Friend hasn’t paid prescription charges for 10 years - what will happen?

[Kat19899]

Please be kind, this was stupid but unintentional and now is beside herself and remorseful.
She was on JSA around 10 years ago and entitled to free prescriptions when she set up her delivery for repeat prescriptions from the local pharmacy. She became more ill and was out of work for a couple of years, didn’t receive JSA or any benefits during that time. However she forgot to tell the pharmacy she wasn’t entitled to free prescriptions anymore and I guess with the stress/depression of being ill and the pharmacy never querying it she just forgot about it. The other day she got a doctor’s prescription at an appointment, paid for the item at the pharmacy like normal and had the sudden realisation she has not paid for 4+ items per month for about 10 years!

She is beside herself, feels awful at costing the NHS money and very stressed that she will go to court and get a criminal record or jail time. Is this likely to happen?? What should she do? I think her options are to call/write a letter telling the truth and offering to pay in full (it would wipe out her savings but she has the money), tell the pharmacy she is no longer eligible and buy a prescription prepayment certificate and hope no one questions it, or say nothing and hope for the best.
She said she does her repeats online and they get sent to the pharmacy automatically. I’m confused about how this can go unnoticed for so long. She’s willing to fully pay but every time the post comes she thinks it’s going to be a court summons.

Lifelong need for medication doesn’t automatically entitle you to free prescriptions. Again, it depends on the condition. For example diabetics who are reliant on medication to treat the condition are eligible, but those who have Parkinson’s disease are not. There are campaign groups working to have the list expanded but the government currently takes the view that provision has been made for long term meds to be made available more cheaply through pre payment certificates.

The links below are for more info in the RTEC prescription checking service and a link to NHS prescription services which includes a list of qualifying conditions/disabilities.

https://www.nhsbsa.nhs.uk/help-nhs-prescription-costs/real-time-exemption-checking-rtec#:~:text=Pharmacy%20contractors%3A%20For%20more%20information,it%27s%20sent%20out%20to%20you.

https://www.nhs.uk/nhs-services/prescriptions-and-pharmacies/who-can-get-free-prescriptions/

There is no provision for backtracking through ten years worth of prescriptions. The checks are random and fines applied individually, so I doubt other peoples’ care will be impacted to any great extent as a result of them not being picked up.

Problem is that the pharmacy don’t have access to details of her condition and if she uses the same pharmacy each time they obviously know her. So because she’s previously been exempt, they’ve possibly just been ticking the appropriate box because they assume the meds are for epilepsy. And if she were to come clean it would cost her around £22000 in fines.

And if you haven’t kept your exemption certificate up to date and renewed every five years, you’ll still be fined if they pick up on it.

Offering to pay over a period of time perhaps?

What a bizarre system the UK is - every prescription free in Scotland but so much for English patients to pay.

She will probably get a Hefty fine. My dd did when her exemption ran out and she didn't pay for one prescription. It's something like £100 plus cost of missed prescription

It's something like 90% of english prescriptions are free, over 60s, children, certain conditions ie diabetes, thyroids, low income etc
Even if you have to pay for regular prescriptions it will only cost less than £10 a month buying prepaid certificate ie £111 over 10 direct debits
All my medication is free because i am diabetic before i was 60 then free because i am over 60

Presumably she should just wait until they write to her to see what they initially say?

It wouldn't be that much. She could have taken out the yearly 'pass' so maybe she has only deprived the NHS of about £1000.

I struggle to see how she did it by mistake but if she actually cares she could easily repay the money by giving it to a charity that works with the NHS.

I think confessing might cause all sorts of problems.

If it was me I would pay the money back to a charity. I wouldn't feel comfortable having profited from something that was my mistake. I know other people would see the money as a bonus though.

Thanks all. Have spoken to her this morning. She only received benefits for about a year when she first needed a repeat prescription and doesn’t have a qualifying condition so has never had an exemption certificate. She’s never been contacted by the pharmacy so whatever box they’ve been ticking has been wrong. I have the same GP surgery as her and there are no boxes to tick about exemptions/payments when you do your repeat online. But I pay and collect at the pharmacy while hers is delivered by a different pharmacy and just turns up at her door.

It sounds as though fines are only backdated for a year or two at the most, so that’s a relief. She has bought a prepaid certificate now so can prove she has already paid for this year at least. But is worried this or calling the pharmacy will trigger checks which is understandable. So whether she really did forget or has just been too scared to come clean she has started paying now.

The box is actually on the prescription when you pick it up. I used to get asked by the chemist when i picked up dh's prescription and they ticked it. I dont get asked anymore for either mine or dh's. DH then got a prepaid cert , only had to show it when it he first bought and they kept a record of the number on his records. Same when i got my medical exemption cert, now we are 60 I never get asked , so must be on their records as well

The box is actually on the prescription when you pick it up. I used to get asked by the chemist when i picked up dh's prescription and they ticked it

I think less places are doing this nowadays, at least for repeats. I pick my friend's stuff up, and just get asked for his address now.

I am on multiple medications for life but don’t qualify for free. “Wrong conditions” 😜. I pay 40% tax snd never qualify for any benefits, even if unemployed ss have savings. I struggle to work sometimes but as a single parent I have bills to pay snd do no option but to get up and go.

I have ADHD. I’m on a split dose (8 years). This means two prescriptions per month for “one”. I’m also on antidepressants (30 years now) and HRT (2 years). None are or will be free. Prepaid prescription is approx £10 per month for all.

It’s not great, but it’s how I was born. It irks me that people think it’s ok to try to beat the system. Depression, unless do debilitating you can look after yourself is not snd excuse. ADHD is the “forgetting everything” illness. This is not an excuse either. I have both of these. I’m also peri menopausal. I have to write lists, set up alerts, direct debits, you name it.

If we all ignored the rules, the cost would be greater. Supply of one of my meds is already low. I have to be organised to be sure I don’t run out. I’ve no one looking out for me do I have to look out for myself snd my child.

You could argue that the prepaid for those of us getting “more medication than we pay for” is unfair in some. Therefore, the only fair way is to play by the rules. Like them or not. It’s the same as shop lifting. Don’t do it. You might get away with it, but the rest of us pay for you.

I think the interesting question is the list of conditions that qualify for exemption was drawn up in 1968 (note cancer was added later). It covers a handful of conditions only. Many life limiting and severe conditions like cystic fibrosis are not included.

Change pharmacy, buy pre payment certificate, cross fingers

@NHSarah · Yesterday 22:39

Her "forgetfulness" resulted in the NHS losing nearly £4,500 in income. Imagine if we all ”forgetful.” NHS services are already at their limit. I'm puzzled about how this situation unfolded. Every pharmacist serving me asks, without fail, if I pay for my prescriptions. If I had forgotten that I no longer qualify for free prescriptions, being asked would jog my memory. People living with chronic conditions often have to bear monthly prescription charges indefinitely. While prepaying reduces the cost, for many, shelling out £4,500 has forced them to make sacrifices. Let’s hope her memory improves.

Rubbish. It's just over a grand at the most! Prepayment certificates are £120-ish and were cheaper 7-10 years ago. NO-ONE would pay £4500 over 10 years for prescriptions. Stop being so melodramatic!

@Kat19899 Glad your mate has her issue sorted now And as I suspected, there is a statute of limitations.

Before I got myself a prepayment certificate, I had to have an item delivered to me on the pharmacy van, because it wasn't ready when I called and I was too unwell to return. I asked the delivery driver about payment and he was utterly baffled; there didn't seem to be any mechanism for them to take money, and I don't know what box would have been ticked on the back of the prescription.

I got someone to take me back to pay a day or two later, and kept the receipt in my purse for months in case the anomaly got picked up. The pharmacy staff thought I was very odd. But I can see how you could get free prescriptions without telling any overt lies.

@FadeAwayAndRadiate If she bothered to buy a prepayment certificate. She didn’t, so my figure stands. Perhaps you might like to prepay for a chill pill?

Epileptics are EXEMPT from having to pay for all their prescribed meds.

So for those who are shaming her. You're wrong

Sorry just read she doesn't have epilepsy.
Hope she gets leniency.

Yep, I posted upthread about this. The campaign group lobbying for Parkinson’s and other conditions to be added came up against a brick wall because the government are saying adequate provision is made for other conditions via pre payment certificates. I think they know it should be updated to be fair to all, but since when do they care about fairness - especially when it comes to healthcare.

The pharmacy still have to tick the box if no payment is received, otherwise the prescription will get bounced back to them.

I didn't pay once. It was Literally my first prescription as an adult age 32. I can't remember if they asked at the top or what but for some reason I didn't pay. Received a £100 fine plus the prescription charge about a week later.

I had no idea medical exemptions expire.

I have a thyroid exemption: it's a lifelong condition and I genuinely assumed it was a lifelong exemption.

I've just checked my card (pharmacy NEVER asks to see it) and it expired in 2022. And you can't just renew it online, you have to "speak to your doctor" as if that's a quick and easy thing in this day and age.

But thanks, OP, because I would have genuinely not known I could be fined for the next however many years.