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?

You do know that there is some evidence that Crohn’s disease is affected by diet on childhood, make sure you tell your pils next time you see them..

Yes and there is research out there showing that the risk of just about any disease is increased by something in the lifestyle of either the person with the disease or their parents.

The sickle society is currently campaigning to have sickle cell disease added to the list.

These patients all require at least 3 scripts a quarter to keep them alive and often are in a tricky situation with work as need to have time off regularly so prepayment certificates are a stretch for many. I know loads of people with SCD who can’t afford their medications so go without in the full knowledge that this will shorten and decrease the quality of their lives. It is a disgrace imho.

It is the most common inherited disease in the UK. I do wonder, were it not a near exclusively BAME illness, would it not have a higher profile?

Please consider supporting their campaign.

Crikey , this thread is literally a race to the bottom , horrible .

I’m hypothyroid and live in Wales. Before free prescriptions came in I got my thyroxine free but had to pay for anything else.

I agree that Crohns meds should be exempt but don’t agree that Type 2 diabetes is always caused by lifestyle choices.

Yes and there is research out there showing that the risk of just about any disease is increased by something in the lifestyle of either the person with the disease or their parents

@Dungeondragon15 Don't say that. It is offensive. Cystic fibrosis,sickle cell and even some cancers are genetically inherited. There is nothing we could have done to prevent these diseases short of prenatal testing and termination. So just don't.

By squabbling over which diseases are most deserving, we are getting away from the main point.

@PigletJohn I did think that as I typed my response but I just couldn't let it go.. it was so bloody offensive and unnecessary

Not to mention inaccurate 😡

When I gained an ileostomy I wondered if the exemption was partly to prevent the administrative checking of so many prescription items. I get around 40 items a month on my stoma prescription and I dread to think of the cost to the NHS. My meds - only 20 or so boxes of tablets by contrast - are included. Without it I only had 6 items a month so I had imagined it would be an administrative thing - in some ways I still think it makes sense.

The £10 a month is indeed a lot for some people and perhaps therefore the list of financial support exemptions should be added to rather than conditions, if what we are really worrying about is whether people are going without because they can't pay.

I agree and I'm exempt. I have hypothyroidism and it has precisely no effect on my life whatsoever. I am also well able to pay for my prescriptions. Yet I get them free. I've always thought it was bonkers.

If conditions affect people so badly they can't work then prescriptions will be free anyway. Otherwise there's the option of the prepayment card. I don't understand why anything should be free just because of the nature of the condition.

@Dungeondragon15 Don't say that. It is offensive. Cystic fibrosis,sickle cell and even some cancers are genetically inherited. There is nothing we could have done to prevent these diseases short of prenatal testing and termination. So just don't.

It's not offensive because it is true. I said "just about every disease", not every disease. There aren't many that are purely inherited. For just about every disease there is always a published paper somewhere suggesting that something increases the risk. With most the is a genetic predisposition plus some environmental factor. I am also not saying that the research is always correct by the way.

Chronic asthmatic, nebulizer at home, many acute admissions, life threatening condition yet I am not exempt. Severe spinal condition affecting my bowel requiring medical management and a huge amount of equipment - not exempt. Borderline hypothyroidism, a few numbers lower on the scale and I become exempt .. madness !

I have hypothyroidism and it has precisely no effect on my life
That’s a bit of a stupid statement because it does affect you , if you don’t think it does then stop taking the tablets and come back to us in a few years and tell us how you are getting along .

have hypothyroidism and it has precisely no effect on my life whatsoever

Isn’t it great what can happen when you can access the correct medication!

DungeonDragon That is a hugely offensive and ill informed remark. It isn’t true at all. How hurtful of a parent whose lost two sons to DMD that their lifestyle was in some way to blame.

Shall I start the list where until we have genetic manipulation and surgery in utero the diseases are not preventable and not impacted by lifestyle (or we do not currently understand the cause) -
Cystic fibrosis
DMD and lesser MDs
SMA
Stills disease
Sickle cell
Pierre Robin
Vater syndrome
Fallots tetralogy
Tay Sachs
Marfans
Pulmonary hypertension
Most leukaemias
Many connective tissue diseases
IPF and NSIP

I could go on all day.

This why it is so difficult to win things. Instead of fighting together we look at our neighbour and say I should have it instead of them whatever “it is. Instead we should be asking for more of the cake instead of fighting each other for the crumbs. No money? Well when they wanted to bail out the bankers they found the money quickly.

DungeonDragon That is a hugely offensive and ill informed remark. It isn’t true at all. How hurtful of a parent whose lost two sons to DMD that their lifestyle was in some way to blame.

It's not hugely offensive or ill informed. I work in the field of medical research and for the majority of diseases there is a publication somewhere that suggests that this or that increases the risk. I didn't say every single disease and I made the point that the research is not necessarily correct. Just that it is there. Whilst your list may look quite long it is actually miniscule compared with the number of diseases that there are.
I personally think it offensive to suggest that one is disease is more deserving than another any whether it is type 2 diabetes or anything else.

Isn’t it great what can happen when you can access the correct medication!

Well, two points here. Firstly I had no symptoms - it was only diagnosed by a general blood test, and nothing changed once I started taking it. But that wasn't really my point.

My point was that, on the meds (and probably off them) I'm perfectly well and so more than capable of working/earning money and so in a position to pay the £10 a month or so that a prepayment card would cost. My point was why should any condition be exempt? If a condition stops people working then they will get free prescriptions anyway.

Chronic Asthmatic and also have chronic kidney disease and I still don't qualify until I'm on dialysis and need a fistula. Hope it never comes to that.

thecatneuterer I'm assuming your thyroid disease was caught quite early then. Stop taking your thyroxine and see what happens over time. What dose are you on?

The prepayment cert is only £120 per year for unlimited prescriptions so I think YABU. If you were on a very low income you'd be eligible for free prescriptions.

Crohns and other types of IBD tend to come in flares (I have ulcerative colitis that's been in remission for years, still on preventative meds and have no issue paying for these!) I work full time in the NHS. The NHS is under huge financial strain, medicines are expensive, they can't just issue free prescriptions to everyone with a long term condition.

I imagine a lot of the people with exception conditions you mentioned are unable to work/on long term sick/reliant on PIP.

I think those who can afford to pay for their prescriptions should do so. I had an income based exception cert as a student but only for a few years, until I graduated, started working then married. The free prescriptions are for those who genuinely can't afford them (e.g. on a student budget/low income/unemployed)

I'm medically exempt because I have epilepsy, but I do agree with you.

I moved to England from Wales a couple of years ago and was firstly refused an exemption card... I'd move back to Wales if I could...

I have RA and I work full time as a higher rate tax payer. I have a PPC but I have been told that I can’t have access to biologics as there is no budget for them in my area. I have been told that the treatment I currently have access to is the best I can hope for and to just ‘deal with it.’ The NHS is a disaster for anyone with chronic illness. to you all.

Citadel - yes it was and it's a low dose - I can't remember what it is. I'm not saying I don't need the meds. I'm saying my condition has no impact on my ability to pay for them. And that's all that should matter. If people can afford to pay they should pay. If they can't then they shouldn't. I don't see the rationale for having exempt conditions.

Exemptions are usually for lifelong illnesses, eg asthma can stop but once you're on thyroid meds you're on them for life.

The NHS can't fund everything.