In times of austerity, the way in which public money is allocated to competing resources is more important than ever, and nowhere more so than in the National Health Service, where inflationary pressures runs high and technological advances and an ageing population drive up costs and demands. Labour’s decision to introduce universal free prescriptions in 2007 raised questions about value for money at the time, but in a decade of public spending restraint, we need to ask whether the policy is affordable and even desirable.
Prior to the introduction of universal free prescriptions, an estimated 93% of prescribed items were already exempted from charges. Prescriptions were just £4 per item dispensed and those who needed regular prescriptions were able to purchase prepayment certificates to cap the costs of their medication at just £80 annually. The income raised annually, after taking into account the costs associated with the regime, was around £30 million annually.
Since charges were abolished in 2007, the volume of prescriptions being dispensed in Wales has increased by over a quarter and Wales is now more dependent on prescriptions than any other part of the UK with an average of 25 items prescribed per head of population per year, more than any other part of the UK. Last year alone, the Welsh NHS spent more than £4 million on paracetamol, which can be purchased for less than 20 pence in many supermarkets, and prescriptions are still being doled out for products such as athletes foot powder and mouth ulcer gel each year.
But the reality is that there is no such thing as a free prescription, the policy is now estimated to be costing taxpayers around £40 million annually and when you take into account that many patients make appointments to see their GP simply to avoid a small charge, we can see just how counterproductive this policy has become.
The context against which this policy is being funded couldn’t be worse. Since 2010 the Welsh Labour Government has imposed record-breaking cuts on the Welsh NHS, making it the UK’s worst funded health system. Ministers have refused a Keogh-style inquiry into high death rates on grounds of cost and argue against a £5million Cancer Treatments Fund to end the postcode lottery in access to innovative new cancer medicines.
Labour in Scotland has argued against free prescriptions, while Ed Miliband has said the policy would be unaffordable in England. Carwyn Jones and Mark Drakeford continue to protect their freebie policy, while other parts of the NHS are crying out for resources. The British Medical Association has warned that the Welsh NHS is facing ‘imminent meltdown’, while the Royal College of Physicians has warned that the NHS in Wales is so under-resourced, Labour’s hospital reconfiguration plans not be realised. Three of Wales’ seven health boards had their accounts qualified in 2013-14 because they overspent, while a further two only stayed within their financial limits because of multi-million pound bailouts. The financial picture for the Welsh NHS is dire because of Labour’s decision not to follow England and Scotland and protect the health budget.
Labour’s policy has become morally indefensible. It is a scandal that Wales is a nation in which millionaires can access free asprin, but cancer patients are unable to access the drugs their clinicians want to prescribe. That’s why the Welsh Conservatives want to end the free for all policy on prescriptions.
Under our proposals whilst the vast majority of prescriptions would still be free, we would return to a system of exemptions from charges for the under 25s, the over 65s, students, pregnant women and new mothers, anyone on income support and the disabled, but extend exemptions to those suffering from chronic conditions or cancer. Everyone else would be charged just £5 towards the cost of their prescription. Amongst other things, the money saved could easily pay for an innovative Welsh Cancer Treatments Fund, improvements in stroke care, additional investment in the Welsh hospice movement and the recruitment of an additional 100 staff for the struggling Welsh Ambulance Service.
Politics is about making difficult decisions and I appreciate that some people may not appreciate paying towards something they currently receive for free. But I believe that if those who can afford to make a small contribution towards the cost of their prescriptions do so, then we will be able to go on protecting the vulnerable, whilst helping Wales to build a stronger and fairer NHS for all.
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