Deputy First Minister and Cabinet Secretary for Health and Wellbeing
Nicola Sturgeon
Statement on abolition of prescription charges at the Scottish Parliament, Holyrood, Edinburgh
December 5, 2007
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Presiding Officer, I am very pleased to have the opportunity today to announce the intention of the new SNP government to abolish prescription charges within the lifetime of this parliament.
In this statement I will set out in detail our proposals to phase out prescription charges over the next three financial years, abolishing them for all by 2011, one year ahead of our manifesto commitment.
Presiding Officer, this government is committed to building a healthier nation. We are determined to tackle the health inequalities that still scar our nation. We want to support people to live longer and healthier lives.
And we intend to ensure that they have timely access to the health and social care services that they need.
In August, when we published our discussion document Better Health, Better Care, we began to set out the actions that will help us realise our strategic objective of helping people, particularly those in disadvantaged communities, to sustain and improve their health, and ensure better, local and faster access to healthcare.
One of the key commitments we made in Better Health, Better Care was to phase out prescription charges for all in Scotland.
The reason for that commitment is clear. This government believes that prescription charges are a tax on ill health. We also believe that they are a barrier to good health for too many people. The fact is more and more of us are living with long term conditions.
Many of those long term conditions can, with the right support and medication, be self-managed by patients in their own homes, enabling them to go on enjoying a good quality of life.
The problem is that many people with long term conditions that are not already exempt from charges simply can't afford the right medication.
In October, I attended a conference organised by the Parkinson's Disease Society. I spoke with sufferers of Parkinson's disease who told me that they did not always take prescribed medication because they could not afford their prescriptions.
Presiding officer, I believe that is unacceptable.
This government believes that people should not be penalised financially because they fall ill. They should not have to make choices about whether to obtain essential medicines. No-one should avoid seeing their GP because they know they can't afford the cost of their prescriptions.
I want the NHS to help people make the choices that are good for their health and wellbeing.
I also want the NHS to be true to its founding principle: the principle of healthcare free at the point of need.
That was the principle espoused and defended by Aneurin Bevan.
It is a principle that this SNP government - by abolishing prescription charges - will be proud to restore.
Presiding Officer, let me now set out our plans in detail.
There are two key elements to the proposals that I am outlining to parliament today.
From 1 April next year, we intend to deliver the first stage of our commitment to abolish prescription charges by reducing the cost of a single prescription from £6.85 to £5.00 - a year one reduction of more than 25 per cent.
In April 2009 the cost will reduce again to £4.00.
And then in April 2010 to £3.00.
From 1 April 2011, prescription charges will be abolished and prescriptions will be free for everyone.
The second element of our proposals will deliver even greater benefit for people with chronic conditions.
Currently people who need a regular supply of medication - often people with chronic conditions - can reduce their costs by purchasing a Prescription Pre-payment Certificate.
PPCs can be purchased for either a four or 12 month period and cover all prescriptions needed within that period.
It is to provide additional help for people with chronic conditions that we will from April next year, reduce the cost of both the 4 month and 12 month PPCs by over 50 per cent.
Next year, the cost of a 12 month PPC will reduce from £98.70 to £48, with further reductions to £38 and £28 on 1st April 2009 and 2010 respectively.
Similarly the price of a 4-month PPC will be halved from the current level of £35.80 to £17 next year, with further reductions to £13 and £10 in 2009 and 2010 respectively.
Of course, PPCs will be completely redundant from April 2011, when we abolish prescriptions charges altogether.
Presiding Officer, I believe that introducing this substantial reduction in the costs of PPCs - in addition to the reductions for single prescriptions - is the simplest and most effective way of providing faster relief from prescription charges for people with chronic conditions.
Let me set out my thinking.
We did, of course, consider compiling a list of chronic conditions that would have qualified for immediate exemption. But many concerns were expressed to us about the difficulty and delay that would be associated with defining a list that was comprehensive and complete and that avoided simply creating new anomalies. Either the criteria for inclusion would have had to be drawn tightly, in which case too many patients would have been excluded; or we could have set them very broadly, in which case the list would have had to be kept under constant review to take account of inadvertent omissions and the emergence of new conditions.
It also became evident that it would take some considerable time to compile even a workable initial list. Many views would have had to be considered and I would not have wanted to rush the process given the complexity and sensitivity of the issues.
Our preliminary inquiries suggested that work to extend the categories of medical conditions that qualify for exemption would have taken until 2009.
This length of delay is one I wanted to avoid - especially since the end result might have been, in the words of one doctor, the "least wrong" list rather than one which was right and fair.
For all these reasons, I decided that the approach I am proposing today is preferable and will deliver real and immediate benefit for all especially those with chronic conditions and cancer.
Similarly, for full-time students and those in full-time training there were administrative difficulties, both in defining these groups and determining how they would show eligibility. In the end, I considered that a more rapid journey towards universal abolition, coupled with larger reductions for those needing regular medication was the better option for this group too.
In summary, presiding officer, by delivering immediate reductions in the cost of single prescriptions and a deep cut to the cost of PPCs, everyone will benefit.
Let me also advise parliament that we have made full provision for the cost of our proposals in the spending review.
To phase out prescription charges, we have set aside over the next three financial years the sums of £20m, £32m and £45m.
We also estimate that the annual recurring cost of complete abolition of prescription charges from 2011 will be £57m.
Presiding Officer, as I have already indicated, in developing these proposals I have listened to many views and suggestions. I have also listened to any concerns that have been raised. Another issue that was raised by some people was that abolishing prescription charges might lead to an increased demand for prescriptions.
The best available evidence that we currently have on that is from the recent experience in Wales.
Prescription charges have been phased out and were finally abolished in Wales in April this year.
Parliament will be interested to know that there is no evidence of increased levels of prescribing during the phased reduction in charges. Neither is there evidence that GP consultations have increased.
But these are early days after full abolition of charges in Wales and it is important to be aware that when full data is available, it may well show some increase in prescribing.
But, Presiding Officer, that is exactly as it should be.
Let us not forget that there are two very good reasons why the phasing out and abolition of prescription charges should result in some increase in the number of prescriptions dispensed.
Firstly, we know that there are patients who currently do not take some or all of their prescribed medication because they can't afford the charges. These patients will benefit greatly from the changes I am announcing today.
Secondly, research also shows that some people don't go to their GP because the cost of prescriptions puts them off. Progressively reducing the cost of prescriptions should encourage patients to see their GP when they need to.
These are the very patients for whom these changes are designed.
That is why it is important to be clear that a modest increase in prescription volume will not be a cause for concern. On the contrary, it will be a sign that the policy is having the desired effect.
Indeed the money we have set aside for this policy assumes an increase in prescribing.
Of course, there may also be a few patients who will opt to visit their GP for medicines which are available over the counter, to avoid having to pay. However, it is my view that this group will be very small, given the easy, low cost availability of self care medication in shops and pharmacies. I also have full confidence in GPs continuing to make prescribing decisions according to the clinical needs of individual patients.
Presiding Officer, I have absolutely no doubt that the abolition of prescription charges will have a positive impact for both patients and our NHS. If patients take regular medication as prescribed, their medical conditions will be better controlled leading to fewer problems, fewer complications and fewer emergency admissions.
I believe that these proposals will be of real benefit to all the people of Scotland.
By removing this tax on ill health we will make a significant contribution to achieving a healthier Scotland. No longer will cost prevent people from consulting their doctor and picking up their prescriptions.
These proposals will remove barriers to good health and support people to make healthier choices, to improve their health and to live longer.
These proposals will deliver real and immediate benefits from April 2008. For those with chronic conditions, the deep cut to the cost of PPCs will mean that from April next year, the financial burden of their medicines will be reduced by up to £50.
And the phased reduction in price for single prescriptions, leading to universal abolition of prescription charges by 2011, will deliver on our manifesto commitment one year ahead of schedule.
Presiding Officer, I believe that these proposals are right for Scotland.
I also believe that they will have the backing of the vast majority of people in the country and hope that they will have the support of this parliament as well.
Next year, the NHS will be 60 years old. Abolishing prescription charges seems to me a very fitting way to mark that occasion.
I therefore urge members on all sides of the chamber to join with the SNP government in removing this tax on ill health and restoring the NHS to its founding principle of care free at the point of need.
I commend these proposals to the chamber.