Prescription Charges

I wrote to my MP, Conservative Damian Green last week (I know! How grown up am I?!) about the spiralling cost of prescriptions on the NHS.  I didn't do this entirely off my own back, you understand, but on the suggestion of the Presciption Charges Coalition (http://www.prescriptionchargescoalition.org.uk/) for whom I had signed a petition several months ago on the subject.  I have a lot of prescriptions; I take five daily medicines, two weekly medicines and various painkillers as and when required.  My repeat prescription sheet has 11 items on it.  At the current rate of £7.85 per prescription, that would cost me £86.35 every time I need my prescriptions to be re-filled.  Now, anybody can agree that that is an unholy amount of money to spend on prescriptions on a regular basis; multiply that by the rest of my life and it becomes astronomical.   I have a prescription pre-payment certificate, which means I pay just over £10 a month for 10 months by direct debit and this covers any prescriptions that I need in a 12 month period. But that is still over £100 per year, which the rest of the tax-paying nation don't have to spend.  And that is my argument, because I will be taking these (or similar) medications for the rest of my life, unless they find a cure in the meantime.  £7.85 is not a large sum to cough up once in a while if you get an infection, which is the only time the average person needs a prescription.  If I were unemployed my prescriptions would be free, so why not when I am diagnosed with a chronic incurable disease? 

Here's my letter, minus my address (don't want the paps round ;)

Mr Damian Green MP

Ashford
House of Commons
London SW1A0AA

Dear Mr Green,

As your constituent, I am writing to ask if you will pledge your support to phase out prescription charges for people with long term conditions.

The Prescription Charges Coalition has just published a report called ‘Paying the Price’, which makes the case for reform to the current system. It uncovers the shocking decisions people with conditions like asthma, heart disease, arthritis, HIV, Crohn's Disease, Ulcerative Colitis, Parkinson's, mental health conditions, cystic fibrosis, auto-immune disease and many others are being forced to make because of the added financial burdens associated with prescription charges. It is wrong that people are forced to choose between food, clothing, bills or their prescriptions. I myself have Rheumatoid Arthritis and Vasculitis, and at age 29 I have eleven prescriptions to buy each time, and I will be needing these prescriptions for the rest of my life.

The prescription charge has again been increased to £7.85 from this April. The current regime of charges seems to actively undermine good health and costs the NHS more. As people are rationing their prescriptions or foregoing them altogether, this is resulting in poorer health or, in extreme cases, hospitalisation. This is clearly unacceptable.

A high proportion of people are already exempt from prescription charges because of their financial circumstances, their age, or the fact that they have certain other medical conditions. It is inconsistent and unfair to deny people with long term conditions the same assistance. People develop a long term condition down to a complex combination of hereditary, environmental or other lifestyle factors. Once diagnosed, many will have their condition for the rest of their lives and if we want them to stay in work and continue to be productive members of society, then the Government needs to address this problem. The present approach to charging is little more than an additional health tax on the sick.

I would therefore be grateful if you would write to the Health Secretary and the Chancellor to call on the Government to reform this arbitrary, outdated and inequitable system, and make it fairer for people with long term conditions. I would appreciate you asking them to commit to phasing out prescription charges for people with long term conditions through staged reductions to the Prescription Prepayment Certificate.

Yours sincerely

Katherine Evans

I am lucky enough to have never had to ration my dosages, or make a decision not to take my medications based on the cost, but I can't deny that it has been a close call at times.  And what I cannot understand is why certain illnesses are exempt, and others aren't.  Now, I am absolutely not suggesting that diabetics should have their exemption revoked, but why is it that diabetes medicines are free, but my rheumatoid arthritis medicines are not?  If I were to not have my medicines I couldn't go to work, and would have to be entirely financially supported by the state through disability benefits.  Surely that would cost a lot more to the government than my prescriptions do?  And the ultimate paradox is that if the medicines I am currently on stop working for me, or my disease gets worse and my rheumatologist can show that I need them, I could have injections of new biologic therapies sent directly to my house by the healthcare companies at no cost to myself.  Now where is the logic there?  So, if the stuff that the NHS currently charges me for turns out not to help, then we'll give in and give you better stuff for free?

I was disappointed by the reply from Damian Green, in that it didnt seem to even acknowledge the request that I put forward, that being that I wanted him to support the phasing out of prescription charges for people with long term conditions via staged reduction of the cost of the Prepayment Certificate.  He wrote me a letter explaining that I could get a Prepayment Certificate if I wanted to (what a complete idiot...)

Rt Hon Damian Green MP
HOUSE OF COMMONS
LONDON SW1A 0AA

25th March 2013
Dear Ms Evans,

Thank you for your e-mail of 15th March about the Prescription Charges Coalition reprt Paying the Price.
I realise that this issue raises some strong feelings, particularly for those with long-term conditions who are not exempt from charges. The Government has no plans for a further review of the list of medical conditions that confer exemption.

There is already an extensive system of prescription charge exemptions in England. This includes provision for people on low incomes who can apply for free prescriptions through the NHS Low Income Scheme, or who get free prescriptions due to the receipt of certain benefits. This system of exemptions means around 90 per cent of prescription items are dispensed without charge.

There is also provision for people who have to pay prescription charges and need them regularly, or need a lot of prescription items. A Prescription Prepayment Certificate (PPC) can be obtained and PPC holders pay no further charge at the point of dispensing, with no limit to the number of items the holder may obtain via the certificate.

As part of the most recent announcement on prescription charges, I am pleased that the Government has not changed the cost of a PPC. The cost of a three-month PPC will remain at £29.10. This will save people money if they need four or more items in three months. A 12-month certificate costs £104 and will save money if 14 or more items are needed in 12 months.

Yours sincerely,

Gee, thanks Damo, if you had actually read my email in the first place you would have known that I am aware of the PPC and what it is, but what I asked was for you to commit to something that I, one of your constituents, has asked for.  And yes, people on low incomes or who get certain benefits can claim free prescriptions, but what about us people on not quite low enough incomes?  The people who forever and always get stuck in the middle, not quite poor enough to be entitled to anything, but not quite earning enough not to need help.

Remind me, when I'm filthy rich and living in a golden house, eating caviar and foie gras for breakfast and having all my pain magically removed by some technological wonder, and the polling card lands on my doormat, just how much help he and his government have given to the chronically sick recently.

Oh, and keep your eyes open for that cure - there's still 11 months on my current PPC so you've got a bit of time

K x
  

Mental Health

And no, before you say it, I don't mean my own (although it is questionable at times).  I struggle with other people's mental health issues, because what I want to say is 'Come on, you know you're nuts, right? You don't really believe what you're saying, do you?'.  I know that this is not a healthy, compassionate, supportive response and so I don't say it.  What I say is 'everything will be OK I promise' and then cry about it.  Which rather elongates the chain of mental health misery by becoming borderline depressed myself.
But when someone very close to you suffers from a mental health issue - and someone very close to me currently is and has had episodes of deep anxiety induced depression for many years - it affects everything, and there's almost nothing you can do.  Of course, I can alleviate as much stress or strain or worrying for that person as I possibly can; but the problem is that the sufferer can very easily replace those anxieties with a whole new set of completely irrational ones.  And the more irrational the worries or fears, the more difficult it is for me to help alleviate them.  So, bit of a vicious circle really, but I can't justify 'completely ignoring the entire problem' as an effective aid to rehabilitation.
The stigma attached to mental health is astounding and I don't just mean the obvious disabilities - ones which make a visual difference to the sufferer and cause people to point in the street.  But the secret, private miseries which can cause people to lead seriously limited lives and experience such debilitating problems are compounded by a general lack of understanding or even mild disinterest on the part of the rest of us. 
We can all do more, learn more, understand and accept more about mental illness; and just watching "One Flew Over the Cuckoo's Nest" does not count.
K x

P.S. 23/03/13  The above post was shorter than my usual fare, partly because I found myself getting angry and upset about the situation as I wrote it and also partly because I was exhausted and was losing my train of thought.  It's frustrating dealing with someone who is going through mental health issues because their understanding of the situation is fundamentally flawed by their illness.  You can't tell someone they are being irrational because the irrationality is part of the problem.  It makes it very hard to talk about, and very hard to write about because I want to justify every sentence with an example and I don't think that's fair on the person in question. Off to search for my magic wand now...
K x