Showing posts with label Prescriptions. Show all posts
Showing posts with label Prescriptions. Show all posts

Wednesday, 4 April 2012

Reporting or campaigning?

The Western Mail’s repeated return to the subject of free prescriptions is starting to look less like news coverage and more like a campaign to re-introduce charges for medicines.  This week’s story highlighted the high average number of prescriptions per head over a year, claiming that it raised “fresh questions about the flagship policy”.  I’m almost tempted to run a ‘spot the difference’ competition by comparing their story this week to one a few months ago.  The questions are not so much fresh as regurgitated.
There was something of a shortage, once again, of critical analysis of what the figures might be telling us.  The average number of prescriptions per head has also been rising in England, despite the high – and increasing – charges for prescriptions there.  That gives a context in which the increase in Wales is not solely down to the fact that medicines are now free – although you wouldn’t know that from any reading of the Western Mail’s story.
But let us suppose that at least part of the increase is down to the fact that prescriptions are free – is that a good thing or a bad thing?  Again context and analysis are everything – and were completely missing from the paper’s reporting. 
It reminds me of a statement by one of the Welsh police forces a couple of years ago that an increase in the number of cases of domestic violence was a good result not a bad one.  It made me stop and think; but the argument was that a greater willingness to report such crime showed that the force was actually being effective in tackling it, and thus creating a climate where people no longer felt that it wasn’t worth reporting.
In a similar vein, if an increase in numbers of prescriptions is because rich people are no longer paying for over the counter drugs, then it’s easy to see why it might be considered a bad thing.  But if it’s the result of less well-off people seeking treatment and taking medicines when they would previously not have done so because they couldn’t afford the medicines, then it’s a good thing – and a clear sign that the policy is achieving one of its stated aims.
It’s a distinction of which readers would be left completely unaware, however, from a report which provided the usual suspects with an opportunity to trot out their usual lines, led as ever by those persistent opponents of free medicine, the Tories.  Their health spokesperson repeats the customary soundbite about millionaires getting free paracetamol (although he varies it a bit by adding bonjela – ah the sheer inventiveness of the man!).
Does anyone know of a single millionaire in Wales who’s ever gone to the trouble of arranging a doctor’s appointment in order to get a prescription for free paracetamol?  I don’t – but then I don’t think I know any millionaires either; they’re not exactly common in Wales in the first place.  It may be a good soundbite, but it’s a deliberately misleading distraction.  They’ll carry on using it though – why wouldn’t they, when they’re being given a free and uncritical platform on which to repeat it?

Thursday, 21 August 2008

Pills and Potions

I'm not convinced that yesterday's story about numbers of items prescribed actually tells us anything meaningful about the effects of the introduction of free prescriptions in Wales. Without a good deal more background information on trends before and after the introduction of the policy, and a lot more detail on what is being prescribed to which categories of patients, I don't see how anyone can conclude that the policy is a "disaster" as some have been quick to claim.

That lack of precision has not prevented those who oppose the policy from jumping to conclusions, of course. It's the old politician's motto - why let mere facts get in the way of a good press release?

The basic case for free prescriptions – which I entirely support – has always been that medicines are an integral part of health care, and that health care should be free to users at the point of demand. The chief argument of opponents has always been that some people can afford to pay for their medicines and that would free up money for other purposes; but I've never understood why they apply that logic only to prescription medicines. Why single out just one aspect of health care for means testing, and why choose this particular aspect?

Some people can afford to pay for visiting the doctor; some can afford to pay for their operations, or their physiotherapy, or their nursing care. Why do some politicians argue that all of these should be free, but medicines should not? I've never heard any of them explain why medicines are so different from all other aspects of health care that they should be paid for whilst everything else should be free.

And since the objections to free prescriptions generally come from the political right, I wonder whether this isn't the thin end of the wedge for people who really believe, but don't admit it, that large swathes of our health services should be means tested rather than free, in order to give yet more tax cuts to the better-off.

That doesn't mean that the policy is entirely without its problems; some people do now visit the doctor unnecessarily to get a prescription for over-the-counter medicines. But some people also visit casualty departments unnecessarily for trivial injuries – isn't the effect the same? If there are cases where the system is being abused, I'd prefer that we attempted to deal with the abuse rather than re-introduce means-tested elements to the health service.