Ulcerative Colitis Petition for Free Prescriptions

On the 27th October 2007 we launched a petition on the 10 Downing Street site to lobby for free prescriptions for Ulcerative Colitis sufferers - as follows.

"Ulcerative colitis is lifelong chronic illness that requires lifelong medication, usually consisting of two or more ongoing prescriptions/medications. Cessation or reduction of such medication will in most cases lead to hospital admission and the requirement for surgery. There is no action that colitis sufferers can take to stop the illness and there is no discernable link between lifestyle and the disease. We would therefore suggest that it is only fair and proper that those diagnosed with colitis should receive free prescriptions for medications associated with their illness."

Andrew Garside

I would ask people to please sign the petition at -

http://petitions.pm.gov.uk/IBDPrescriptions/

Colitis Petition FAQs

1) Why do you think prescriptions should be free for Colitis Sufferers.

The underlying principle of the NHS is that treatment should be free at the point of use. The fact is that Colitis and certain other conditions are treated by the lifelong use of medications. This effectively means that patients suffering from these diseases only get free diagnosis - and not free treatment.

As the principle of paying for prescriptions seems to be deeply embedded in our culture then it is appropriate to show a parallel -

Take for example that you went to casualty and they diagnosed that you had a broken leg. Applying the same principles they would give you a piece of paper saying your leg needed putting in plaster. You would then go somewhere else and pay £100 to get your leg put in plaster.

2) Do sufferers of other diseases get free prescriptions

Yes the sufferers of the following conditions get free prescriptions -

• A permanent fistula requiring dressing.
• Forms of hypoadrenalism such as Addison's Disease.
• Diabetes insipidus and other forms of hypopituitarism.
• Diabetes mellitus except where treatment is by diet alone.
• Hypoparathyroidism.
• Myasthenia gravis.
• Myxoedema (underactive thyroid) or other conditions where supplemental thyroid hormone is necessary.
• Epilepsy requiring regular anti-epilepsy medication.
• If, because of a permanent disability, you cannot leave your home without help.

On the other hand sufferers of the following life threatening chronic conditions don't -

• Asthma (http://petitions.pm.gov.uk/Asthma/)
• Those requiring lifelong immunosuppressants following transplant surgery (http://petitions.pm.gov.uk/Transplantees/)
• Those suffering from Colitis, Chrons and other auto-immune diseases (http://petitions.pm.gov.uk/IBDPrescriptions/), (http://petitions.pm.gov.uk/freemeds/)
• Those suffering from Cystic Fibrosis

The list appears to be wholly arbitrary

3) Don't those on low income get free prescriptions anyway

Technically yes - but in reality no. The governments definition of low income is far below what most people would consider low income. This is also a means tested benefit - and most people choose not to apply for means tested benefits.
The reality is that if your income is about £3-6 more per week than you would receive in unemployment benefits then you probably don't qualify. For example most single people earning the national minimum wage wouldn't qualify.
In addition to this people on low income quite often can't afford to pay £100 up front for an annual pre-payment - and can't pay by direct debit as they only have basic bank accounts.

4) Won't the costs bankrupt the NHS

Whilst it is hard to prove I expect that making prescriptions free for life threatening diseases would produce a net saving for the NHS. There is a tendency with such diseases for patients to be in denial when the disease is well controlled. They often then cease using the medication - partly to save costs of the prescriptions.
This results in extra consultant visits (about £100 each), hospital stays (About £200 per night - or about £2,000 per episode) and in many cases it also results in major surgery (J-Pouch £8,000 to £15,000). These costs probably far outweigh the extra £100 of revenue from each sufferer.

5) How would this be administered

The current list based system of exemptions is cumbersome to administer and over burocratic. In reality most medication used to treat serious chronic illnesses are specialised - and have little or no use in treating acute illness. Based upon the use of computer systems to create prescriptions then a fairly simple approach could be taken

Primary Exempted Medications

Certain drugs such as azathioprine, asacol, asthma inhalers etc are only used for conditions that meet our proposed criteria. These would automatically be marked on printed prescriptions as exempt.

Secondary Exempt Medications

These would be drugs such as steroids which may also have other uses. They would be marked as exempt on the prescription if the person was also receiving a Primary Exempted medication (not necessarily on the same prescription.)

There may be still a need to have a list/exemption based system for certain conditions - but I believe this would be rare.

Colitis sufferers would still have to pay for drugs not directly related to their illness - which I believe is only fair and proper.

6) Who would administer the scheme

The decision for which drugs would receive primary exemption and which would receive secondary exemption would lie with the National Institute for Clinical Excellency (NICE).

7) Why not have free prescriptions for all

Most people would agree that a prescription charge is necessary to stop patients going to GPs to obtain medication for minor ailments that could be treated by a pharmacist. On this basis the total removal of prescription charges is not in anyone's interest.
I would therefore propose that free prescriptions should be limited to conditions meeting the following criteria.

• The condition must be either -
  • Life threatening if not treated by medication
  • Highly likely to require hospital treatment if not treated by medication
  • Severely debilitating if not treated by medication
• The condition must require ongoing medication - I would define this as medication being required for a period exceeding 12 months.
• The condition must be one capable of being treated solely or mainly by the use of medication - conditions that can be treated through changes in lifestyle should be excluded

8) Should changes be made to prescription charges in general

I believe the prescription charge should be treated as a per month charge and not a per-item charge. In this way if someone claiming presents a receipt and some kind of tear off from the last prescription and it lies within the past month they should get the prescription free.

I think this would be fair and stop the following anomalies

• Currently if a doctor prescribes a medication - and it doesn't work as the diagnosis was incorrect then the patient has to pay a new charge for the medication that will (or may) work. This is common in medicine as treatment is a process of elimination.
• If a condition requires multiple medications then the patient has to pay multiple charges. This is unfair as it reflects only the current state of drugs available to treat the condition. It doesn't relate to the cost of the drugs - as they may all be inexpensive.