would have to have risen to £951.30 pw or about £49,500 a year to have kept pace. The average weekly wage in Spring 2002 was in fact £464.70 pw, less than half that.

A European-wide study found that the cost of prescriptions in the UK was relatively high compared to the cost in seven neighbouring EU countries (1).

3.4 Those who defend the current prescription charge system state that the chronically ill, or those needing multiple items to treat their condition, could reduce their costs by purchasing Pre-Payment Certificates (PPC).

3.5 Anyone who expects that they will have to pay for more than 5 prescription items in 4 months, or 14 items in 12 months, would be able to obtain the items more cheaply through PPCs. From April 2003 a 4-month PPC cost £32.90 whilst a 12-month PPC was £90.40. However research by the National Association of CABs found that many people on low incomes were not able to benefit from PPCs because they could not afford the lump-sum payments which they require.

One-in-five GPs are so concerned that their patients cannot afford the charges that they admit to breaking the prescribing laws to ensure that poorer patients get the medicines.
Six per cent of doctors said they had paid the charges themselves to ensure that patients obtained vital medicines.
Eight in ten doctors reported that patients were missing out on necessary drugs because they could not afford them

(3).