Perscription Charges Consultation: Is Wells biting the bullet?

The Health Minister, Jim Wells rose in the Assembly today to announce a consultation on the funding of certain prescription drugs. The Minister, calmly and in a very affable manner set out the difficulties his department faces in funding drugs to combat cancer.

Wells argued that he is in an impossible position with increasing costs on one side and increasing demand on the other forcing him to make more and more difficult decisions in the area of what drug the health service can afford to purchase. So, what is Wells solution for our drugs issues

Proposals

  1. Creation of a Specialist Drugs Fund. This fund would pay for drugs that are too expensive for use at the moment.
  2. The Minister argued against the re-introduction of the old charge system citing administration costs and the high rates of exemptions. Cost of administering the old system was around £2.5 million per year
  3. Wells favours a lower flat rate charge with a “season ticket” rate of around £25 per year for patients.
  4. This charge would NOT be used to fund other black holes in the Health Service and would be used for drug purchases.
  5. There will be transparency for the public to see where this money is being spent.
  6. The current consultation is open for 3 months.

According the BBC’s Colletta Smith, the Department of Health is hoping to raise £10 million for the fund with these charges.

Overall, I thought Wells did incredibly well today in the chamber. He was engaging with members and often praised the tone/approach of those who were sceptical. Notes of concern were raised by the SDLP, Sinn Fein and TUV. The Minister sought to reassure the other parties that he has no interest in using this as a revenue raiser for other parts of the HSC to get more money.

If you want to take part in the consultation you can do so here

 

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  • Granni Trixie

    Im not at all surprised at this uturn by the DUP as we simply cannot afford free prescription charges for all. LIke water charges will prove
    to be im sure, it was always going to happen.
    Why years ago did they not chose to improve the system of charges instead of abolishing them? Why praise affability guff by slow learners?.

  • Barneyt

    Refreshingly normal debate. I cant imagine it would be so civilised in Westminster. The same debate would have descended into a havehave not, NHS preservationdismantle debate. Despite the natural alignment the two main unionist parties have with the Tories, I sense over here health is seen more as a community service…and they may afford the NHS more protection.

    The specialist drugs fund is however, not going to make a dent? Cancer treatments are prohibitively expensive, so its a drop in the ocean. Despite assurances, these funds raised will at some point fall into the parallel funding bucket, and a hole will be plugged somewhere. Increased in the charge will emerge and it will be extended, despite the admin costs of levying the prescription change.

    I see this change and any other universal prescription charge as I do the USC in the ROI. It will become a readily collectable source of revenue.

  • So Wells considering:
    a) return of old system of prescription charges
    b) small standard universal charge on ALL prescriptions no exceptions
    c) a prescription tax on everyone registered with a doctor.

  • c) of course, exemptions apply to all those excluded from old system. So, charge predominantly on the healthy population.

    Total tax on 400,000 of population if the numbers are to add up – though with this Executive, who knows.

  • GEF

    Sinn Fein will veto any attempt to reintroduce prescription charges full stop.

  • chrisjones2

    Simplest would be a fixed price annual charge of say £50 or £10 an item. Would stop current nonsense of people demanding prescriptions for paracetamol that can be bought for a few pence

  • chrisjones2

    Well in the Republic the charge is €144 / month for those with major health problems. So in pursuit of a national system will they:

    1 promise to abolish charges in the South
    2 put up charges in NI to those ruinous levels
    3 lie to the public?

    Answers on a postcard to …………

  • Barneyt

    All in favour of cutting out clear abuse of the system. I wonder could you make an assessment of each engagement a patient has with their doctor to determine if a charge is due. How do you balance clear abuse (using the appointment system for another purpose) and turning genuine needy cases away?

    I do favour a healthy enough charge for a missed appointment though.

  • Barneyt

    Great question. Wouldn’t it be great to be faced with such a conundrum.

  • OneNI

    “Despite the natural alignment the two main unionist parties have with the Tories, I sense over here health is seen more as a community service…and they may afford the NHS more protection.”
    Of course it is the Tories that have protected that service by increasing health spending (which NI benfitts hugely from via Barnett formula) and it was the Tories who first pledged not to cut health spending (which NI then duly followed – as the Tories had provided the cash).
    The NI Assembly stupidly abolished prescription charges – in essence cutting millions from the health budget. Notably the Tories in England did not.
    NI Assembly belatedly beginning to realise you cannot have you cake and eat it.
    Who affords the NHS more protection?
    The record is clear – the Tories!
    Dont let prejudice get in way of the facts

  • Dan

    £10million….that’s around the amount that Sinn Fein and sdlp have squandered so far on the Casement Park white elephant, isn’t it?

  • chrisjones2

    We are talking about drugs not doctors. At the moment you can walk into a chemist in NI say ‘I have diarrhea’ and they will give you a packet of generic Imodium free and bill the HNS. You can then flog them or do what you want with them Is that wise?

  • chrisjones2

    It seems they are

  • Redstar2014

    I find it difficult to take seriously a so called minister bleating about saving money when he’s cost the dept thousands in legal through his inherent bigotry on the gay blood debacle

  • QuintinOliver

    On a procedural point, para 65 of the Stormont House Agreement -https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/390672/Stormont_House_Agreement.pdf – states:

    65.The maximum consultation requirement on policy will be reduced from
    twelve weeks to eight.

    But Jim Wells’s DHSS&PS has launched a 12-week effort in this case; I wonder why?

    If it is a complex and controversial issue, requiring careful consultee consideration, or over a holiday (or election!) period, then maybe 12 weeks is better, to engage those impacted and interested more fully. Some might require even longer – Heathrow or Gatwick runway extensions, nuclear policy, North / South Inter-Connector, Scotland’s referendum…

    But if not, who decides on eight weeks, or six, or four? Are we risking policy constriction? or ‘consultation constipation’?

  • Jay

    Nobody should have any problem with paying a small fee that will go to a good cause. Put the party politics aside!

  • chrisjones2

    Agreed …but thats a drop in the ocean of waste

  • chrisjones2

    Apparently SF do …according to posters on here

  • chrisjones2

    Oh come on. You cant expect our ranks of civil servants to keep up to speed with every change

  • Tacapall

    So is the even higher amount of £millions being squandered up at Twaddle not a white elephant ?

  • PaulT

    “Of course it is the Tories that have protected that service by increasing health spending (which NI benfitts hugely from via Barnett formula) and it was the Tories who first pledged not to cut health spending (which NI then duly followed – as the Tories had provided the cash). ”

    Really so the 20 billion of “efficiency savings” plus budget increase of only 0.1% isn’t cutting spending !!

    Oh, your right, I forgot, in true Alice in Wonderland economics Gideon put back 3 billion so it’s called investing minus the 20 billion !!

    With regards to Barnett, as long as your happy to live with crumbs from Englands table good for you, others think it’s a rubbish idea.

    How can you run a state(let) if the only time central government recognises a need is when it affects their own voters.

    Had NI NHS needed funding there would have been no assistance, but when Englands NHS needs extra funding there’s a few crumbs thrown to NI as well,

    how can a Minister run that or any department when needs are calculated by the needs of people in another country,

  • Joe_Hoggs

    It’s a violation of human rights.

  • hugh mccloy

    Taxing Illnesses

    Statement

    “Prescription charges were abolished in Northern Ireland in April 2010. The cost of free prescriptions was found from increased efficiencies within the Department’s health budget at that time and no additional funding was sought to support the introduction of the policy”

    Consulation documents

    “1.10 The recommendations will incur implementation costs and the Department
    wants to ensure that these costs can be met sustainably in the long term. It is
    therefore also proposed that prescription charges should be re-introduced to
    help fund a Specialist Medicines Fund, which will keep funding for specialist
    medicines on a firm financial footing in the long term.”

    NOTE THE WORD “ALSO”

    “10.5 The HSCB currently spends around £120m a year on approved specialist
    drugs £27m of which are cancer drugs. The HSCB has indicated potential
    NICE approved specialist drug pressures of approx £12m in 2015/16. While it
    is extremely important that patients should be able to access unapproved
    drugs where there is a compelling clinical reason, it is of course vital that we
    continue to fully fund therapies that have been assessed by NICE and found
    to be clinically and cost effective. It is of primary importance that we continue
    to meet our commitments with respect to NICE approved drugs.”

    This charge is about paying for scripts that were made free already at no cost to the tax payer

  • Mister_Joe

    If so, why haven’t the campers launched a case before the European Court?

  • Tacapall

    Unfortunately the majority of people in this country dont agree with your perception of whats a violation of human rights Joe, not even your own mother parliament.

  • Dan

    Of course it is.
    Your point?

  • OneNI

    Point is, whilst clearing up Labour mess the Conservatives protected health spending – Labour in Wales havent. Your initial point contains an assumption that Tories will be bad for NHS – but facts point in opposition direction.
    I was trying to point that NI has benfitted from that – ‘not crumbs from Englands table’ but big slices. Are you one of those Pig flying Nationalists who deny we are heavily subsidised?
    You say that UK govt only recognises needs of its voters – all the more reason to get Conservatives, Labour and Liberal Dem organised here. Why dance to the old nationalist unionist tune when support for UI is declining, Republic has mountians of debt and UI is economic madness

  • PaulT

    Is it worth pointing out that the choice does not have to be a health service like the UK NHS or Irelands one, there are other health services available, I’ve heard the French and German versions discussed on RTE, the German one which is the oldest NHS in the world, seems to work pretty fairly and returns a surplus of several billion Euros a year.

    Considering Richard Branson runs a chunk of the UK NHS among many other tax dollar troughers I think I’d go for any version except the UK one, at least in Ireland if you don’t have a medical card you can actually choose your health insurance [rovider and demand a good service instead of allowing your PM shovel your cash into buying beardies next tropical paradise island

  • Catcher in the Rye

    No it isn’t.

  • Catcher in the Rye

    That’s why the minister has sought to tie it in with cancer drug funding.

    If SF vote against it he’ll accuse them of blocking a cancer treatment fund.

  • OneNI

    Oh Quintin keep up. With 12 weeks Sinn Fein can suck their teeth and make belligerent noises all the way to polling day on 7 May. The following week they can slip in an ambivalent response to the consultation or demand a few concessions and the policy is adopted. All done and dusted well in advance of election to the Assembly.
    With 8 weeks people would have to make a policy pronoucement before the general election!

  • OneNI

    Neil Wilson hits the nail on head – this Cock eyed Executive wants to spend £560m topping up benefits over 5 years and over the same period collect ten of millions from ill people!

    http://www.niconservatives.com/news/executive-threatens-hit-sick-people-prescription-charges

  • D99

    Not sure about your logic here Chris – if the Imodium is free, why would anyone pay for it when you try to flog it? Or do you mean that you can get a script for Imodium from your doctor if you have diarrhoea and then flog it to someone who also has diarrhoea but can’t be bothered to go to their doctor for a prescription?

  • Naive

    This is the problem with the Health Service (and government
    in general) we have evident of much needed reform. NI Audit office report ‘Primary Care Prescribing’ states “potential savings of £19 million could have been realised if all GPs had prescribed as efficiently as those in the average performing practice,” yet instead of looking and implementing recommendation
    we go for the quick win.

    Just look at reports from England for example recent research from the Royal Pharmaceutical Society found “The cost of treating common ailments in community pharmacies was found to be £29.30 per patient. The cost of treating the same
    problems at A&E was found to be nearly five times higher at £147.09 per
    patient and nearly three times higher at GP practices at £82.34 per patient.”

    If we try and reform the system we will save more and help more people (sound naive I know) but continuing down this path will only quicken the descent in a private health system.

  • Zeno

    Who is the 400,000? There are over 1.2 million people over 18.

  • OneNI

    Bah £10m? What about the A5 £60m wasted!

  • D99

    Given that National Insurance contributions and income tax are levied to pay for the Health Service, charging for prescriptions is an additional tax targeted at those who are ill. If there’s not enough money to pay for specialist drugs, then increase national insurance or tax, or better still, increase the taxes on the profits of the companies that charge so much for the specialist drugs in the first place. Or, at least don’t waste hundreds of millions on cutting tax on corporate profits.

    If street lights go out, if there’s not enough for A&E services, or ambulance cover in a particular area, will this ‘government’ just levy a small charge to pay for these things?

    Next thing they’ll be wanting to charge for things that are already covered in our rates bill – like emptying the bins or water services.

  • Zeno

    Yes but they will spend it upgrading Football Stadiums, hiring companies to do non existent research or paying the almost 400 “staff” that work for OFMDFM. It won’t be wasted.

  • Dan

    How much was wasted on Tamiflu too?

  • barnshee

    “how can a Minister run that or any department when needs are calculated by the needs of people in another country,”

    Its quite– simple raise whatever taxes you can —yourself and then spend it as you wish. Just don`t ask those nasty Brits to top it up -starve-die of lack of medical services etc etc–all at your own expense

  • Zig70

    It’s the same logic as used to justify the doctor’s fee in the South. If the prescription levy is a good idea then you couldn’t argue against a Doctor levy on the same basis.

  • hugh mccloy

    Another austerity u turn

  • Superfluous

    Apologies if anyone has covered this – but isn’t the prescription charge supposed to be a disincentive to waste in an all-you-can-eat system, rather than a device to raise revenue?

    I read up a little while back on the Swedish health system, where they introduced affordable micro-charges for many things including prescriptions and visiting a doctor. It was not really intended to generate revenue from the patient, but more so they could make the patient aware of their own consumption (a bit like the plastic bag tax is not about the tax revenue). It resulted in wastage in the health service dropping considerably, leaving more resources available to spend on the likes of expensive cancer drugs.

  • PaulT

    How much will the OO cost taxpayers this year, not just rate rebates and new flutes etc, but policing the marches, policing riots etc

  • PaulT

    “Are you one of those Pig flying Nationalists who deny we are heavily subsidised?”

    Still waiting to see the actual figures on that, funnily enough, been waiting to see the figures for years and HMG refuse to publish.

    “get Conservatives, Labour and Liberal Dem organised here.”

    the pop of England is 60,000,000 it’s the people of England who pick the government, you take what you’re given.

    “when support for UI is declining”

    Based on a bloke on the street with a clipboard, see above re subsidised, you just throw out empty slogans to avoid discussion

    “Republic has mountians of debt”

    Irish debt is a fraction of UK debt. Ireland borrows money on the markets at a lower rate than the UK, growth has taken of in Ireland in the last two years, the only growth seen in the UK is Gideon’s spin, it’s built on debt fuelled household spending and London house sales.

  • Joe_Hoggs

    The banning of the parade originally was the result of Republican violence against a minority community in relation to a parade that has went on for decades.

  • barnshee

    “How much will the OO cost taxpayers this year, not just rate rebates and new flutes etc, but policing the marches, policing riots etc”

    It all depends on how revolting the nats/republicans are – hard to predict

  • PaulT

    The OO is even banned from Primary schools in Scotland, IIRC a teacher was sacked for putting up a poster of Diamond Dan in a classroom, wasn’t Diamond Dan designed by a child as part of OO kids colouring competition.

    NI has been more than generous to the OO up to now, but I think it’s time to move more in line with the UK and Ireland and start making a move into the 21st century

    Cos really, stacking tyres outside a primary school in Feb in preparation to poison your own kids with toxic smoke in July is very backward and to just have OO whingers on Nolan complaining about a lack of pallets is not the right direction to go in

  • PaulT

    “protected health spending”

    By taking out 20 billion but putting 3 billion back, and limiting annual budget increase to 0.1% ???? really…you spin me right round baby right round.

    “Labour in Wales havent”

    Oh dear, heard that bit of spin demolished on R4 this morning, you forgot to mention that report said the NHS was largely the same across all regions.

    Oh, Wait, tell us that under the Tories waiting times are a bit lower in England, just don’t mention that England has walk-in Centres and Wales doesn’t which distorts the figures.

    Really is this all you have to offer, rubbish tory spin gleamed from spreadsheets, and spun out to the party faithful

  • PaulT

    IIRC when the Gay Blood thing was kicked back to London the Minister there promptly went legal and tried to kick it back to Stormont.

    Regarding waste, the DWP is the worst by a country mile, Slugger pin-up IDS is so bad that he is in court more than the NI CC in trying to prevent data been released.

    PS
    The 20 billion new welfare system will never happen, it will go the way of the 12 billion NHS system and a lot of other vanity projects by HMG Ministers. Why do none you care about the waste in London, it’s your money they’re wasting too

  • barnshee

    “Cos really, stacking tyres outside a primary school in Feb in preparation to poison your own kids with toxic smoke in July is very backward and to just have OO whingers on Nolan complaining about a lack of pallets is not the right direction to go in”

    COULD NOT AGREE MORE
    (I don`t think the OO organise bonfires)

  • PaulT

    same old same old no OO fingerprints anywhere for the religious and cultural organisation which ran OUP and UUP and now runs the DUP, the same OO whose approval was needed for the GFA complete with private meeting at No.10, the same OO who are wrapped up with fleggers and public disorder for the past 2 years.

    Your reply is exactly why NI needs to follow the British and Irish and corral the OO in a corner away from shops, away from schools and away from normal decent people in general

  • Old Mortality

    ‘…charging for prescriptions is an additional tax targeted at those who are ill.’

    No it isn’t. It’s just a contribution towards the cost of providing the drug in question. Every prescription should show its true cost so that recipients are more aware of the cost of their treatment. Some might even feel grateful.

    ‘Next thing they’ll be wanting to charge for things that are already covered in our rates bill – like emptying the bins or water services.’

    And it’s disgraceful that we have to pay for gas and electricity. Imagine having to pay to keep warm!

  • Tacapall

    Now you can correct me if Im wrong here Joe but if memory serves me right violence has followed Orange Order parades in that area for generations and the last time widescale organised violence occurred it was carried out by members of the Orange order and their supporters. Why dont you ask the local MP and fellow Orangemen Nigel Dodds, did you not watch on the news as one of his fellow orangemen mistook him for a PSNI officer and hit him on the head with some sort of object knocking him unconscious. Im absolutely sure you are very aware of that fact but like a typical Orangeman believe that your violence is justified but nationalist violence is wrong.

  • barnshee

    Still no proof that the OO organise bonfires then?

  • Joe_Hoggs

    Tacapall, I have no recollection of that.

  • chrisjones2

    …because their political representatives are very poor / don’t really give a damn until the election campaign starts?

  • chrisjones2

    increase the taxes on the profits of the companies that charge so much for the specialist drugs in the first place……..

    most of whom dont pay tax in the uk. Doh

  • Tacapall

    Same old same old, whats new Joe, that would be your normal response to difficult facts that contradict your orange tainted view of history, obviously you get your historical facts from your local Orange lodge.

  • chrisjones2

    i agree

  • chrisjones2

    Sensible politics then …..look ….themuns dun it

  • Joe_Hoggs

    I don’t understand the question.

  • Joe_Hoggs

    The Orange don’t organise the bonfires but don’t let that stop sectarian PauIT and his hate for all things Protestant.

  • chrisjones2

    …and the peelers…we pay for them all the time but most of the time we don’t use them Let those whose houses are burgled pay on a case by case basis and those who are arrested cough up for the costs of prosecuting them. PSNI would soon become the finsest force that money could buy

  • D99

    True. So if they currently pay nothing and if we increase what they pay, then they would be paying something. It’s not acceptable for them to operate in the UK and not pay taxes here.

    And, to be consistent, it’s probably not a good idea to create another tax haven by cutting corporation tax here so they can dodge tax in other countries they clearly operate in.

    Your point above to Old Morality about paying for the police or other services as and when we need them, hits the nail on the head and reveals the absurdity of what’s being suggested.

    On the other hand, maybe we could pay the MLAs on this basis – as and when we need them – that would save quite a bit.

  • chrisjones2

    Keep dreaming. They pay no tax here as they are not domiciled here.

  • chrisjones2

    maybe we could pay the MLAs on this basis – as and when we need them – that would save quite a bit.

    What a wonderful idea …but they would starve ……what a wonderful idea

  • chrisjones2

    Doh ………………………you can sell it on ebay

  • chrisjones2

    well to be fair it was his predecessor who did that

  • Nimn

    It never ceases to amaze me how within a half a dozen posts we become so seriously OT. Prescription charging to Twadell to the A5, back to the OO and tyres and the peelers to big business.
    What the Hell is the point of moderation on this site?

  • Reader

    Superfluous: (a bit like the plastic bag tax is not about the tax revenue).
    Yes it is – they charge the tax on paper bags too. “single use carrier bags”

  • Zeno

    I don’t know what the real cost is Paul and I don’t think anyone else does either. The almost 400 who work for THE OFFICE OF OFMDFM costs us £16.6 million a year. That is £2 million more than the total wages and expenses of all of our MLA’s. It is costing us over £180 million to make sports grounds more comfortable while we apparently can’t afford to fund drugs for cancer patients.
    It’s like having someone in your house who needs drugs to just survive and spending the money instead on a wide screen tv and a lazyboy chair.

  • Kevin Breslin

    Hugh you know yourself even without the debt, austerity comes into the Health Service through a much higher rate of inflation than anything else bar perhaps universities. We need some sort of a tax revenue increase. So to be fair to Maeve, and your justifiable aversion to Sinn Féin, was there any harm in the question?

  • Practically_Family

    In fairness with this as with most other places where NI politics is debated, were it not for the Ussuns/Themmuns angle it would get very quiet, very quickly.

  • Practically_Family

    But the plastic bag tax, as imposed in NI, is entirely about raising revenue.

  • Practically_Family

    But if they charge and you don’t have the money spare, how do you get to work/school/job interview/probabtion meeting/adult friendship group if you keep pappering your keks?

  • Reader

    Maybe D99 means to charge VAT or import duty on drugs. Though actually, that isn’t going to help the NHS. Both UK PLC and Bastard Pharmaceuticals Megacorp will see the same net price before and after any such change.

  • hugh mccloy

    No harm in the question, the question is not the issue the stance is. medicines were made free to the public at no cost on the health budget even taking into account inflation post RPA & CSR.

  • Superfluous

    You’ll have to excuse my lack of cynicism – they certainly sold us the plastic bag tax as an environmental thing, and if I was designing a revenue generating tax I might try to stay away from one that requires a big logistical challenge in collecting the tax, for such a small bit of revenue.