HL Deb 15 July 1991 vol 531 cc1-3

Lord Stallard asked Her Majesty's Government:

Whether they will abolish the health benefits low income scheme and simultaneously widen the grounds for exemption from dental, optical and prescription charges.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)

My Lords, we have no plans to do either. The National Health Service low income scheme ensures that no one is called upon to pay more than they can afford and complements the existing charge exemption arrangements which are available on the grounds of health or status.

Lord Stallard

My Lords, I thank the noble Baroness for that fairly disappointing reply. Is she aware that the grounds for exemption under the low income scheme are inconsistent? For example, a pregnant woman can get help with some charges but not for a visit to hospital. Pensioners are exempt from prescription charges but not from other charges. The help available rarely covers the charges, the scheme is too complicated and the claim form is 19 pages long. As we know from experience, that automatically deters very many needy claimants. Does the noble Baroness not accept that what is needed is a review of the whole scheme, with particular emphasis on the cost-effectiveness of the low income scheme? I am sure that the result of such a review would be the abolition of the scheme and an extension of the exemptions.

Baroness Hooper

My Lords, the present arrangements have been in place since 1968 but the method of assessment was changed to its present form in 1987. We conducted an internal scrutiny during last year and as a result my honourable friend the Minister for Health has announced a review of the administration of the low income scheme. It is intended to complete the review and to consider proposals before the end of this year.

Lord Ennals

My Lords, the Minister replied as if the National Association of Citizens' Advice Bureaux had not already published its study of this matter. Has she noted that the CAB report shows that, because people on low incomes are failing to receive assistance with NHS charges, poor people are doing without or are not fully receiving the health care to which they are entitled? Does she agree with the CAB report that the grounds for exemption are inconsistent and that the claim form, at 19 pages, is absurdly complicated? Why are not the Government prepared to take serious note of the CAB study and re-examine the scheme, which the CAB says is not working?

Baroness Hooper

My Lords, it so happens that it was shortly after the Government announced their intention earlier this year to have a review that the National Association of Citizens' Advice Bureaux produced its report. It has been welcomed. We find the recommendations helpful. We are looking at a scheme which handles in excess of I million claims each year and cases of dissatisfaction represent overall a very small percentage of the total.

Lord Ennals

My Lords, are the Government considering the recommendations made in the CAB report?

Baroness Hooper

Yes, indeed, my Lords. The recommendations will be carefully examined as part of the review.

Lord Molloy

My Lords, will the review of which the noble Baroness has informed the House consider the possibility of changing the way the current system is administered? Such a change in the procedure might prove less expensive. Maintaining the rules is a burden on the NHS, whereas when the procedure was reasonably free the burden of administration was reduced.

Baroness Hooper

My Lords, the review will examine all aspects of the administration of the scheme, including the length and content of the claim leaflets, publicity and current procedures.

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