Payment for prescriptions

How about not charging anybody for prescriptions? Those who can afford to pay would pay through their taxes.

The majority of people spend most of their lives without ever needing a prescription. The most expensive groups are children, the elderly, pregnant women and those with chronic conditions, most of whom are currently exempt.

Healthcare charges should operate like a proper insurance scheme. Neither of my sisters nor my partner have ever been in hospital, although they probably will one day. They've paid all their lives for the time they need care - which is how insurance schemes work. People who don't need medical care are the lucky ones.

growstuff

No, Doodledog, that's not necessarily true. Higher earners get tax relief on their pensions, so they actually receive a higher subsidy from the government than basic rate taxpayers. Not only that but there are pensioners who have another source of income and sometimes have hardly ever worked in their lives. I don't see that it matters whether people work in a traditional job for their money - it should be the income from all sources which is taxed, which should then be used for universal healthcare.

I'm not disagreeing with taxing all sources of income. The government can raise the cap on NI by all means, and reduce the tax relief on pensions while they are at it - you will hear no argument from me. But they are not measures that we were discussing. My point stands (regardless of caps and so on - it gets to feel like sitting exams in here sometimes).

If people paying up to the cap are then expected to pay again when they need treatment there is no incentive for them to stay in the NHS. I don't think for a minute that if they could get away with it the government wouldn't encourage people to leave - they already allow fee-paying patients to jump NHS queues.

My point was that if there is a two-tier system of paying for prescriptions too, the NHS will disappear. Also, not all drugs cost the price of a prescription. You can buy paracetamol over the counter, but there are other drugs that are cheap but prescription-only. We could easily end up with those who pay getting private prescriptions for cheaper drugs and using the NHS for expensive ones (on the same principle as seeing a consultant privately and using the NHS for the recommended treatment). This would reduce the money available to those who are on the lower tier of treatment, as currently the £9 paracetamol charges contribute to the expensive drugs for more serious illnesses) and ultimately more and more people would end up outside of the NHS, with only those with no alternative (including older people with existing conditions) staying for a lower level of service.

People should be careful what they wish for, IMO.

Can I point out there is no such thing as a free prescription. It all has to paid from somewhere and in Scotland's case it's taxes. I live in Scotland, am over pensionable age and still working. I've said for years I would be happy to pay the prescription charge because I can afford it and have it free when I can't. Surely there has to be a simple way of managing free prescriptions for the people who need it. Not sure how it would work but what about anyone below the national average wage, as a starting point, gets free prescriptions and take it from there. I agree with a previous poster that means testing usually costs more than it saves.

Higher earners would have to pay their taxes (and for the NHS) anyway. If they choose to pay on top of that for private healthcare, that's their business.

PS. NI is capped, so higher earners don't pay more.

No, Doodledog, that's not necessarily true. Higher earners get tax relief on their pensions, so they actually receive a higher subsidy from the government than basic rate taxpayers. Not only that but there are pensioners who have another source of income and sometimes have hardly ever worked in their lives. I don't see that it matters whether people work in a traditional job for their money - it should be the income from all sources which is taxed, which should then be used for universal healthcare.

I do wish people would read the thread.

I quoted someone who'd said that pensions had to be declared, saying that I hadn't heard that this was the case, and questioning the sense of such an arrangement. Someone posted to say that it is not the case very soon afterwards, but many pages later people are still quoting my post as though I am saying that you have to declare a pension if you go to hospital. This has been corrected more than once.

As for pensioners being well off because of occupational pensions - I don't see that as relevant. Someone with a high occupational pension (which I don't have, in case anyone assumes I am posting out of self-interest) will have paid a lot more NI than someone on a basic pension or pension credit, so there is no reason why they should also be singled out to pay again for medication.

Everyone has to feel that they are paying for the NHS if it is to work. If those on higher incomes are charged more for treatment as well as paying more tax they may as well go private and leave the NHS even more unfunded than it is already. By all means increase taxation to pay for it, but the NHS has to remain free at point of need, or if it is not it has to cost the same for everyone, if we are not to end up with even more of a two-tier system than we have now.

Problem is that means testing will almost certainly cost more than any money saved as will the admin involved in collecting fees in hospital for food etc.

elleks

Doodledog

If you have a State pension and in Hospital for more that 4 weeks you are supposed to declare it, as you not "entitled" to it. How many do that?
I don't have a state pension yet, but I didn't know you were supposed to declare it if you are in hospital. Probably a lot of people are also unaware of that. I suppose there is a certain logic in that the State is 'keeping you' when you are in hospital; but how do people pay the rent or other commitments if their income is stopped - outgoings are not restricted to food and/or other things that would be covered in a hospital stay.

And if there's a partner still at home, all the bills don't magically halve just because one of the pair is in hospital.

Just to reiterate that state pension does not stop after 4 weeks in hospital. Som benefits are, but SP is not one of them.

sazz1

Yes I would agree with pensioners paying for prescriptions if we had higher pensions. We have one of the lowest in Europe.
I don't agree with people paying if they have a long term condition eg diabetes, cancer, COPD, etc.
We shouldn't have to pay for GP visit, or hospital stays though.
Main problem is not enough people working and therefore not paying NI and tax. People should be forced to take any job if one is available. Too many people not interested in working below their qualification level. That's why we have rotting fruit, flowers and vegetables in the fields.

Some pensioners have low pensions, but many don't because they have additional pensions and/or additional sources of income. Comparing UK and other pensions is like comparing apples and pears. You can look this up for yourself, but the average pensioner household has a higher disposable income (after housing costs) than the average working age family.

Where's your evidence that people are unemployed because they're not interested in working below their qualification level? Fruit picking jobs in Kent aren't much good all year round to people living in an inner city in the North East (for example).

Treetops05

Many would stop visiting Dr's and refusing to go to hospital, we'd go backwards on health care. As for paying for hospital food (having married a retired hospital chef) I'll get my family to bring food in every day. Better for me and cheaper

I think that's why there's an on-site M & S Simply Food at my local hospital!

I wonder if anybody has actually thought through charging for GP visits, hospital food and more prescriptions. There would have to be exemptions for people who simply couldn't afford to pay and others such as the terminally ill. The admin involved to collect it all and chase up the bills would be huge.

I don't think anybody is disputing that the NHS does far more than it did in 1948 - thank goodness! (I'd have died a few times by now).

However, what it comes down to is whether it should still be a national system of available healthcare for those who need it and paid for by those who can best afford to pay - or whether it's every man, woman and child for him/herself, with the wealthiest paying for the best treatment and the rest doing their best with quack remedies and (let's face it) dying or living a life in pain.

Yes I would agree with pensioners paying for prescriptions if we had higher pensions. We have one of the lowest in Europe.
I don't agree with people paying if they have a long term condition eg diabetes, cancer, COPD, etc.
We shouldn't have to pay for GP visit, or hospital stays though.
Main problem is not enough people working and therefore not paying NI and tax. People should be forced to take any job if one is available. Too many people not interested in working below their qualification level. That's why we have rotting fruit, flowers and vegetables in the fields.

Many would stop visiting Dr's and refusing to go to hospital, we'd go backwards on health care. As for paying for hospital food (having married a retired hospital chef) I'll get my family to bring food in every day. Better for me and cheaper

Don't those who would be means tested eg receiving one or other of state benefits eat at home? Why should anyone be penalised for receiving such a basic element of care, the food generally leaves much to be desired. The free prescriptions for all in Scotland was introduced as the cost of administration outweighed the cost of prescriptions. Of course it was reported as a political move to the electorate.

Is it fair that we who will be soon better off by some £600 - in two instalments watch as we see millionaires receiving many more times than us. Ken Clark was saying how he did not agree with everyone getting this money. He was receiving £1,100 towards heating his two houses! Will Rishi Sunak and his multimillionaire wife receive money, and will Boris be paid to heat No 10?. Surely that should be a cut off point taking into account the income(s) of the individual homes.

I am happy to pay to see a GP in France, because I haven’t contributed anything over there. Not here.
Gabrielle56 that’s an excellent idea.

No , no and er..no
We all pay into N.I. to pay for NHS.the governments seems to think these contributions are just extra top up for the tax pot and don't ring fence the funds.neither do they have apolitical and cross party consultation and decision making for NHS policies which IMO they absolutely should! NHS is too important for each successive party/minister to muck about with in a "new broom"manner, the waste in NHS is obscene. Has been for decades always will be-why? Too much money sloshing about and inconsistent management of the whole shabang! It needs to be taken OUT of the political arena and kept as an important and unfiddleable entity, not up for grabs by every shark in the pond!

I wish people would not say that they are happy to pay to see the GP, or whatever. You already pay, through your taxes. If the NHS needs more money, put taxes up. I know its not as simple as that, but that is the principle.

My husband was one patient We have 67,000,000 people in the UK. If just 5% were admitted....

The medication bag saga WAS 3-4 years ago Last month nothing was prescribed so you are far more up to date My husband had taken in his own medication on each occasion but the last doctor who saw him disagreed with what the previous one had prescribed... hence the polythene bag

So yes... you are quite right growstuff, situations change. I hope that such wastage of medications cannot occur now

Sadly the country is no longer the same as when Bevin set up the NHS.
The population has grown massively. The population has aged massively and Medicine has advanced far , far beyond anything Mr Bevin could ever anticipate
For instance, when I qualified as a doctor in 1980 , if you had a heart attack you were either facing rapid death or a long , miserable time of being a cardiac invalid in heart failure.
Now , although some deaths occur so many people are saved by amazing surgical techniques and new medicines. It really amazes me how much difference there is in this single speciality. Multiply that across the board and we simply cannot expect the NHS to be the same as it was in 1948.
GP practice is very different and Consultant's are no longer Gods .
It is no longer possible for the NHS to be" free at the point of contact " as Bevin planned.
I am totally not in favour of private medicine but I do think charging small fees for things like meals and for consultations would be helpful.
As someone said , it might also put off those time wasters ( of which there are a surprising number) who turn up on our door step daily demanding attention for trivia.

widgeon I don't think you could multiply all that many million times.

I've been told to take my own medication into hospital next week.

Most hospitals, including A & E, won't even issue any medications after a patient visit, apart from a few exceptions. Patients have to go to the GP, which I know is a source of irritation.

Cost of prescriptions

My pharmacist said of the essential item prescribed by my GP 'This costs an arm and a leg. I shall order a cheaper version.' I explained that I had tried them all with my chronic complaint ... to no avail. Had to get the doctor to intervene on behalf of his prescription.

waste of medications

When in hospital 3 0r 4 years ago, my husband was seen, just before discharge by a new doctor who insisted upon changing the medications my husband was accustomed to....and which worked for his chronic complaint. A LARGE bag of untried stuff was issued. My husband( ex GP and then Hospital specialist) said he prefered the tried and trusted remedies which had been satisfactory for years and left the bag on his bed.
He was chased down the corridor by a nurse who tried to stuff the bag into his hand. 'I neither want nor need them'
...'but you must take them home' said the nurse
So we did to avoid argument and deposited them in a large cake container until we decided what to do with them.

After a 999 call recently he was taken to the same hospital. One of the ambulance attendants asked what medications he had been on. she searched through the box saying anxiously ....All these are out of date. They must be discarded ' she pushed a large polythene bag full of the stuff she disapproved of into the grip I had packed for husband's stay in hospital saying she would dispose of them
Some hours later I received a call from the hospital pharmacist in a state of panic, asking why my husband had a bag of out of date still sealed drugs in his overnight bag, had he been on those drugs and anyway why were they still sealed and also he could find no record of anyone having prescribed them anywhere

Multiply this by several millions for a repetition of a similar NHS story elsewhere and subtract from the cost of the NHS and also reduce the cost of management anyway and one might have a considerable rebate

The NHS will definitely need to create a brand new department to cover these plans, this will involve even more managers and admin staff. As with every new NHS idea the costs seem to far outweigh any benefits.

Nonsense.

If medicine is perscribed by a doctor, you need it, and should not have to pay to get it.

Likewise if a stay in hospital is necessary, food, toiletries and bed-clothes should be provided, free of charge.

In Denmark, where we do have a health service that is entirely free of charge and government funded like the NHS, we are paying for these things through our Income tax, council tax and so on. We do actually pay a small amount for medicine when we collect a perscription, but nothing like the actual cost of it. Everything else is free, including nightwear and dressing gowns that hospitals provide. You put them in the dirty linen basket when you dress to go home.

However, it is no good demanding lower taxes if you want these benefits - the money has to come from somewhere. What we can and should do, is to demand that the system is run efficiently.

As someone whose health condition requires 11 different medications daily, affordability is a big issue. Do we really want to be like the US where people die because they cannot afford healthcare?.