To think the NHS medical exemption is not very fair?

[user87382294757]

DH has crohns disease. Needs regular prescriptions and bloods, has an IBD nurse etc.

Advised some conditions can exempt you from prescription charges and checked the list. It says-

You can get all your NHS prescriptions free if you have a valid medical exemption certificate because you have:
• a permanent fistula (for example, caecostomy, colostomy, laryngos-tomy or ileostomy) which needs
continuous surgical dressing or an appliance;
• a form of hypoadrenalism (for example, Addison’s Disease) for which specific substitution therapy is
essential;
• diabetes insipidus and other forms of hypopituitarism;
• diabetes mellitus, except where treatment is by diet alone;
• hypoparathyroidism;
• myasthenia gravis;
• myxoedema (that is, hypothyroidism which needs thyroid hormone replacement);
• epilepsy which needs continuous anticonvulsive therapy;
• a continuing physical disability which means you cannot go out without the help of another person; or
• cancer and are undergoing treatment for:
– cancer;
– the effects of cancer; or,
– the effects of cancer treatment.

Why these conditions and not others? It seems unfair that someone with diabetes type 2 (which is often self induced through diet and lack of exercise) can get these for free and others with other chronic illnesses cannot?

I'm cross that it seems a selective few illness have been given more priority than others for this. AIBU?

When would you introduce them @Davros?

I have Type 1 diabetes which is an auto immune condition. Having diabetes makes you more susceptible to other auto immune diseases and a simple infection can get serious very rapidly without treatment. Because diabetes long term can affect nerves it can damage or affect all parts of the body from feet to eyes. I am very grateful for my free prescriptions and for the NHS. There are American people who cannot afford their insulin and who are dying.

I'm in Scotland so they're free here.

Before they were free the system was completely arbitrary- think it's the same list of conditions as on the English list above.

I'm a psychiatrist and I thought a lot of my patients really deserved free prescriptions- they had become unwell with e.g. schizophrenia or bipolar as young adults and it had really affected their ability to work consistently in well paid jobs. They were often on several prescriptions- more than one mental health medication plus physical medications as you're more likely to get physical health problems if your mental health is poor- so had several to pay for or get the prepayment certificate. Funnily enough if they were "lucky" enough to get T2 diabetes from their antipsychotic or hypothyroidism from their lithium then they would get all their prescriptions free! On the other hand I also have bipolar but it hasn't stopped me from studying and working so although I'm delighted to have free prescriptions now, I wouldn't consider myself to be someone who would need prioritised for them if they were to be rationed. This is why it doesn't even make sense to do it according to what illnesses people have.

I know it's still much better than the horrific stuff that happens in the USA but I think the NHS should be completely free- I never want to have to offer a patient treatment that they can't afford.

Your DH's drug Humira by the way is the most expensive drug for the NHS given cost and rate of usage. It's been running at more than 400 million a year. Perhaps knowing this will help you to feel better paying £10 a month for a PPC?

Alsohuman I'm not sure, maybe 70 years old or retirement age or means tested? I just think free prescriptions for all and sundry at age 60 is unfair. No doubt changing it would cost too much but still ......

The cynic in me believes this may contribute to the enormous difficulty those with under - - active thyroid face in obtaining effective treatment in this country.

As someone exempt for a thyroid condition I wholeheartedly agree with you. I’ve moved abroad and now getting access to a wider range of meds. On the NHS they just throw the cheapest generic thyroxine at you for life and don’t consider any other (more expensive) treatment options.

Davros it would cost more to means test than it would save, but you would still like it to be done so some 60 year olds don't get something you don't think they deserve?

The list was put in place (cancer being a recent vote winning addition) because the original conditions left untreated cause death. The new NHS didn’t want people dying because the couldn’t afford prescriptions.

I just think that every single 60 year old getting completely free prescriptions, regardless of ability to pay, doesn't make sense or sound fair

Davros Agreed. DM is 67, still working and on 40k pa. Gets three different drugs per month for free. She often comments that she really should be paying as she can afford them.

Whether it makes sense or is fair - and I agree with you - is secondary if making it fairer, ie means testing would cost more money. In the six years I’ve been entitled to free prescriptions I’ve had just two filled. A lot of my friends aren’t on regular meds either so we’re not costing much.

Considering the cost of drug treatments for conditions such as crohns is often incredibly high I think it a bit much to complain about the fact that you have to pay £9 each month for a pre payment certificate. You are well and truly getting your moneys worth out of the taxes you pay the NHS (unless you are a millionaire) so stop money about the fact that someone else doesn't have to pay anything for their (probably) far less expensive treatment.

money moaning!

Surely £10 a month for all prescriptions is really good value. Given that the actual cost would be a lot higher I can't see how people can moan about having to pay that.

I would rather everyone paid more tax and we got a better NHS with free prescriptions for everyone, but given that many people don't seem to want to pay more tax then this won't happen. We can't have everything for free!

For info 2019 Fact and Figures about Uk Diabetes WWW Disbetes org UK

Why are people going on about whether type 2 diabetes is often associated with diet and lifestyle? What's that got to do with anything?

^my daughter has cystic fibrosis. she takes a bucketload of drugs daily and will for the rest of her life
no exemption^

Wow, that's shocking.

@Dungeondragon15 because the OP implied Type 2 Diabetics shouldn’t be exempt because they only have themselves to blame for being lazy and fat like her friend who ignores medical advice.

Many of us pointed out there are many slim, fit type 2 diabetics who inherited the disease - like everyone on my Dad’s side over 40 and most likely me in a few years, our genetic link is too strong and they need insulin and metformin to stay alive.

Many of us pointed out there are many slim, fit type 2 diabetics who inherited the disease - like everyone on my Dad’s side over 40 and most likely me in a few years, our genetic link is too strong and they need insulin and metformin to stay alive.

OP said that it is often induced by diet and lack of exercise which is true. I agree that it is not nice to imply that they shouldn't be exempt for that reason though. If you want to go down that road you could probably make a case for some cancer treatments not being exempt too.

I am luck enough to be except as unluckily have one of the conditions I need 7 items every month. My 17byear old son suffers appallingly with severe SAR. He is currently of 5 different meds a month which don't adequately control it. He has now had all treatment on offer including immunotherapy and the only option is likely to be adding even more drugs if he can toleratetgem. I appreciate we will have to get a prepayment certificate but again this is something he is born with and something over which he has no control. Maybecacsliding scale could be introduced for the worst caseds of conditions, but i suppose this leaves the system open to abuse. It's really hard to know. Regardless I am so happy we live in a country where meds as subsidised. Havingforgotten y drug due to an almighty mix up when travelling I had to buy them abroad only discoverefortnights supply on on one of the drugs is over £80 and another£39. Other home in around the £20 marks. If we over in a country where we had to pay for medication in full. I wouldn't be taking what I need to due to the costs. It's frightening. I've almost died twice with the meds. I think I'd be long dead by now without. I suppose at least that gives a litle more perspective.

Op, if everyone in the Uk was genetically inclined towards type 2 diabetes then almost all of us would have it because the western diet is high in calories and carbs.

Yes if you know you are genetically inclined towards it you can take extreme (and they are extreme!) measures to turn your lifestyle round to try and stop the onset, but this is much easier said than done.

These measures can include eating no more than 800 calories a day which is a starvation diet, fancy having a go on that yourself?

Stop demonising sick people.

I have hypothyroisism. No idea why that gives me exemption status tbh as levothyroxine is only £3.12 for a months supply off script. I always pay for mine anyway as I dont believe in ripping the nhs off.

*hypothyroidismbloody phone

Also, if you can't afford to pay upfront for a PPC, it costs £10.20 a month

Not sure if it’s been pointed out but the monthly cost is 10 months not 12 so it’s the same as yearly just spread out

Tallgreen because if you didn't take thyroxine then you'd eventually die. It's a hormone that's essential to all bodily functions.