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?

I have a medical exemption. My mother does too (for a different condition). My understanding was that the conditions on the list tend to be associated with other conditions, in that if you have "X", you're statically more likely to suffer from "Y" and "Z" as well. Or from side-effects, which may require their own medical treatment.

For myself, I have been denied treatment that was necessary, because of contraindications with the medication I take daily, and the medication I needed temporarily. I take medication which is processed through the kidneys, and effects my body's ability to process certain medications and alcohol, for example. This means that I've been prescribed 5 "alternative" treatments to take, combined, when for other people, one standard treatment would usually be fine. The cost to me, would have been prohibitive had I not received a total exemption.

It's a balancing act, and there is no way to balance it out make it fair, unfortunately. I was put on medication which worked really well for me. After a few years, I stopped being given the branded product, and was given a generic medication, the variety of which changed each month. It caused me dreadful headaches, and contravened NICE guidelines. When I complained, I was told the branded medication cost 10 times as much as the generic, so I could no longer have it. When I moved and got a new doctor, I asked about it and was told it was no problem at all. Different GP's and trusts take a different stance on things. Everything is arbitrary, and so it's all inherently unfair.

You could go on forever with this, long term mental health conditions which require daily and complex medication also not on the list as are lots of other long term conditions... like PPs have said, pre payment is less per month than paying for 1 prescription so it's definitely significantly cheaper. There's always going to be people who fall outside of the list, however much it's extended as everyone has their on perception of what's 'deserving' of exemption. The NHS also have exemption or support schemes for people on low income and also those who get certain tax credits. I think if there was any more exemption everyone would be exempt & the nhs would crumble even further!

I know someone with type 2 who says they won't bother trying to change diet as they get free prescriptions anyway
🙄 And you believe that, not only of them but of all those fat, lazy people who have type 2 diabetes, huh?

If you want to make the point that your DH shouldn’t pay for medication, then do so, and campaign for that. But don’t go pointing the finger at patients whom the NHS has deemed should get free prescriptions.

Isn’t there an exemption for people who can’t afford it?

It should be reviewed.

It’s also daft that prescriptions are free at age 60 when most people are still working.

I receive free prescriptions and am extremely careful about only ordering medication I actually need. We could fund free prescriptions for all if people treated this less like a free for all and more like a finite resource that has to be paid for. My dad and dfil both used to order everything on their list and only use a fraction of it. When df tried to return to the pharmacist it was mostly disposed of. He realised it was an enormous waste and is more careful now. My friend pays for prescriptions and get gluten free bread etc which she needs but and doesn't use half of it.

Other than 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 agree with you. Your DH should receive free medication it's not a race to the bottom though.

Tory ideology is what doesn't add up.

Oh, it adds up very well, believe me.

@Idontwanttotalk I had no idea about any of that, despite having an under active thyroid for over ten years

I have one of those conditions which entitles me to free prescriptions for everything. Whilst a lot of things are interconnected and compromised by one initial condition (one reason why I wouldn't bother with life insurance, even if anybody would sell it to me, because almost any non-accidental cause of death could be attributed to have been triggered or exacerbated by the basic condition), it is ludicrous that, if I developed a fungal toenail, I'd get my treatment free, when somebody with asthma has to pay for their inhalers.

They probably figure that it would be a minefield to decide whether something could have in any way been a result of the basic condition or not, so it's easier to just say all prescriptions are free. Why they don't simply get rid of the other minefield of the 10% or so of people who have to pay and make them free for all, I don't know. As the Welsh PP said, it costs as much to administer as they would 'lose' to make everybody exempt.

I can't help thinking it a sad state of affairs that there are whole departments tasked with checking up on people and sending out fines to people who have had much-needed prescribed medicine and not paid for it. Yes, they've broken the law, but it's hardly up there with bank robbery, is it.

There have also been instances where people with a condition which qualifies for automatic free prescriptions, but who haven't realised that they need to send off for the exemption card (or have accidentally let it expire) have been fined for 'fraudulently' claiming free prescriptions and subsequently had their appeal rejected.

This will be an unpopular viewpoint, but I think the very fact that pre-payment certificates actually exist is, in itself, in very poor taste. Yes, if people regularly needing a number of items can avoid being whacked for an absolute fortune, it's much better than the alternative - but it's also an acknowledgement by the government that many will struggle to pay, through no fault of their own, so we'll ease their struggle, but we still want to make sure that they do still struggle to an extent - this is very important to us that some of the people in society who suffer from the poorest health shouldn't have access to their necessary healthcare without any worries at all.

As has already been said, it's silly to compare it to the price of coffee at Starbucks when, for many, it can be a choice of getting their medicine or eating at all. Compare it with the recent outcry about removing free TV licences for over 75s who are not getting pension credit. Not saying that over 75s should have to pay, but the cost is not that much more each month for entertainment than for potentially life-saving medicines.

Wearing my cynic's hat here, I do wonder if the decisions are made purely with regard to the long-term cost to the NHS rather than the needs and well-being of the individuals concerned. e.g. if a person with diabetes had months where they couldn't afford to buy their insulin, that would lead to a lot of very expensive hospital treatment over a number of years; whereas somebody with asthma who couldn't afford their inhalers might suffer a massive attack as a direct result and simply die within minutes.

For the same reason there are only 300 people in HMRC tasked with chasing down £4.4bn of tax fraud while 3250 DWP staff are going after £1.2bn in benefit fraud? Tory ideology is what doesn't add up
Yes, that is crap. Not surprising though!

I recognise that graphic ...

Just realised that photo is unreadable. It was backing up how much bigger a problem tax fraud is than benefit fraud

DGRossetti I got it from mumsnet. Did you post it?

As I am sure others have said, the exemptions were decided on decades ago and the only thing that has been added is cancer. They have probably decided that it is too costly to add more in England. If they did decide to how could they do it "fairly". The only way really would be to remove prescription charges as in Wales and Scotland.

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Thanks

It makes me very mad too. Husband had had asthma since he was a baby, my son has a long-term condition. Neither can be cured, both have sometimes struggled to pay for prescriptions. My husband could die without his medicines.

@HippyTrails

"I agree that it's unfair. I have an exemption certificate due to having hypothyroidism which I was diagnosed with 2 years ago BUT I have been quite severely asthmatic my whole life - if I didn't take inhalers 2-3 times a day I would not be able to breathe so why is this not included on an exemption?"
But since you were diagnosed with Hypothyroidism you get all your prescriptions free don't you?

People often don't understand what hypothroidism affects.

Wearing my cynic's hat here, I do wonder if the decisions are made purely with regard to the long-term cost to the NHS rather than the needs and well-being of the individuals concerned. e.g. if a person with diabetes had months where they couldn't afford to buy their insulin, that would lead to a lot of very expensive hospital treatment over a number of years; whereas somebody with asthma who couldn't afford their inhalers might suffer a massive attack as a direct result and simply die within minutes.

Decisions aren't being made though. They are just keeping the status quo as there would be uproar if they removed stuff. With regard to diabetes the decision not to charge would have been made in the 1950s when the only medication was insulin.

Dh used to get free prescriptions for hormone treatment needed for a genetic condition. Last time he reapplied it was a tick box only form and his rare treatment wasn't on there so he now has to pay.

Slightly off-topic, but is anybody else very concerned about what would happen if the NHS were eventually scrapped? We keep being told it's getting more and more unsustainable, but I would be absolutely stuffed without it.

The obvious alternative would be private healthcare insurance, but would there be any compulsion on companies to cover all applicants and/or to charge a standard set premium?

Because of my condition, I simply could not work full time and would have a very limited range of employment opportunities open to me (and that's assuming that employers would even choose somebody with significant health problems over a healthy candidate).

I hear stories of other countries - even rich, developed, western nations - where people who suffer from poor health are often pretty much hung out to dry, and it sounds horrific.

you do all know you can buy a medical cert at a far reduced cost available to all and sundry deserving or not

Oh and you can't cure type 2 diabetes only put off medication for a while - fundamentally there is something wrong with your body (it is resistant to insulin) but it is also connected with heart disease, vascular dementia, stomach problems, circulation issues, nervous system issues in temrs of feeling in hands and feet particularly, ability to heal and a shed load of other stuff. However I do believe it should be medication related rather than nec condition - so asthma inhalers should be available but the link through to other conditons is not as strong

I get my prescriptions for free due to hypothyroidism. Everyone should for serious diseases; asthma and mental health conditions in particular. There must be a tipping point where it's cheaper to give the medications for free rather than run the scheme. Given that the Scottish, NI and Welsh are coping just fine, it would make sense for England to follow suit. Of all the possible uses for tax receipts, surely this is one of the most important.

There is a different way to reduce prescription costs, which is further limitations on which medications are suitable for prescriptions. I believe some such as paracetamol and ibuprofen have already been removed, which is fine because they cost pennies and arguably come under self-care.

I might be wrong but there are also mental health issues which are life threatening and those medications are not free either.

@decomposingcomposer actually, yes. I do know how difficult the process is. I've been through it and been successful. I'm highly aware of how difficult it can be. In addition, I also know that a high percentage of people who are declined at the first stage, are successful in appeal.

PIP isn't about your condition, it's about how your condition affects you. I didn't suggest that it's easy, simply that claiming PIP would help to cover certain costs.