Fining patients with long-term conditions ‘fundamentally unfair‘, says RPS

Robbie Turner

Issuing fines to patients who forget to renew their medical exemption certificates for free prescriptions is “fundamentally unfair”, according to a senior figure at the Royal Pharmaceutical Society (RPS).

Robbie Turner, director for England at the RPS, was speaking after it emerged that between 2016 and 2017 a total of 979,210 fines amounting to more than £13m, were issued by the NHS Business Services Authority (NHSBSA) to people who had claimed free prescriptions they were not entitled to.

Although the NHSBSA was unable to provide a detailed breakdown of the fines, the RPS believes a large number of those penalised had simply forgotten to renew a legitimate exemption certificate.

Medical exemption certificates are issued to people who are receiving treatment for certain conditions, including cancer and a small number of long-term conditions. The certificates are issued for five years, at which point they must be renewed. Patients claiming free prescriptions using an expired certificate can be subject to a fine of up to £100 plus the cost of the prescription.

Turner said: “It’s easy for patients to forget to renew their certificate. The government needs to set up an effective reminding system, not a fining system. We’d like to see a far more constructive approach which supports and informs patients, rather than makes them bear the burden of a system which is fundamentally unfair in the first place.” 

But Brendan Brown, NHSBSA spokesperson, told the BBC, who obtained the figures through a request under the Freedom of Information Act, that it is the patient’s “responsibility to make sure that they do hold that exemption that they are declaring that they have. Fraudulent and other mistakes… do cost the NHS millions of pounds which could be spent on frontline NHS services.”

John Kell, head of policy at the Patients Association, said: “The point of free prescriptions is to ensure that patients get the medicines they need without incurring financial hardship.

“If the system to administer them is regularly tripping people up through administrative technicalities, and then fining them for the privilege, it is not serving its purpose.

“The system must be designed to go with the grain of how people behave, and support them to ensure they have the paperwork in place to show their entitlement, not make financial gains from catching them out.”

The RPS is a member of the Prescription Charges Coalition, a group of more than 40 bodies calling for patients with long-term conditions to be exempted from prescription charges. “The system of exemptions was set up in 1968 and is out of date, and arbitrary,” said Turner. “We’d like to see a review of exemptions as people need better access to their medicines, not a financial penalty for a mistake.”

Prescription charges were abolished in Wales in 2007 and in Northern Ireland and Scotland in 2010 and 2011, respectively.

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The Pharmaceutical Journal, Fining patients with long-term conditions ‘fundamentally unfair‘, says RPS;Online:DOI:10.1211/PJ.2017.20203116

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