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Thursday, June 18, 2009

BMA criticises Tories

After what I said yesterday about the 'producer interest' I think it is worth making it clear that although the view of the British Medical Association on health matters is significant it should not be the deciding factor in the determination of policy.

Thus the fact that the BMA have openly criticised the Welsh Conservative's decision to press for the re-introduction of prescription charges is an important intervention but needs to be judged in a wider context. Nevertheless in this particular instance I think they are right.

The Welsh Liberal Democrats did argue against the introduction of free prescriptions. Our view was that we should be extending the categories of the long-term sick who would be exempt from paying instead. That position has remained our view up until recently and technically we have still not changed our policy.

However, circumstances change. It is more difficult to undo a policy such as this than it is to oppose its introduction, whilst an examination of the actual experience reveals that some of our fears about the policy were unfounded, not least that there would be systematic abuse, a rise in the number of prescribed medicines and problems on the border. In fact there is no evidence that any of that has happened to any significant extent.

As a result we held a consultation at our spring conference on the way forward. All of the responses, together with the outcome of an indicative but non-binding vote favoured maintaining the status quo. It is my intention therefore to come back to Conference with a motion recommending that we now support free prescriptions in Wales. There has been no dissent on this position within the group or anywhere else within the party that I have been aware of.

In moving their motion yesterday, the Conservatives illustrated better than I could the problems with introducing charges. They argued that 93% of prescriptions were free on the old system and that it was only right that those who could afford to do so should pay. However, they also argued that the list of exemptions should be extended.

The upshot of all this would be that the number of people who would actually be paying would be very small but the costs of administering an exemption system and means-testing would be quite significant, abuse would be a major problem and the sort of revenue the Tories anticipate raking in from the change completely unrealistic and almost cancelled out by the extra costs. It would also be true that even on the Tory system a millionaire with a long term illness would still get his or her prescription free of charge.

They were unclear on the price that would be imposed on a prescription or the amount of money it would raise. I think we can dismiss their figure of £30 million as completely unrealistic. If they are going to cost their manifesto on the back of an envelope as well then we will have a very interesting Assembly election.

And then there is the impact on health of reintroducing a charge. The argument that people are put off purchasing all of the medicines prescribed by a doctor because of the cost is actually quite a strong one, particularly when their income puts them just above the threshold for a free prescription. The Welsh Liberal Democrats are in the process of moving-on on this issue, I think it would benefit the Welsh Conservatives if they did the same.
Not quite sure what you mean here by ‘producer interest’ Peter. I would just like to point out that BMA Cymru Wales never tries to exert undue influence on health policy in Wales and I think you may credit us with having more influence than we actually do as I’m sure that our policies are never “the deciding factor in the determination of policy”.

We are always open and honest when it comes to our policy positions and try to publicise them as much as possible so that our members, politicians, the media, the general public are made aware of what the association thinks. We even blog ourselves now, as a way of extending our communications - www.bmacymruwales.blogspot.com. We wouldn’t be doing our job of representing our members if we failed in this respect. And as we consult with our members – who work on the frontline in the NHS - on all aspects of policy, I would like to think its always informed policy that we put forward.

I am very pleased to see that the Welsh Liberal Democrats have moved away from the viewpoint of being against free prescriptions, to one now in support of the scheme. I’m sure it’s not easy for a political party to change tack like this, so I applaud you Peter and the rest of the Lib Dems for this.
It was not a dig at you or the BMA Richard who are doing an outstanding job in representing your members and keeping elected representatives informed about issues. It was a defensive statement about why I am trying to change the Lib Dem position, pointing out that I was doing so on the merits of the case rather than because I had listened to one group more than another.
What would be the impact of introducing a voluntary 'opt out' of the free scheme? I'd like to be able to pay for my prescriptions and for those of my family but I understand that this is not the case(or an option) for everyone. Is this feasible?

or could there be a option to make a donation towards the cost of prescription so that even those who couldn't afford the total cost could make a contribution if they wished? or would these options just result in huge administration costs?
Could be administratively difficult but an interesting idea. I did feel strange myself not paying for a prescription the other day and would have appreciated an honesty box.
I too would pay for a prescription if given the option. Last time I had a prescription, I actually felt embarrassed that I was having it for free knowing full well that I could afford to pay for it and that the money for the prescription could have gone elsewhere where it is needed more.
"so I applaud you Peter and the rest of the Lib Dems for this."

Don't applaud us yet, it needs to go through conference first as Peter points out.
why dont all you who want to pay give the £ to charity ?

I cannot afford the £7 odd per item for mu regular medicine... if charges were brought back I'd be truely in trouble, I'd have to make the choice between food on my table or paying my bills and collecting my prescription. no one in modern day Wales should be in that poition
Worth pointing out that prescription charges are, in fact, second charges, since those of who have been paying NI conts for years should get the medicines we have been insuring ourselves against needing 'free' - just the same as we're being de-frauded by the govt when we have to pay for eye-checks, dental treatment etc etc.
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