home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
Software Vault: The Diamond Collection
/
The Diamond Collection (Software Vault)(Digital Impact).ISO
/
cdr14
/
uk50301.zip
/
UK50301.TXT
Wrap
Text File
|
1995-03-11
|
9KB
|
173 lines
ABLEnews World Desk
[The following file may be freq'd as UK50301.* from
1:109/909 and other BBS's that carry the ABLEFiles
Distribution Network (AFDN) and--for about one week--
ftp'd from FTP.FIDONET.ORG on the Internet. Please
allow a few days for processing.]
Taxing the Ill
Following last week's rise in prescription charges
in Great Britain, Christine Doyle reports on some
surprising solutions to the high cost of drugs.
How much you pay for a prescription is--like the hospital waiting
list--an NHS barometer. So, predictably, the announcement last week
that the new charge will break the sensitive 5-pound barrier, rising
to 5.25 pounds from the current 4.75, led to howls of protests from
patients, doctors and pharmacists.
Four out of five prescriptions are free but, because many are repeats,
this leaves about one in three people who must pay. If prescribed more
than one item for their complaint, they could be charged more than 10
or 15 pounds because each item must be counted separately.
Bronwen Morris, who was collecting a prescription at her local
pharmacy in west London last week, sums up much recent criticism. "I
am a pensioner, so I am exempt, but there are so many people--young
and old--on low incomes. Many will now be too scared of the cost to go
to their doctor." In her view the 300 million pounds raised from
prescription charges is a selective "tax on being ill."
Linda Lamont, director of the Patients' Association, agrees: "We have
gone though the credibility barrier. Many patients now feel they can
afford only one of the drugs prescribed by their GP."
Zayd Mahfooth, pharmacist at the busy Spatetree Pharmacy in East
Sheen, west London, says: "We are always being asked which is the most
necessary medicine."
Often cheaper to go private
Few people, if they are realistic, expect prescription charges to be
abolished. Yet, faced with a charge that seems set to keep rising,
they might well ask if the present system is too rigid. Although some
patients can get prescription "season tickets" and save costs, could
others pay less by buying some drugs directly from the chemist
or--extraordinary though it seems--by asking their NHS doctor for a
private prescription?
Bizarrely, hundreds of such common drugs as antibiotics, strong
painkillers or asthma inhalers, which patients cannot obtain except by
a doctor's prescription, cost much less than the prescription charge.
Equally, large numbers of the drugs which can be bought over the
counter for less than 4.75 pounds are often prescribed by doctors.
Patients who are not exempt from charges could end up paying much more
than some drugs are worth.
If you are being prescribed medicine, ask your GP if you could pay
less by buying the drug directly. Dr Ross Taylor, of the Royal College
of General Practitioner's advisory prescribing committee, says: "I
usually advise patients if this is the case." According to a
Consumers' Association booklet, at least 700 medicines may be sold
over the counter at less than 4.75 pounds.
However, research by the Proprietary Association of Great Britain
shows that some doctors think patients might feel they were getting
inferior treatment if they were given advice on which medicines to
buy, rather than receiving a prescription. Sheila Kelly, its director,
urges patients to check.
Pharmacists may not offer the information unless asked
Pharmacists may not offer the information unless asked. "Quite a lot
don't, even though it should not jeopardise their income," said one
High Street pharmacist. Pharmacists buy in drugs at cost price and in
addition to a monthly dispensing allowance receive a fee for each drug
dispensed. But if they sell the same drug across the counter they are
able to ask the full retail price.
For antibiotics and other less expensive drugs which cannot be sold
directly to patients, the second but much more controversial route to
cutting costs is to ask the NHS doctor for a private prescription.
Which? Way to Health reported last summer on Dr Stephen Bamber, a
Norfolk GP who pioneered this approach. His local pharmacist agreed a
fixed fee for dispensing a list of 20 medicines prescribed privately
to NHS patients so that they could buy them below the 4.75-pound
prescription charge
By using both methods you could, for example, buy cough medicines
advised by your doctor over the counter for around 2.60 ppunds and pay
less than 2 pounds for a course of privately prescribed antibiotics, a
total of less than half the present prescription costs.
However, the British Medical Association warned doctors who followed
suit that they could be breaking the law by being in breach of their
NHS terms of service. The Health Department disputes the BMA's
interpretation and has firmly said so in a letter to all Family Health
Service Authorities (FHSA). So long as doctors write a private
prescription at the request of--or with the consent of--their
patients, they are not in breach of their NHS contracts. GPs cannot,
however, ask their patients for a fee.
No legal reason now why GPs should not write private prescriptions
Dr. Patrick Hoyte, a medico-legal adviser to the Medical Defence
Union, thinks the BMA is playing semantics while patients pay the
cost. "Everyone knows that many common drugs are very cheap. I
prescribed myself penicillin privately and paid only 50 pence. As I
see it there is no legal reason now why GPs should not write private
prescriptions."
One solution might be for patients on repeated doses of cheap
medicines to complain to their FHSA if their GP will not write a
private prescription. However, Dr. Rhidian Morris, chairman of the
National Association of Fund-Holding Doctors, believes many GPs are
more concerned about saving time rather than breaches of contract. "If
I have to look up the price of every drug I am prescribing, I could
add three minutes or so to every consultation. We are already very
stretched."
Dr. Morris, like Dr. Taylor, tries to help patients save money "by
prescribing, increased quantities, say two months' supply rather than
one of cheaper drugs...But I have to feel sure this is safe." Water
tablets for raised blood pressure, non-branded "generic" sleeping
tablets or major painkillers might fall into this category.
Be warned, however: pharmacists can set their fee for dispensing a
private prescription. Some add on 1 pound or more. Some simply make up
the cost to the current prescription charge. As a rule of thumb look
for no more than a mark-up of 50 per cent.
Looking ahead, Zayd Mahfooth says the present system could be
simplified by treating each NHS prescription as if it were a private
one for all drugs below the NHS charge. When medicines cost more, as
most do, the prescription charge would apply. Last summer, a
parliamentary select committee on health made a similar suggestion.
The Government is attracted to the idea, not least because private
prescriptions, like drugs bought across the counter, do not show up on
the GPs' annual drugs bill of more than 2.4 million pounds.
Critics, such as Tim Astill, director of the National Pharmaceutical
Association which represents pharmacists, fear the move would lead to
further blurring of the distinction between the NHS and the private
sector. Some patients may feel that overall they get more from the NHS
and do not mind charges.
Yet, when the Government insists it is not trying to make money out of
NHS patients, it seems absurd that, as things stand, it can be cheaper
to go private.
[Sometimes It Pays to Go Private, Christine Doyle, 3/1/95]
A Fidonet-backbone echo featuring
disability/medical news and information,
ABLEnews is carried by more than 460 BBSs in
the US, Canada, Australia, Great Britain,
Greece, New Zealand, and Sweden. The echo,
available from Fidonet and Planet Connect, is
gated to the ADANet, FamilyNet, and World
Message Exchange networks.
ABLEnews text files--including our digests Of
Note and MedNotes (suitable for bulletin use)
are disseminated via the ABLEfile
Distribution Network, available from the
filebone, Planet Connect, and ftp.
fidonet.org
...For further information, contact CURE, 812 Stephen St.,
Berkeley Springs, WV 25411. 304-258-LIFE/258-5433
(earl.appleby@deafworld.com)