Chris Nelms

Something strange is happening with the charging for medical prescriptions. It is widely known that the British Government’s deficit in income compared with its expenditure has caused The Treasury to explore all means of saving money and increasing the taxation of the electorate without actually taking the politically damaging step of announcing an increase in tax rates. I suspect that one area which is being exploited is prescription charging.

I take a daily capsule of Omeprazole to control acid production in my stomach because repeated burning and scarring of my oesophagus was causing a constriction, and threatened serious longer-term problems. My specialist prescribed the medication and indicated that I shall have to take it indefinitely. When my GP first started prescribing this medicine in 2007 he did so for three months at a time and I paid a prescription charge of £6.85 for that quarterly supply of capsules.

On 1st April 2008 the Government raised the charge for prescriptions to £7.10, an apparent increase of 3.65%. However when I next visited my GP’s surgery in Mere, Wiltshire to obtain a repeat 3-monthly prescription the receptionist said I could now only receive my prescriptions four weeks at a time “because of a change in the law to save waste”. I asked how this would save waste when I need to take to take this medicine daily and she gave one of those ‘it’s nothing to do with me and I don’t care anyway’ shrugs. This had the effect of making the real increase in my prescription charge an enormous 337%, not the 3.65% announced by the Government. Furthermore, the surgery announced a reduction in their opening hours at the same time so that patients who don’t work in Mere would find it extremely difficult to visit the surgery every 28 days without taking time off work, and for those of us who live several miles from Mere we would incur additional transport costs as well as the inconvenience. By coincidence, soon afterwards Louise was prescribed a course of antibiotics by another GP at the same surgery, who also repeated that he could only give her 28 days’ worth of medicine at a time. On that occasion the surgery actually cut up the drug manufacturer’s bubble pack with scissors, dividing a single box of pills into two so that my wife had to pay a double charge.

I was sufficiently incensed by this to write to my MP to enquire how this ‘change in the law’ had been kept so quiet. He forwarded my letter to the Department of Health, and received a reply from the Rt Hon Dawn Primarolo MP, Minister of State. Ms Primarolo stated: “While it may now be common practice for prescriptions to be issued for one month or 28 days at a time, there has been no Government directive to specify the length of time for which prescriptions should be issued. Responsibility for prescribing, including the issue of repeat prescribing and the duration of prescriptions, rests with the doctor who has clinical responsibility for that particular aspect of a patient’s care.” She goes on to say: “The decision of how much to prescribe for how long is…..a complex one and should be left to the doctor.”

Therefore my GP’s receptionist misinformed me by saying the law had changed. Presumably she did this either because she was poorly trained by the doctors for whom she works or because the surgery has introduced a policy of restricting prescription duration so that patients pay more for their medication. I wrote to my GP, Dr Edward Halsey, at Mere Surgery, enclosing a copy of Ms Primarolo’s letter, and invited his comments. He didn’t reply by letter but telephoned me at 9.45 one evening. His approach to the questions in my letter was guarded but he did conclude by saying that I could have a quarterly prescription “if you want one”. Well of course I would prefer to pay £7.10 for a three-month supply of my medicine than £23, and be saved the aggravation of visiting the surgery so regularly to collect it.

So a few days later Louise visited the surgery to collect my quarterly supply of Omeprazole. Curiously, instead of 13 weeks’ supply, the doctor had prescribed 12 weeks. She queried this and the good doctor was summoned from his consulting room. He gave no reason why he thought a quarter comprises 12 weeks when it is clearly 13, but he amended the prescription so we got there in the end. It remains to be seen whether we’ll have a similar battle in three months’ time. Also it makes me strongly suspect that many other patients at that surgery who didn’t challenge the receptionist’s “change in the law” story are still paying too much for their medicines.