Prescription Charges (Exempt Medical Conditions) (Hansard, 19 February 1991)

§ Mr. Gary Waller (Keighley)

I beg to move, That leave be given to bring in a Bill to provide an exemption from payment of prescription charges in respect of any permanent medical condition or ailment. I hope that the House will give me leave to bring in the Bill for which I am about to make a case. In addition to the various categories of people, such as retirement pensioners, children under 16 and pregnant women, who are entitled to free prescriptions, people suffering from one of a list of medical conditions and disorders are also included. Those conditions include, among others, various forms of diabetes, Addison's disease, colostomy and epilepsy requiring continuous anti-convulsive therapy. However, there is a longer list of permanent conditions, sufferers from which may still be required to pay for vital drugs and medicines. Those include Parkinson's disease, cystic fibrosis, psoriasis, and schizophrenia.

There is no logical reason why some conditions are included while others are not. To give them their due, I do not think that Ministers have attempted to justify the distinction on the basis of logic. When the list of exempt conditions was drawn up in 1968 to coincide with the reintroduction of prescription charges by the last Labour Government, it was argued by medical practitioners that they could agree to exemption only for readily identifiable medical conditions that called automatically for continuous, life-long medication. However, even then the list must have seemed arbitrary and illogical. I wonder how much time since then has been spent by Ministers and their civil servants in responding to patients and hon. Members who questioned the basis for the list.

Those people who do not qualify for free prescriptions but who require regular medication are able to take advantage of prepayment certificates, which are better known as season tickets. That often provides a considerable saving. Furthermore, the Goverment may justifiably point out that, as a result of the present exemption arrangements and of the season ticket system, a prescription charge is paid on less than one item in five dispensed, whereas in 1968 the proportion was close to two in five items dispensed.

Nevertheless, the fact that only a minority of patients have to pay makes it all the more galling for sufferers of disabling and unpleasant conditions, who are given the impression that their complaints are regarded as less significant and are taken less seriously than other complaints which confer exemption. Medical science has moved apace during the past decade and for several conditions, such as Parkinson's disease, drugs are available which can make an enormous difference to the quality of life for sufferers.

As has been repeatedly pointed out, the difficulty is that an extension of the list, although not necessarily costly to the Exchequer in itself, could lead to yet further calls for the boundaries to be moved. I do not think that the fact that change would present difficulties is an overwhelming reason for maintaining the present inertia.

The cost involved in extending the list need not be as great as it appears at first. Many patients will already be exempt from paying charges because they are elderly, because their disability prevents them from leaving home 151 without help, or because they are entitled to income support. Some of the costs could also be clawed back by altering the arrangements so that prescriptions in respect of medications for ailments other than a specific condition are not free. At present, if people need a prescription because they have influenza or the bad throat from which I am suffering, it does not cost anything if they are exempted by virtue of one of the conditions specified in the regulations. Some people would go further, arguing that any list of exempt conditions is bound to present problems and that it would be better to abolish lists altogether, relying instead on the season ticket system. If that were done, it would no doubt be possible for prepayment certificates to cost a great deal less.

I mention these points because I suggest that almost any system would be better than the present one, which maintains the illogical distinctions to which I referred. Perhaps the principal factor which prevents change is the belief that people are less likely to complain about a system which has been hallowed by time. We require a fresh look at the whole scheme of prescription charge exemptions to assess whether help could be directed more effectively to people who need it.

In bringing forward this Bill today to extend help to sufferers from conditions other than those on the existing list, I hope to demonstrate that there is a consensus which believes that a change sooner rather than later is not only desirable but necessary.