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.


Cibwr said...

I think I am correct in saying that over time the cost of administering the system of collecting payments on prescriptions was actually approaching the revenue generated? If so there are sound economic arguments for abolishing the charge. Taxation should sort out the difference, that is why we have taxes rather than a pay as you use system for everything. Claims that prescriptions are rocketing due to millionaires getting their paracetamol free are empty rhetoric and devalue the arguments. Free at the point of use seems to me a good principle that we should embrace, and one we should once again extend to dentistry and opticians!

John Dixon said...


Quite agree about extending the principle to dentists and opticians - a point to which I shall be returning!