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Saturday, July 16, 2011

Is this the end of free prescriptions?

There is an intriguing article in the Western Mail this morning, which reports that Hywel Dda Health Board has become the first in Wales to introduce a “restricted” medicines list, including painkillers and hay fever treatments, from which GPs cannot prescribe

The paper says that it is feared that other health boards, charged with saving up to £1m a week each, could follow suit, undermining the Welsh Government’s free prescription policy. Indeed the British Medical Association has already leapt in with both feet, describing the move as “immoral”.

Their argument is that this policy is inducing GPs to break their terms of service. They say that GPs have an obligation under their NHS contract to prescribe those medicines they think are necessary for the patient’s treatment and that the health board is exceeding its remit in seeking to restrict that.

For the defence the health board argue that money spent on “cheap-to-buy” remedies is better used for treating more patients with more serious conditions. I suppose it really depends on what is on the list. If it is items such as painkillers or hay fever remedies then I don't see the problem.

The free prescription regime was designed to deal with medicine that would have been prescribed when it cost the patient £6 or so per item, not to introduce a free-for-all at the chemist or create queues at doctors' surgeries for those who wanted free access to relatively cheap and easy to obtain medicine. Were we really aiming to increase the number of packets of paracetamol that were dispensed by 268,000 between2006 and 2010? Can we justify a 10% rise in prescriptions for athlete’s foot powder?

Certainly, if the reaction of their spokesperson is anything to go by, the Welsh Government is fairly relaxed about the proposal. They say that determining what medication is given on prescription is a matter for the prescriber. That looks like a green light to me, unless there is activity going on behind the scenes that we do not know about.
As someone who used to work for a LHB, there was occations when complaints were made the GPs wouldn't prescribe things like sanitary towels! They are cheap enough, and not a medical condition!
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