In the English NHS charges are made for prescription drugs, although only a small minority of patients have to pay them. Charges were abolished in NHS Wales in 2007, Health and Social Care in Northern Ireland in 2010 and by NHS Scotland in 2011. In 2010/11, in England, £450m was raised through prescription charges, some 0.5% of the total NHS budget.
When the National Health Service was established in 1948 all prescriptions were free. The power to make a charge was introduced in the NHS Amendment Act 1949, and proposals for charges were a factor in the resignation of Aneurin Bevan from the Labour Government in 1951. Charges were introduced in 1952, by the Conservative government at a rate of 1 shilling per prescription. There were exemptions for people in receipt of National Assistance, War Disability Pension, children under 16 or at school, and venereal disease patients. In 1956 the rules were changed so that a charge applied to each item prescribed. In 1961 it was doubled to 2 shillings. Charges were abolished by the Wilson Government on 1 February 1965, only to be reintroduced on 10 June 1968 at a higher rate of 2 shillings and six pence but with a wider range of exemptions. In 2014 the prescription charge was £8.05.
The existing list of medical exemptions is essentially a list of conditions for which long term life saving medication was available in 1968 and has never been revised since. The policy on prescription charges has been dismissed as a "dog's dinner" by the Social Market Foundation who said in 2003 that the current rules on who pays for medicines and who does not are unfair and illogical.
In 2008 88% of patients in England got prescription charges free.
Now prescriptions are free for:
- children under 16,
- people 16-18 and in full-time education,
- people who get some Means-tested benefits,
- people over 60,
- women who are pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx)
- people who have a certificate (HC2) entitling them to help under the NHS Low Income Scheme. An HC3 certificate gives some help but not exemption from charges.
Patients with any of these conditions who have a valid medical exemption certificate (MedEx) are entitled to free prescriptions, for all conditions, not merely the qualifying condition:
- Epilepsy needing continuous therapy
- a permanent fistula
- diabetes mellitus
- diabetes insipidus or hypopituitarism
- Addison’s disease and other forms of hypoadrenalism
- Myasthenia Gravis
- any continuing physical disability which stops you going out alone
- undergoing treatment for cancer, including the effects of cancer, or the effects of current or previous cancer treatment
Medical Exemption Certificates last for five years or until the 60th birthday, whichever is sooner. A Certificate does not provide help with the cost of NHS wigs or fabric supports.
Prescriptions for medicines administered at an NHS hospital or an NHS walk-in centre, personally administered by a GP, contraceptives and for medicines supplied at a hospital or clinic for the treatment of a sexually transmitted infection or tuberculosis are always free.
War pensioners do not pay if the prescription is for their war disability.
A person who falsely claims exemption is liable for a penalty charge which is five times what they should have paid, up to a maximum of £100 plus the original charge itself. If they do not prove entitlement to help with health costs, and do not pay the amount stated in the penalty charge notice, the NHS may take court action to recover the debt. The penalty charge is increased by 50 per cent of the penalty charge if they does not pay within 28 days of the date the penalty charge notice is sent.
Other ways of paying less than the full prescription charge
For those that do not qualify for free prescriptions a Prescription prepayment certificates area available. They are worthwhile if more than 14 prescriptions in a year are needed. This is available by 10 monthly direct debit instalment payments. If you buy a season ticket and subsequently become entitled to free prescriptions you do not get a refund.
Some medicines do not cost as much as a prescription charge, and can be bought from the same pharmacist.
Refunds are available if an exempted prescription is paid for. The refund must be claimed within three months on form FP57, which can be got from the pharmacist.
- Department of Health Resource Accounts 2010/11
- Bevan, Aneurin. "Bevan’s Resignation speech 23 April 1951". Socialist Health Association. Retrieved 27 December 2013.
- "Prescription Charges". Socialist Health Association. Retrieved 27 December 2013.
- "Prescriptions policy is 'dog's dinner'". BBC News. 15 June 2003. Retrieved 27 December 2013.
- "After the concessions – carry on campaigning for the abolition of prescriptioncharges in all of the UK". Abolish Prescription Charges. Retrieved 27 December 2013.
- "Protestors call on Gordon Brown to abolish prescription charges". PR Week. 1 February 2010. Retrieved 27 December 2013.
- "PROCEDURE FOR ISSUING AND REFUNDING FP57 FORMS (RECEIPT & REFUND OF PRESCRIPTION CHARGES) IN ENGLAND". para. 19. Retrieved 9 November 2014.