Budget Pain Worse With HIV

posted: 24/06/2010

Low income is a major problem already for many people living with HIV. The emergency budget and service cuts will now make a bad situation even worse.

Here we try to pick out how the budget that is claimed to be ‘tough but fair’ will affect people living with HIV in NW England. We find out how tough and unfair it will be on many people living with HIV.

The Institute for Fiscal Studies analysis shows that the poorest 10% of the population (typically people on benefits and workers on the minimum wage) will face the worst financial pain of the whole population. Excluding cuts in Disability Living Allowance, Housing Benefit and funding for important public services like social care, over the next five years they worked out that the spending power of the poorest 10% of the population will fall by 2.6%.

Add in the affect of changes in disability living allowance, housing benefit cuts and cuts to public services and the poorer part of the population will suffer even more than this.

The budget will cut the incomes of the richest 10% of the population by just 0.6% compared with over 2.6% for the lowest income tenth of the population. How fair is that?
 

What we have to tell you below makes for depressing reading.

We think people with HIV have a right to know how the planned changes over the next five years could affect them.

These changes are not all cast in stone. They have to go through Parliament and you can tell your MP what you think.
 

Disability Living Allowance
Many people with HIV receive Disability Living Allowance (DLA), a benefit paid at different rates to compensate for disability and mobility problems. The budget announced that people on DLA will have a strict new medical examination; these medical examinations will start in 2013. Some people will lose DLA, others will go onto a lower rate. The government aims to cut spending by £1.4 billion within two years of these medicals starting.

We do not know yet if people who have DLA ‘for life’ will have these medicals.
 

Housing Benefit
Housing Benefit / Housing Allowance will be cut after one year by 10% for people claiming Job Seekers Allowance. The amount of Housing Benefit will also be capped, depending on how many bedrooms you have.This and other changes will be cuts costing people on the benefit £1.8 billion a year.

People will either have to pay the extra for their rent from their other income, move somewhere cheaper or smaller, and if evicted for rent arrears are likely to be refused rehousing as a homeless person. Eviction for rent arrears is treated as making yourself intentionally homeless so people are not entitled to be rehoused.
 

Unemployment
There are around 2.5 million people unemployed and about 0.5 million job vacancies. Unemployment is higher in NW England than most other regions. The job vacancies are often low paid.

The budget alone will increase unemployment by another 100,000 and independent experts expect it to reach close to 3 million.

Job seeking prospects will worsen and it is already harder to find work with a condition like HIV.
 

Slow-burn cuts and taxes
Over the next five years people on benefits will slip further behind in what their benefits will be able to buy and with tax changes.

VAT rises at the beginning of January to 20% and VAT always hits people on low incomes hardest.

Most benefits will be uprated for inflation in a new way that will leave people increasingly worse off. This will cut £6 billion from benefits over the next five years.

Child Benefit is frozen for three years from next April – a £3billion cut. Parents who are working will be compensated by Tax Credits, but that doesn’t help parents who aren’t working.
 

Social Services
Local Government and other public services are most used by people who are on lower incomes. Social Services departments of local councils now face cuts of between 25-33%. Social Services provide essential services to people with HIV and they help fund HIV community services like George House Trust.

The AIDS Support Grant which is used to pay for extra support for people with HIV and community HIV services is no longer protected by a ‘ring-fence’. This means councils can now spend it on whatever they like.

We don’t know yet how cuts of between one quarter and one third will affect essential social services for people with HIV and community organisations but we should start to know more from October. We can expect some painful cuts and changes.
 

NHS cuts
The NHS in NW England has been told to save almost £1 billion within the next three years. We do not know whether this will affect people with HIV.
 

State Pension Age to rise sooner
Details are sparse but the government is planning to raise the age at which men and women will get a state pension sooner than was planned. Men who are now 59 will have to work one more year before they can claim a state pension. Pension age will be 66, not 65 as now, for men from 2016. It does not stop there.

They are consulting about raising the pesnion age to possibly 70. Pension ages for women and men could be raised by one year every five years until it reaches 70 for both sexes. If they start this in 2016 as they say they now plan to, men now aged 40 would not get a state pension until they reach 70. Three out of four people will have some disability by the age of 68. Many people with HIV (among many others) are not fit enough to work until the current pension age of 65, particularly in a region like NW England.

Benefit cuts and changes will make it harder for people with disabilities like HIV to live with a decent fair income before pension age.
 

Expect more pain
In October the government will publish its Public Expenditure Review. We can expect lots more cuts in government spending. The government is already saying that it will try to reduce cuts in education and some other public services (but it has not said that it wants to protect social services) by making even more cuts and changes to benefits.
 

Since the second world war, no government has managed to cut public spending for more than two years in a row. This government plans five years of cuts.
 

Some reputable economic commentators, and President Obama, are warning that European countries are behaving like a panicking herd, cutting spending harshly and that this has a high risk of plunging the world into recession once again. The harsh medicine of cuts could kill economic recovery and make the situation even worse.
 

Heath Inequality
The Marmot Review earlier this year was to help the government plan policies that will end harsh health inequalities. It showed that the poor die 7 years younger than the rich, and the poor become disabled 17 years sooner. Cuts to services and benefits in NW England will worsen the already bad record of ill-health, disabilities and early deaths in this region. More unemployment and low income harms people’s health and well-being.

Reductions in benefits, and those 25%+ public service cuts expected in the Autumn Spending Review are estimated to increase alcohol related deaths by about 2.8% and cardiovascular deaths by 1.2%. Both of these disproportionately affect people living with HIV. Every £80 cut in social welfare spending per person causes this, according to a Europe-wide analysis by Oxford University epidemiologist David Stuckler, reported in the Guardian on 25 June and in the British Medical Journal. There are likely to be between 6,500  and 38,000 more deaths in the next ten years. If the economy worsens, extra deaths rise steeply. Apart from benefits cuts, it is cuts to social services and health budgets especially that cause the most health harm. 

The Treasury is ending the public sector agreement with the NHS to raise the life expectancy of the poor. Marmot presented the government with a vision and plan to make sure everyone has a ‘healthy income’, enough money to live healthy lives and improve life expectancy.

The budget and cuts to come make it even more likely we will go backwards and poorer people and people with disabilities, like many people with HIV in NW England, will face worsening life expectancy and poorer health.

Sit back or act?
These changes are not all cast in stone. They have to be passed by Parliament and you can tell your MP what you think. With your postcode you can contact your own MP here.

Help for people on Low Incomes on our website

Prescription Charges Review

posted: 01/06/2010

The long-awaited review of prescription charges by Professor Ian Gilmore has appeared. Over a year ago, Gordon Brown promised at the Labour Party Conference to end prescription charges for people with long term conditions. People with cancer were exempted from charges but people with other long-term conditions, like HIV, are still waiting.

The report recommends that people with long-term conditions should have free prescriptions. It sets out a plan for how the government should change the unfair prescriptions system to make sure people get the medications they need to stay well.

You can read the full report.

Depends on autumn spending review
The coalition government has welcomed the review, but says it will only consider this in the autumn, as part of the Spending Review. Many MPs already support this campaign.

HIV and prescriptions

Since the start of 2009 Greater Manchester HIV clinics (among most other HIV clinics) have stopped prescribing any drugs except those for HIV and their treatment side effects. People must now turn to a GP for prescriptions for all other healthcare needs, such as depression and anxiety, and sexual dysfunction.
 

Some help already available

For some people with HIV this means paying for these prescriptions - some people are exempt, some are exempt because of low income, and some people can buy a discount card. Find out what help is available with English prescription charges here.

There are 22 members of the Prescription Charges Coalition, including Terrence Higgins Trust:

Androgen Insensitivity Syndrome Support Group, Arthritis Care, Association for Spina Bifida and Hydrocephalus, Asthma UK, Behcets Syndrome Society, British Heart Foundation, Diabetes UK, Disability Alliance, FibroAction, Klinefelter’s Syndrome Association, Mind, Motor Neurone Disease Association, MS Society, National Ankylosing Spondylitis Society, National Association for Colitis and Crohn’s Disease, National Rheumatoid Arthritis Society, Parkinson’s UK, Pernicious Anaemia Society, Rethink, The Stroke Association, Skin Care Campaign, Terrence Higgins Trust

Free Computer and Internet for Children

posted: 14/01/2010

Want a grant from the government of up to £528 for a computer and internet access? Grants are now available for low income families with children living in England who don’t have access to the internet. This includes people on NASS or UK Border Agency Support.

Depending on what you need, you can get up to £528 to spend on a computer (the computer type could be a lap-top, desk-top, or net-book), and the cost of one year’s internet access.

Who can get this?
You need children in school years 3 to 9. This will normally mean children who are from 7 to 14 years old, at a state school.
 

It’s for families with lower incomes. This means

• if your child has free school meals OR 
• you receive income support OR 
• you get income-based Job Seekers Allowance OR 
• you get child tax credit OR
• you get income-based Employment Support Allowance OR
• you get NASS or UK Border Agency support while claiming asylum (but not section 4 support) [It has to be ‘support under Part VI of the Immigration and Asylum Act 1999’]

How to claim

• Ring the helpline for parents 0333 200 1004 for an application form. They will ask you some simple questions to check you can claim.
• Fill in the application form and send it with proof
• You get a decision within 3 weeks (and your proof documents returned – The decision will either be

1. No, OR
2. send more information, OR
3. Yes

If Yes, approved, you will get

• a Notice of Entitlement
• Instructions on how to get the computer and internet
• They tell you who can supply the computer and internet package
• A Home Access Grant payment card preloaded with the money
• A PIN number (in another letter)

You then contact the supplier you choose to get the computer and internet package.

The rules are explained in more detail here

Companies offering the Home Access computer scheme
You can only get compter and internet access through companies that are part of the scheme. So far these include

• Bli Education 
• Centreprise 
• Comet 
• Misco
• Positive IT Solutions 
• XMA 

How many people can get these grants?

The scheme will run for the next 18 months but there is a maximum of 270,000 grants available, one per household. We think the grants could run out quickly.

How to apply?

Call 0333 200 1004
 

Details at Home Access.

Please tell people who don’t have computers, who have school age children.
 

Low Income?

posted: 15/12/2009

Over the next few days a new section of the George House Trust website will help people with low incomes. It will have sections on

• Increasing your income
• Cutting Spending
• Dealing with Debt
• and the help George House Trust offers.

Many people living with HIV have low incomes, some migrants with HIV even have no income whatsoever, and long term conditions usually add to people’s living costs. At the very least there are hospital appointments and often prescription charges to pay.
 

The Low Income pages will point you to where you can find the information you need to help yourself, and explain the support George House Trust can offer.
 

You will find Low Income  advice and information here. On the website front page it is under All About Our Services 

Help with Prescription Costs

posted: 01/12/2008

Who has the right to help with prescription costs?

Greater Manchester HIV clinics will now only prescribe HIV treatment drugs and drugs for managing any side effects. This leaves medicines for anything else (depression, sexual dysfunction, contraception etc.) to GPs to prescribe, and that means some people have to pay for those GP prescriptions.

Many people are entitled to free prescrriptions; some can get free prescriptions because of low income, and there is a discount scheme to cut your costs. 

Other help with healthcare costs is available, including for travel expenses to and from hospital.

Citizens Advice Bureau has clear infomation here on all the help that is available for healthcare costs.

For prescriptions, some people can get them free, some people can get a full exemption on grounds of low income, and some people can get a discount by buying a prepayment certificate.

Free Prescriptions

You are entitled to get prescriptions free of charge if you:

• are over 60
• are on Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance or the guarantee credit part of Pension Credit. Your partner and children will also be entitled to free prescriptions. (If you are getting Working Tax Credit and/or Child Tax Credit, you may be entitled to free prescriptions, depending on your income - see below - Help with health costs if you are on a low income)
• have a listed medical condition (HIV is NOT listed, see page 30 here for full list) and have a valid medical exemption certificate. You have to ask your GP if you think this might apply to you - ask for Form FP92A
• have a continuing physical disability which means you cannot go out without help from another person and have a valid medical exemption certificate - ask the doctor, hospital or pharmacist for Form FP92A
• are under 16 in England or Scotland. You must show age proof to the pharmacist
• get a war or service disablement pension, need prescriptions for your war / service disability and hold an exemption certificate - ask the doctor, hospital or pharmacist for Form FP92A
• are a prisoner
• are pregnant, or have had a baby in the last twelve months and have a valid exemption certificate. This includes if you have had a miscarriage after the 24th week of pregnancy, or your baby was stillborn. Ask the doctor, midwife or health visitor for Form FW8.
• you live in Wales

To claim, just tick the box on the back of the prescription form.

They do random checks afterwards to check that people who ticked the box were eligible. There is a penalty charge and possible prosecution for people caught claiming when not eligible.

In England, for full details of people who can get help with prescription charges, see the Department of Health leaflet HC11 Help with health costs.

If none of the categories mentioned in this list applies to you, you may still be able to get free prescription on the grounds of low income – see next section: Prescriptions for low income

Prescriptions for low income

If you have difficulty in meeting your health costs and do not qualify for any other kind of help, you may be able to get help under the NHS low income scheme.

The amount of help you get will depend on the amount of income you have. You might not be entitled to any help at all if you have too much in savings / capital. There are two types of certificate: a full help certificate (HC2), and a limited help certificate (HC3), which tells you how much you have to pay.

Full help certificate

If you are entitled to a full help certificate, you will get:-

• free NHS prescriptions
• free NHS dental treatment, including check-ups
• free NHS sight tests (including sight tests at home) and full value vouchers for glasses or contact lenses
• full repayment of necessary travel costs for hospital treatment
• full repayment of travel costs if travelling abroad for treatment
• free NHS wigs and fabric supports
• travel costs if travelling abroad for treatment.

Limited health certificate

If you are entitled to a limited help certificate, you will get no help with prescription charges (but see Prepayment Certificates for prescriptions below) but may be able to get some help with the costs of:-

• dental treatment and check ups
• private sight tests
• vouchers for glasses or contact lenses
• wigs and fabric supports
• necessary travel costs to and from hospital for NHS treatment
• travel costs if travelling abroad for treatment.

How to apply for help on the low income scheme

To apply for either a full help certificate (HC2) or a limited help certificate (HC3), complete form HC1, which is available from local benefit offices, NHS hospitals, dentists, opticians and pharmacists. Form HC1 can also be filled in online.

Do not wait until you need a prescription or treatment before you apply for a certificate. Getting a refund after you have paid is better avoided. You would need to ask the pharmacist for a special receipt when you get your prescription, which you then have to use to reclaim the money. If you don't get the special receipt when you hand in the prescription, you can't claim a refund.

Remember, if you don't qualify now because your income is too high, if your income drops you can always make a fresh claim.

Send the completed form HC1 to

NHS Business Services Authority
PO Box 370
Newcastle Upon Tyne
NE99 2ZA
0845 850 1166
website

Prepayment Certificates for prescriptions

If you need frequent prescriptions but do not qualify to get them free of charge, you can buy a prepayment certificate which could save you money.

Prepayment certificates save you money if you have to pay for more than three prescription items in a three-month period, or more than 14 items in a twelve month period. Remember each drug prescribed counts as a seperate item, so two drugs on one prescription counts as two items.

In England prepayment certificates last for either three or twelve months. You can pay for the twelve month certificate by direct debit, in ten equal monthly instalments.

Before buying a prepayment certificate, make sure you are not entitled to free prescriptions, as it can be difficult to get a refund once you have paid for your certificate.

You can buy a prepayment certificate:

• over the phone from the NHS Business Services Authority 0845 850 0030
• online from the NHS PPA website
• from the pharmacist
• from your Primary Care Trust

You are sent a plastic card (like bank card) that you show to the pharmacist each time you hand in your prescriptions and tick the box on the back of the prescription to say you have a Prepayment Certificate.

Health Care Help

Help with health care costs can be for:

• prescription charges
• NHS dental charges, including check-ups
• sight tests
• vouchers towards the cost of glasses and contact lenses
• travel costs to and from hospital for NHS treatment
• travel costs if travelling abroad for treatment
• wigs and fabric supports, for example, abdominal and spinal supports, and support tights.

Details of all the NHS health care help available.