Health chiefs in rad­i­cal plan to slash cost of free pre­scrip­tions

The Scottish Mail on Sunday - - Front Page - By Dawn Thomp­son

SCOTS pa­tients may soon be forced to pay for medicines un­der an NHS ‘drug-ra­tioning’ scheme.

Peo­ple who go to their GP with mi­nor ail­ments ex­pect­ing free treat­ment would be told to visit their lo­cal phar­ma­cist.

In­stead of get­ting treat­ment on pre­scrip­tion, they would have to buy medicines.

The Scot­tish Govern­ment in­tro­duced free pre­scrip­tions in 2011. But they cost £1.3 bil­lion last year and health boards are strug­gling to bal­ance the books. One board is now con­sid­er­ing rad­i­cal pro­pos­als that would see it refuse to is­sue pre­scrip­tions for cer­tain medicines. NHS Bor­ders has al­ready agreed to ‘re­strict pre­scrib­ing of some low clin­i­cal value medicines’ as it cuts costs.

Scot­tish Tory health spokesman Miles Briggs said: ‘There’s no

ques­tion health boards are un­der se­vere fi­nan­cial strain. But huge in­vest­ment in health down south will pro­vide sig­nif­i­cant sums for Scot­land through the Bar­nett For­mula. It’s es­sen­tial the SNP passes that on.

‘If the SNP is com­mit­ted to free pre­scrip­tions, it’s es­sen­tial this ra­tioning for some pa­tients does not take place. That could lead to huge dis­crim­i­na­tion against those with cer­tain con­di­tions.

‘The Na­tion­al­ists in­tro­duced free pre­scrip­tions – it’s down to them to en­sure it’s prop­erly re­sourced.

‘Af­ter 11 years of fi­nan­cial mis­man­age­ment of our NHS un­der the SNP, we are in­creas­ingly see­ing a post­code lot­tery de­vel­op­ing in the avail­abil­ity and de­liv­ery of ser­vices in our Scot­tish NHS.’

Parac­eta­mol is among the most com­monly dis­pensed medicines, de­spite be­ing sold for as lit­tle as 15p for a packet of 16 tablets. Free­dom of In­for­ma­tion re­quests show free parac­eta­mol has cost Scot­tish health boards more than £57 mil­lion since charges were scrapped.

Ear­lier this year, NHS Tay­side banned one-off pre­scrip­tions for parac­eta­mol and ibupro­fen to save £1 mil­lion a year.

Now NHS Bor­ders has is­sued an ur­gent warn­ing in a pa­per on ‘pre­scrib­ing cost con­tain­ment’. It said that ‘if al­lowed to con­tinue, the cost of medicines could the­o­ret­i­cally con­sume all avail­able re­sources in NHS Bor­ders’.

Pro­pos­als in­cluded an agree­ment ‘to re­strict pre­scrib­ing of some medicines of low clin­i­cal value’.

NHS Bor­ders said: ‘Pre­scrib­ing costs are ris­ing faster than our an­nual bud­get up­lift. For 2018-19, the sav­ings plan for pre­scrib­ing is £1.6 mil­lion. We run re­minders via so­cial me­dia and other chan­nels, sign­post­ing peo­ple to their lo­cal phar­macy where a phar­ma­cist is best placed to ad­vise on com­mon con­di­tions such as coughs and colds, ath­lete’s foot and hay fever.

‘The board en­cour­ages self­man­age­ment where pos­si­ble, ei­ther through pur­chas­ing painkillers from a com­mu­nity phar­macy or via the mi­nor ail­ment scheme.’

NHS High­land has al­ready is­sued a sim­i­lar warn­ing on the dan­gers of ris­ing costs.

Scot­tish Labour health spokesman Anas Sar­war said: ‘This is a deeply con­cern­ing sit­u­a­tion.

‘It is ab­so­lutely es­sen­tial that ev­ery­one should be able to re­ceive the medicines they need, re­gard­less of their abil­ity to pay.

‘But it is clear that the SNP’s fail­ure to prop­erly re­source our NHS is putting that prin­ci­ple in jeop­ardy.

‘Rather than pat­ting it­self on the back for in­tro­duc­ing free pre­scrip­tions, the SNP Govern­ment should be en­sur­ing the sys­tem has the fund­ing it needs to work.’

Alex MacKin­non, the Royal Phar­ma­ceu­ti­cal So­ci­ety’s di­rec­tor for Scot­land, said: ‘If com­mu­nity phar­ma­cists see pa­tients and can treat pa­tients that have mi­nor things, then we’re keep­ing them out of GPs’ surg­eries, to al­low the doc­tor to spend more time with a pa­tient who’s re­ally got some­thing se­ri­ously wrong.

‘We’re keep­ing them out of ac­ci­dent and emer­gency as well, which is a hor­ren­dous cost and we’re keep­ing them away from swamp­ing the NHS 24 lines as well.

‘So, from a pro­fes­sional body per­spec­tive, we’re ab­so­lutely sup­port­ive of what’s be­ing planned.

‘Com­mu­nity phar­ma­cists are re­ally good at re­spond­ing to symp­toms. They know when to treat, ad­vise or re­fer to an­other prac­ti­tioner when ap­pro­pri­ate.’

Dr Andrew Buist, chair­man of BMA Scot­land’s GP com­mit­tee, said: ‘With the pres­sures fac­ing gen­eral prac­tice, it is re­ally im­por­tant that pa­tients know what help is avail­able to them when they need clin­i­cal care.

‘Com­mu­nity phar­ma­cists are able to pro­vide as­sis­tance with a range of con­di­tions and may of­ten be more speed­ily avail­able than a GP.’

The Scot­tish Govern­ment failed to re­spond when asked to com­ment.

Ear­lier this year, the NHS in Eng­land banned doc­tors from rou­tinely pre­scrib­ing treat­ment for 35 mi­nor con­di­tions to save al­most £100 mil­lion a year.

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