Medical exemption fines: could they be better spent?

by RPS England Board Chair Sandra Gidley

The Government have announced plans to strengthen checks at pharmacies for entitlement to free prescriptions in England.  Whilst we all want to see fraud stopped, I have to ask – is really the right approach?

Only patients in England can be judged to have committed prescription fraud because prescriptions are free in Scotland, Wales and Northern Ireland.

Many patients who fall foul of the medical exemption fine have simply forgotten to renew it. They only need to do this every five years, so it’s a diary date that is easy to miss. We shouldn’t label people with a serious long term condition who have forgotten to renew their medical exemption certificate as fraudsters because they have made a genuine mistake.

Fines, along with prescription charges in general, disproportionately penalise those on low incomes. Patients faced with having to pay for a number of items on a prescription will often ask ‘which one of these can I do without?’ The answer is none of them as they have been prescribed to improve their health, but the reality is they often can’t afford all of them.  Research from the Prescription Charges Coalition shows that 1 in 3 people surveyed had not collected a medicine they needed because of cost.

We’d like to look at it from another angle and revisit the idea of having prescription charges at all in England. The list of conditions exempt from medical charges hasn’t changed since 1968, leaving it outdated, arbitrary and unfair.

Pharmacists are health professionals who advise patients about their medicines. As a profession we should not be expected to police the prescription exemptions system and there’s a real concern that this move could damage patient trust in the profession.  It also puts pharmacists in a very difficult position as how can we deny access to life-saving medicines to someone who qualifies for free medicines just because they haven’t completed the right paperwork?

It’s right that people who commit deliberate fraud should be fined but it’s important the Government spends any income from fines on improving NHS services including making sure patients get access to medicines they are entitled to.

The RPS is a member of the Prescription Charges Coalition, a group of nearly 40 organisations campaigning to end prescription charges for people with long term conditions.



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