Day and Night – Taxman or Policeman



I didn’t know that I’d end up a taxman or policeman… A new electronic system for checking eligibility for NHS fees exemption has been announced by the Department of Health. The system will run concurrently with the new electronic transmission of prescriptions from the GP’s desk to the patient’s chosen pharmacy.

Pharmacies will be able to verify patients’ claim to exemption by accessing the information from the Department of Works and Pensions…

Currently one can tick ‘income support’ on the back of the prescription form without producing proof. The pharmacy however then marks the ‘evidence not seen’ box. With the new system it will probably be, ‘Sorry love, the computer says pay or die!’

I’m not looking forward to it. Why should it be the pharmacist to do the dirty work and bear the brunt of irate patients? Why not link the DWP data to the GP’s computer so that before issuing a script the patient can be reminded of their obligations to pay? That could help. According to the Prescription Charges Coalition (a group against NHS fees) a third of paying patients end up choosing not to fill their prescription or part of it because of cost.

Readers of my column know that I come from a tuck shop background but I much prefer to be thought of as a health professional than a glorified shop keeper. I am an NHS contractor just like a GP practice, why should I be demonised for collecting an NHS tax (to call it what it is). I’m definitely neither a taxman nor a policeman.

The whole NHS fee system is some dodgy lottery anyway. How come diabetes, hypothyroidism and epilepsy patients don’t have to pay yet asthma, high blood pressure and hyperthyroidism patients have to pay? If your thyroxine levels are high you pay, if low you don’t.

Work that out….

That’s not the only intrigue: A pair of compression stockings constitutes two fees. Is sense common? I have to stand at the counter and explain to a justifiably annoyed patient that the rules are what they are, it’s two fees not one otherwise you get one stocking…. A diabetic has to renew their medical exemption certificate every few years. Hey? Isn’t diabetes a marriage ‘til He do us part? Unless the guy from Nazareth comes back and Lazaruses walk, diabetes is a lifelong maintenance job. Someone send a message in a bottle please. Who knows? The Department of Health could get it.

As an interlude, I’m sorry if the phrase above is blasphemous. Some of these prophets are supposedly untouchable. I can’t help but think that if one so much hates the ways of the West, why not just dig a canoe and sail to where life is more divine?

Here is a suggestion (and we can use any mode of transport); all of us who have to pay should emigrate to Wales, Scotland or Northern Ireland. Everyone gets free prescriptions there.

I should admit that the NHS fee does not reflect the cost of the prescribed item; it could be 28 pence or over £300. We send for incineration, on average, twelve 40 litre yellow bins full of patient returned medicines every month. I know it’s a bit of work for everyone involved but this is why the DH recommends monthly repeats- not every two months or worse still every 3 months. When there is a medication change or the ultimate misfortune befalls you- your number being up- it could be that 3 packs of a 28p drug and 3 packs of a £300 drug will be cremated. No returned medicine may be re-dispensed, or donated to the third world. I go to Zimbabwe for a few days at the beginning of each year to commemorate the passing of my father. His local rural clinic did not have penicillin in stock, he died.


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