Friday, 11 March 2016


Free NHS prescriptions are one of the landmark achievements of The Scottish Parliament. And this needs to be reiterated as the Annual Conference of the British Medical Association's Scottish Committee convenes in Clydebank today. For a motion has been tabled at the conference by the Ayrshire and Arran branch calling for the reintroduction of means tested NHS prescription charges on the grounds that providing these medicines free is 'a drain on NHS resources and adds to GP's workloads'.

As an MSP I presented the original Holyrood Members Bill to abolish these charges in Scotland. And I am proud to have done so. The charges were abolished in Scotland in 2011. Any move to reintroduce the charges would not be in the best interests of patients or our nations health.

NHS Prescription charges were introduced in 1951. The charge of 1/- [one shilling] was intended to be temporary to help pay for Britain's war in Korea. Sixty years later they were finally abolished in Scotland but only after the charge had risen to £6.50 per item on the prescription.

The evidence I presented to Parliament in 2004 showed that tens of thousands of patients were going without the medicines they needed because they could not afford to pay. The means testing principles were illogical and contradictory. Some patients were exempt from payment on the grounds of age. Others, such as pregnant mums, were exempt on the basis of their particular health condition. There was no logic to which conditions should be exempt and others charged. It was entirely arbitrary based on the cost implications to the Exchequer. This meant that a retired multi-millionaire for example did not have to pay a penny but a low paid care worker had to meet the cost in full. MSPs on £65,000 a year were often exempt by virtue of their age or an existing health condition but cancer patients requiring multiple drugs at one time could rack up a small fortunes in medical bills.

The founding principle of the NHS, that the service be available to all citizens free at the point of need and paid for out of general taxes was of course completely breached by prescription charges.
Wales and Northern Ireland had abolished the charges years before Holyrood finally did so in 2011. Today only NHS patients in England now pay for their prescriptions. The charge currently stands at £8.20 per item. And it is due to rise again on April 1st.

Prescription charges mean the sick must pay twice for medical treatment, once out of their general taxes and secondly from this additional 'tax on the sick'. Economically the case for reintroducing prescription charges is weakest of all. NHS Scotland gave evidence to support my Bill showing that the cost of admitting patients to hospital whose condition had deteriorated through not accessing medication [£600/day] far exceeded any income they might gather from prescription charges. Leaving aside the cost to the wider economy - of days lost to prolonged sickness absence from work - the cost to the NHS of administering the means-tested system and protecting it from fraud reduced again any financial advantage further. The cost of medicines prescribed by GP's to their patients represents less than 0.5% [half of one per cent] of NHS Scotland's annual budget. 

NHS prescription charges are profoundly and politically unpopular because they undermine the fundamental principle of an NHS free to all.

 I am sure the BMA in Scotland will recognise the powerful case for ensuring patients in Scotland do not go without the medicines they need and oppose the motion to reintroduce prescription charges. And I urge them to work with their colleagues in England to see the charges are abolished there too.