Health Minister Considers Scrapping Prescription Fees

A wide ranging review will be held into whether Northern Ireland should continue to have prescription charges, Health Minister Michael McGimpsey has announced. Mr Gimpsey made the pledge as MLAs urged him to consider following Wales` example of scrapping the fees.

The minister, whose party vowed in its election manifesto to get rid of the charges, announced the review would be made up of pharmacists, doctors and patients` representatives and would report back with recommendations at the end of the business year following concerns that the fees are deterring some patients and their families from accessing vital drugs and medicines.

He claimed it was an issue of social justice. “We aim to remove the inconsistency and inequality inherent in existing prescription charges,” the minister said. “This will also restore a key principle of the National Health Service – that healthcare should be free at the point of use.

“It was, after all, a Stormont Government that brought the National Health Service to Northern Ireland. And now it can be a Stormont Government renewing its commitment to the founding principles of the NHS.”

In April, prescription charges were scrapped in Wales after a majority of Assembly members backed in January the plan by their Health Minister Brian Gibbons.

General Practitioners and pharmacy representatives welcomed the decision to provide free prescriptions, arguing it was good news for those who found it hard to pay for medicines and who was often put off seeking remedies because of their cost.

However manufacturers have been critical, warning it could lead to drugs going to waste and funding for medicines being lost. In Northern Ireland it is estimated around 28 million prescription items are dispensed in the province annually, with £13 million generated from the charges despite a total spend of £360 million by the Department of Health on drugs and medicines.

Free prescriptions are available to certain exempt groups but for the majority of people items cost £6.85 each. Mr McGimpsey said there were a number of inconsistencies in the current exemptions which highlighted the unfairness of the prescription system.

“Like all members who have spoken today, I have been listening to my constituents and I know only too well the large number of people, people with serious, often chronic conditions who still have to pay for the very medication that is keeping them alive,” the Ulster Unionist minister said.

“That is not the kind of health service I believe in. It is not a free service. That principle apart, I believe there are other serious inequities and weaknesses in the current system which needs to be addressed.”

The minister queried whether there was a rational explanation as to why some groups were entitled to free prescriptions in Northern Ireland and others were not.

“Why is a prescription issued by a hospital consultant free, when the same prescription, written by a GP for the same illness, indeed for the same person, attracts a charge?” he asked. “I haven`t got a good answer to that one yet either.

“And why do we charge a 59-year-old who may have a serious illness, yet a 60-year-old with a different illness who may be better off can get their prescriptions free? I could go on. But I think the point is clear. The current system cannot be the best system. We need to change it.”

Earlier Kieran McCarthy (Alliance, Strangford) called for all options to be considered by the review. However he noted research had proven prescription charges were deterring patients from accessing drugs. “The long term costs to our National Health Service could end up far greater in terms of avoidable hospital treatment,” he warned.

Tom Buchanan (DUP, West Tyrone) said if prescription charges were scrapped, it could result in increased demands for doctors` time. However he was primarily concerned with anomalies in the system of exemptions from prescriptions and asked for the current list to be reviewed.

“Some chronic conditions are currently exempt while others are not,” he noted. “The argument is made that it is one thing for a diabetic, for instance, to receive free prescriptions for their condition but that should not necessarily mean that these patients should receive all their prescriptions free for conditions unrelated to the diabetic illness.”

Michelle O`Neill (Sinn Fein, Mid Ulster) pledged her party`s support for any initiative by the minister to phase out prescription charges over the lifetime of the new Assembly. “The current cost of a prescription at almost £7 per item has a detrimental effect of excluding many people from receiving the correct medical treatment,” she told MLAs in her maiden speech. People on low incomes cannot access the medications they need. This cannot be allowed to continue and we must end it now.”

Rev Robert Coulter (UUP, North Antrim) said there was an ethical issue over whether people should be made to pay what amounted to a health tax. “Make no mistake about it, that is what prescription charges actually are,” he said. “Strip away all the arguments and you come back to this point. That is why the Welsh Assembly, which has fewer legislative powers than we do, abolished prescription charges on April 1.”

Carmel Hanna (SDLP, South Belfast) said the policy of scrapping prescription charges would need to be carefully costed before the executive could commit itself to their abolition.

“It is estimated that free prescriptions in Wales will cost £25.5 million for the first year,” she said. “Certainly I am sure and I have no doubt that our minister will do a cost and benefit review and will measure the impact of abolishing prescription charges.”

Dr Kieran Deeny (Independent, West Tyrone) said free prescriptions would eliminate prescription fraud and help patients with several conditions requiring drugs and medicines. But he said the review must look at all sides of the argument including the down sides.

“I think dangers we have are if we have free prescriptions rights across the board that medication will not indeed be appreciated by patients,” he said. “There would be wastage. We have a problem regardless of GPs on poor compliance and that is something we will have to look at.”