In article <[log in to unmask]>,
[log in to unmask] writes
>Prescriptions charges are a bad tax administeed by a system which has
>become unjust and chaotic.
>They fail to achieve the reasonable aim of encouraging a brief thought
>about purchasing medicines rather than attending.
>
>If more tax should be raised to support the NHS, and it should, then it is
>not proper to levy it on a small proportion of the population, at exactly
>the times when they are least able to pay it.
>
>What advice should the incoming government be given to assist them in
>producing a sensible and effective system of charges - or should it be
>removed altogether?
Adrian is quite right - the present system of charges is a mess. I would
favour reducing the charge to some small level just high enough to deter
frivolous consultations (now that I have written the phrase I quite like
the idea of a frivolous consultation!) but extending it to most people.
It is crazy that diabetics, epileptics and patients with thyroid
deficiency can get all their precriptions free, but asthmatics, patients
with heart failure and hypertensives can't. For that matter, it is also
crazy that many poor patients with children consult their GPs in a sort
of ritualised way when their children have viral illnesses simply to get
a (free) prescription for paracetamol.
Here is one suggestion: patients who are entitled to free prescriptions
should be able to register with a chemist to obtain those medicines
which are also available OTC. The chemist could keep an eye on their
consumption and advise them when they should see their GP (although in
my experience chemists are much too quick off the mark when it comes to
increasing our workload).
I had thought about suggesting that everyone with a chronic illness
should get free prescriptions, but then I thought about patients who
smoke and drink too much and keep their oesophagitis under control with
a proton pump inhibitor. It would stick in my gullet for them not to pay
anything. Perhaps there are classes of drugs for which everyone should
be charged (after all, if you can afford booze and baccy you can afford
a prescription charge).
This is awful - I am beginning to sound like a Tory or a New Labourite!
Toby
--
Dr Toby Lipman
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