Keep Free Prescription Promise

posted: 21/01/2010

UPDATED 26 January - further information

Gordon Brown promised at the labour party conference in 2008 to end prescription charges for people with long term conditions like HIV. Over a year later people are still paying. Now the Prescription Charges Coalition of 20 charities has called on Gordon Brown to keep his promise.
 

‘Prescription charges are a deeply unfair burden on people with long-term conditions — those who need medicines the most for day-to-day quality of life', they say in their letter. ‘Patients should not be prevented by an NHS charge from accessing treatment to improve their quality of life.'
 

Time is short because of coming election

The charities said they hoped that the government would be able to find a way to implement this policy as soon as possible. Time is short – new regulations need to be tabled within the next month or the general election will shut the door to reform.
 

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Keep Free Prescription Promise

posted: 07/12/2009

A simple email now to your MP could help Gordon Brown keep his promise. Over a year ago, at the Labour Party 2008 conference, Gordon Brown pledged to scrap prescription charges for all people with long-term medical conditions, including HIV. He didn’t say when he would scrap the prescription charges, leaving us all waiting in the dark. We are still waiting.
 

People with some health problems never have to pay prescription charges. But the list of conditions that passport people to free prescriptions hasn’t been updated since it was written in 1968. HIV is not on the list, simply because HIV was discovered almost twenty years after the list was made.

While HIV medicines themselves come free because they are prescribed by the hospital, other medicines (for depression, anxiety, and everything else) have to be paid for.

Many people with HIV have no right to free prescriptions and these costs rapidly mount up. Some people cannot afford to collect the drugs they need from the chemist.
 

Actions, not words

Please email your MP to ask the Secretary of State for Health for the abolition of prescription charges for people with HIV and other long-term conditions.
 

Easy-peasy

Simply click the link, then add your details and it will write a custom letter from you to your MP – please be patient while it writes your personalised letter.
 

Disunited Kingdom

Each prescription item now costs £7.20 in England. Wales has already abolished prescription charges, Northern Ireland abolishes them in 2010 and Scotland will abolish them by 2011 - meanwhile Scotland is cutting the cost year by year - they are £4 now and will be £3 from April. England? they went up in April again to £7.20.

Prescriptions, HIV and Charges

posted: 10/03/2009

The British Medical Association has branded as pointless the Department of Health's consultation on making everyone with a long-term condition exempt from prescription charges. 

It says this is a waste of time and energy and the government should just make all remaining prescriptions free once more. Just 1 in 10 prescriptions are now paid for and this will fall even more because cancer patients will get free prescriptions from 1 April.

In Wales and Scotland all prescription charges have either already been abolished or are about to be abolished.

HIV treatment costs

Since the start of this year Greater Manchester HIV clinics (among 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 amd anxiety, and sexual dysfunction. 

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.

The charging review

The Prescription Charges Review will consider how to implement prime minister Brown's commitment to exempt patients with long-term conditions (LTCs) from prescription charges over the next few years following the exemption for cancer patients.

It will consider:

• how to define the range of long term conditions affecting patients that should be exempted from prescription charges;
• how exemption from charging can best be phased in, with due regard to:
  - what is in the best interests of patients
  - the potential impact on the wider health care system
  - implications for existing policies on management of long term conditions
  - implications for public expenditure

The review will report to the Minister for Public Health and the Secretary of State for Health in Summer 2009.

It would be good to have your say on exempting HIV as a longterm condition from prescription charges but it seems the Deaprtment of Health doesn't want to hear - there is no way to feed your views to the department at the consultation page.

Last September Gordon Brown announced that “as over the next few years the NHS generates cash savings in its drugs budget we will plough savings back into abolishing charges for all patients with long-term conditions”.  The Department of Health has established the Prescription Charges Review, chaired by Sir Ian Gilmore, to make recommendations on how this policy will be implemented. 

Charging by diagnosis or disability

The idea that we should discriminate in levels of charges according to diagnosis or disability is fundamentally misconceived. Herpes is a chronic condition. So are HIV and ME.

TB and syphilis are perhaps not chronic conditions because they can be treated and people cured, but it is in the interest of the rest of the population that people take their treatments properly and become clear of infections.

Continuing to restrict help with prescription charges to save money is a false economy. Despite the help available, the simple existence of charges is enough of a barrier to put off some of the poorest and most vulnerable. 

George House Trust supports the BMA argument, prescription charging has reached the point where the income from charging isn't worth the administrative and other costs of collection. Scotland and Wales are already seeing the benefits of free prescriptions. We don't need a review, we need prescription charges in England scrapped.

Department of Health Consultation

source

Migrant Treatment Charges

posted: 17/12/2008

Before Christmas we expect the Appeal Court's decision on the government's appeal against the ruling early this year that all refused asylums seekers and many other migrants are in fact "ordinarily resident" and so fully entitled to all NHS free treatment, including HIV.

We are hopeful the Appeal Court will uphold the High Court's decision in the case which was supported by the entire HIV sector. But the Department of Health and the Home Office both still appear intent on restricting access to the NHS even further. They plan to extend the rules to cover primary healthcare, such as GPs. The department has been sitting on the results of a consultation on these proposed changes for four years, but is expected to release them shortly.

There is concerted opposition to banning migrants from primary healthcare, because a stitch in time saves nine - catch problems early and they are cheaper to treat and diseases don't spread; delay treatment by putting up charging barriers and we can safely predict expensive emergency hospital treatment and the spread of transmissable infections costing society far more than earlier care. But more important, it is the human and "right" thing to do for people in the country - and we made a commitment to treating all who need it to the world over 30 years ago in an international Convention that we are still breaking. The department does know what to do - it has recently published a guide to NHS trusts on the Human Rights approach to local healthcare.

Passports for treatment

Under the current system, asylum seekers who are awaiting a decision on their status are entitled to free primary healthcare, while even those who have been refused can be treated at a GP's discretion. But clinical decisions about who gets free care at times never reach doctors, says Dr Sally Hargreaves, of Imperial College London.

A study of GP practices in Newham Primary Care Trust, London, found that almost 70 per cent of practices asked for passports and about where patients had come from. This suggests frontline reception staff are inappropriately stopping migrants from seeing a GP. The government has said that the new ID cards now being issued to migrants (coming to everyone else over the next few years) will soon be used instead of passports to prove the right to healthcare and other services.

Confusion

Adam Hundt, the lawyer who won the court case, often gets calls from doctors who are unsure about what they should do with patients. “The clinicians are left with the decision between disobeying management or disobeying their Hippocratic oath,” he says.
 

Frustration and confusion surrounding who is entitled to free healthcare is echoed by the NHS. Nigel Edwards, director of policy for the NHS Confederation, says that the rules are “quite complex and keep changing. The Home Office has got to get its act together in not having large numbers of people waiting for their status.”
 

Donna Covey, chief executive of the Refugee Council, says: “The rules are complicated and people don't know how to apply them. You have the Immigration Minister not knowing the difference between asylum seekers and economic migrants, and if the minister responsible doesn't understand those differences, then you can't expect overworked and underpaid healthcare professionals to understand them.”

Thousands in healthcare no-man's land

There are thousands living in the UK stuck in a healthcare no man's land, including the estimated 155,000 to 283,500 failed asylum seekers, who, after their refugee status is refused, have nowhere else to go and often no means to pay for healthcare.

Charities that work with migrants say that the Government, in its effort to crack down on the supposed problem of “health tourism”, is victimising people such as failed asylum seekers and that because of confusion over entitlement, migrants often receive patchy and inconsistent care.

Treatment Catch-22

Many people are confused about their rights. Refused asylum seekers are caught in a Catch-22 situation: they cannot be deported immediately, yet cannot have free healthcare; nor can they afford to pay for it because they are not allowed to work. “We can't send them back tomorrow, so what can we do in the meantime?” 

 
How other European countries do it
Susan Wright, director of the health charity Médecins du Monde UK, says the problem with the government's claim that a “pull factor” exists - that people come to the UK for free healthcare - is that other countries in Europe offer equally flexible, if not more flexible, policies for free healthcare for undocumented migrants or asylum seekers.

• Italy: There are payment exemptions for asylum seekers and those with low incomes from the national health service.
• France: Undocumented migrants can access a state-financed insurance fund.
• The Netherlands: The Government has set aside money for “medically necessary” care for undocumented migrants.
• Belgium: Undocumented migrants can access government-sponsored Emergency Medical Aid, which gives free access to A&E and other services.

Includes material from source

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.