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?

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.

And if you are on a low but not low enough income £120 per year, in addition to all of the other costs caused by a chronic illness can be £120 per year too much.

Crohns and other types of IBD tend to come in flares

Could you come and tell my Crohn's that then? I have to take medication daily to try and control it. Plus I have terminal ileal damage that means I have to take daily meditation because I can't absorb nutrients because of the damage plus I have a stricture caused by Crohn's which causes daily problems.

Now I have enteropathic arthritis, caused by Crohn's, which causes me daily pain and difficulty using my joints for which I take daily and weekly medication.

So, do please come and tell my body that it isn't there all of the time and should actually be relapsing/remitting.

Please also realise that relapsing/remitting illnesses also pose a huge difficulty for the patient when trying to remain in employment or in the ability to claim benefits. Needing a lot of time off sick due to relapses can cost you your job, yet you may be deemed not I'll enough to get benefits as for portions of time you don't have symptoms and could therefore work.

I also need weekly physio in order to be able to move. Without it the pain just becomes too bad and I end up virtually bed ridden. The physio makes it just about bearable for me but all that is available on the NHS is a course of 6 appointments and here it isn't hands on treatment. So I have to pay privately for my treatment.

I also need a total knee replacement that the NHS is so far refusing to provide as I am considered too young. So, I am likely to have to pay privately for that too. Somehow.

So, yes, you might say £120 a year isn't much to pay but for me it's a lit on top of £200/month for physio that is essential for me if I am going to be able to continue to work and remain self caring.

@Queenunikitty oh no that's terrible
I'm lucky I've been on biological for 10years in my area (I'm not sure lucky is quite the right word as you have to have a high disease score to qualify but you know what I mean) although I have literally just the other week been switched to a bio similar as they are now approved hopefully this will open up the treatment to a wider audience as the drug costs drop from something like £10k a year to £2/3k a year.

user87382294757 - exactly my thoughts...theres so much misinformation on this thread being thrown about by negative minded people. Humaira and its alternatives were expensive which is probably why my partner kept getting told next time youre ill we'll place you on that and next time became next time again and again for many years before they finally put her on it in 2018 which is when the patent lapsed and it became a lot cheaper.

Also @dungeonkeeper there may be papers suggesting that crohns is caused by diet and lifestyle but there are also many more suggesting it is triggered due to a malfunction in the immune systems ability to recognise self and non self antigens and this malfunction may be inherited. The truth is a lot of this work is theory in practise as research is still ongoing so theres no definite link to anything however stem cell replacement therapy is a big thing being researched right now and has shown promise in various blood disorders and crohns disease showing that's it's probably more likely to be a genetic predisposition than dietary or lifestyle factors . I do know that my partner's younget brother also had the disease and sadly passed away a few years ago.

To all those saying be grateful it's only 10 quid a month then how about we scrap all exemptioms except kids and people who have actually retired and everyone else including those on benefits pay a flat rate of £10 a month for access to prescriptions whether you need them or not. I'm sure that would bring in a lot of funds for the nhs which it badly needs and the 90% dont pay figure would swing the other way. Would you all be prepared to pay?

Personally I work in the nhs and I see on a daily basis how hard everyone works and most do a great job as do the scientists in the research field without much recognition or reward, however it's the higher ups like the gov, dwp and the likes setting these crude outdated rules and over complicating things which people then try to abuse and more moneys wasted trying to stop people from abusing the system.

@decomposingcomposers, its annoying hearing people firing assumptions thinking they know more about a condition than you when you're the one who lives with it on a daily basis. Not going to lie has caused many an argument with my partner when we've struggled getting the help she needs. Its turned her life upside down so can know full well what you're probably going through thankfully we've avoided surgery up to now though she has been prepped on more than one occasion. Hope your crohns improves.

@Uzzyp1

Thank you, and the same to your partner too. It definitely is annoying how people assume to know how an illness affects you as we are all different.

Thankfully I've avoided surgery too, so far. It was suggested 10 years ago in order to remove the stricture but I have a fear that the disease will just start up somewhere else so I refused it unless it became absolutely necessary.

I think many people believe that Crohn's just affects the gut (if they even know what it is in the first place) and don't realise that both the disease and the medications used to control it can have systemic effects, many of them serious.

I don't like the way that many people are forming a hierarchy of conditions. I think that any condition requiring long term treatment should be exempted from charges.

I think prescriptions should be free for everybody.

Not a popular view I know. I also think we could do with a universal basic income.

We are a bit backwards in the UK to be honest

Chloe, I agree with your sentiments but since prescriptions are free in Scotland, NI and Wales, shouldn't that be "we are a bit backward in England"?

@Iggi999

Yeah sorry that's what I meant

As somebody who is mostly British living in England but with non-English but mostly British parents sometimes I get a bit confused.

Yeah I think we need to catch up with Scotland on many things, including smacking kids. And, y'know, having a royal family. But I'm probably a classic socialist so I'd probably fit in better not in a very naice conservative region of England.

A small list of people get the equivalent saving of £2 a week...because if they didn't get treatments they would cost the NHS a shit load more.

It is an outdated system, but the prepayment certificate is so cheep I have no idea why people complain about prescription costs.

Whispers

Yes indeed my husband has life long asthma from age about 1 month, he had to pay for his prescriptions all his life and yes he did buy pre-payment certificates. Now he is retired he does get free prescriptions but I overheard his doctor one day say to him on phone that 'you are one of our heavier users (he has hereditary blood pressure and eczema as well, none of which are self inflicted like type 2 diabetes as you say)'. I was livid, I was tempted to say I never come to the doctors, let him use my entitlement.

And if you are on a low but not low enough income £120 per year, in addition to all of the other costs caused by a chronic illness can be £120 per year too much

I have an annual prescription pass, current rate is £104 per year.

You can pay in ten monthly installments of £10.40 so if you are averaging a prescription per month this is cheaper without a big upfront payment.

You can pay in ten monthly installments of £10.40 so if you are averaging a prescription per month this is cheaper without a big upfront payment.

Yes, I do. Still doesn't mean that I can comfortably afford it.

Plus, when that year's subscription runs out they don't send you new confirmation of continued subscription until after the following month's payment has been made. So you have to pay for prescriptions issued in that 6ish week period between last year's card running out and the next year's starting. I have 10 items prescribed per month so I have to pay that £90 up front and then claim it back.

Still doesn't mean that I can comfortably afford it.

That wasn't my point - my point is that nobody has to pay the £104 upfront.

So you have to pay for prescriptions issued in that 6ish week period between last year's card running out and the next year's starting

I've had a prepayment card for well over a decade and I've never had this gap or had to pay and claim back. I've paid both up front and monthly at different times.

The notification of expiry and renewal has always arrived in plenty of time to ensure no gap. There is also an option to autorenew so that even if you forget you are still covered.

Perhaps you have just been unlucky?

The notification of expiry and renewal has always arrived in plenty of time to ensure no gap. There is also an option to autorenew so that even if you forget you are still covered.

I do auto renew. But the card has an expiry date on it. Mine is 17th of July.

Once the card has expired I can't present it in the pharmacy as proof of exemption. So I have to wait for the new one to be sent out. Once that arrives it shows the start date as 18th July so the cover was in place but I just didn't have the proof.

Renewal notice is sent out a couple of weeks before card expires but the new card is not sent out until after the direct debit has been taken. It usually takes about a week or so after that for card to arrive so there is definitely a period of time when your old card expires and you don't have a new one.

During that time it says you need to pay for prescriptions and then claim it back.

It usually takes about a week or so after that for card to arrive so there is definitely a period of time when your old card expires and you don't have a new one

My card (when it was a card) always arrived before the expiry date of the old card. Incidentally I've never onced been asked to present the card in all the years of having it - I simply mark the box to state I possess a prepayment certificate. I assumed that fact that the card was largely redundant was the real reason for stopping them.

You seem to be unlucky if your new card arrives so late and you have a chemist who won't allow you to check the box to declare you have a certificate.

I've had to show my card every time and I've just checked on the website - it appears that as of February this year they no longer send out cards so hopefully that solves the problem.

It also clearly says that if you need to pay for prescriptions before your certificate arrives then you need to get a specific form from the pharmacist and reclaim the payment and that you need to present your certificate whenever you collect a prescription.

So maybe you are just lucky that your pharmacy doesn't ask to see yours.

So maybe you are just lucky that your pharmacy doesn't ask to see yours

I doubt it. I don't always use the same pharmacy and I'm not always even in the same region. Wherever I happen to be I just check that declaration box on the prescription, never been told to pay up and claim back.

That is in over a decade - possibly longer I can't recall when I first discovered the PPC.

Oh and yes, they discontinued cards a while back - my renewal date is March and honestly its made zero difference to me.

Ive never shown my exemption card

Not been a problem so far

Though it’s interesting that they have discontinued the cards

Oops

Please ignore me

Im talking about completely the wrong thing

Doh!

The free prescriptions are for those who genuinely can't afford them (e.g. on a student budget/low income/unemployed)
Or if you happen to be 60 years old.
Surely it must be worth establishing means testing for older/pensioner benefits, even if it initially costs more? With the increasing elderly population its got to be worth it

What would be the point if it costs more?

I’m type 1 diabetic and have never paid for a prescription in my life. I got dealt a shitty hand and don’t feel bad about having an exemption certificate. I’d rather pay for prescriptions and not have this shitty illness but I can’t change it.

C8H10N4O2

Well I have, including at a hospital pharmacy in April this year, seemingly 2 months after they discontinued the cards. I had mine, not sure what would have happened if I didn't have it. Will be interesting to see what happens when it renews for me this week.