Prescription Charges: Long-term Health Conditions

Preet Kaur Gill Excerpts

Monday 11th March 2024 Westminster Hall

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Dame Maria. I thank my hon. Friend the Member for Neath (Christina Rees) for opening the debate, and for sharing Mia’s story and her reasons for creating the petition. I thank Mia for doing so, and I pay tribute to the more than 20,000 people who signed the petition to bring this issue to Parliament. I hope that my remarks do justice to this important subject.

As we know from the Budget debates this week, this Parliament is set to be the first in modern history in which living standards have dropped over its course. Faced with a crippling cost of living crisis since the Government tanked the economy and sent prices soaring, people are having to make impossible choices that they never would have dreamed of making in the past—between eating or heating their homes, between paying their rent or going into debt, or, for people with chronic conditions, between paying for their medicines or forgoing other essentials. It is a shocking situation that far too many people in this country find themselves in.

We all understand the immense challenges faced by people with chronic or long-term conditions. That is part of why the next Labour Government have made it our mission to reform health and care services to build an NHS fit for the future by improving capacity and providing it with the staff, technology and resources it needs so that all patients get the treatment they need where and when they need it. We will deliver 2 million more NHS appointments a year, and reform primary care so that people with long-term conditions can request face-to-face appointments with a doctor of their choice, meaning better continuity of care and better outcomes for patients.

Whether it is the debilitating pain faced by many people with endometriosis, Ehlers-Danlos syndrome or polycystic ovary syndrome, the struggle of living with chronic anxiety or depression, or the fatigue and disabilities associated with conditions such as multiple sclerosis or POTS, I cannot do justice, in the time I have, to the many daily hurdles that many people living with such conditions face, but being able to afford essential medications should clearly not be one of them. I thank my hon. Friend the Member for Neath for sharing some people’s stories today.

I recognise that the cost of prescriptions in England, which is currently £9.65 per item, is a burden on many people living with chronic conditions that are not on the medical exemption list. I acknowledge the Government’s argument that the prescription prepayment certificate scheme can reduce the outlay, and that there are a number of exemptions from paying for prescriptions for certain demographics, including those on low incomes. However, paying up to £111.60 a year for medication is a heavy outlay for many ordinary people during a cost of living crisis, and the issue of fairness in how different conditions are treated remains.

When the medical exemptions list was first drawn up in 1968, it was limited to readily identifiable permanent medical conditions that automatically called for continuous, lifelong, and, in most cases, replacement therapy, without which the patient would have become seriously ill or even died. There has been only one review since then, under the last Labour Government, when cancer was rightly added to the list. Many Members and our constituents have criticised the medical exemptions list as being out of date, inconsistent and arbitrary, based on patterns of illness and treatment that have changed significantly since the 1960s.

Previously, when this issue was debated in relation to exemptions for cystic fibrosis, the then Minister, the right hon. Member for Charnwood (Edward Argar), stated:

“We do think it would not be right in this context to look at one condition in isolation, separate from other conditions, because others would rightly argue that their condition was potentially equally deserving of an exemption if it fitted the same criteria.”—[Official Report, 2 February 2022; Vol. 708, c. 185WH.]

As the petition focuses on a range of conditions, will the Minister say whether the Government see a case for looking again at the medical exemptions list now?

Will the Minister also tell us what she knows about the take-up of the prepayment certificate, and whether its price is a barrier to some people getting the medication they need? What assessments have the Government made of how the addition of cancer to the medical exemptions list improved outcomes for people with cancer? Does the Minister agree that no one suffering from debilitating chronic illness should be priced out of the medication that they need?

At a time when the cost of living is continuing to rise, the Government should consider what more they can do to support people with these essential costs. Applications to the NHS low-income scheme have surged on the Government’s watch, up from just over 267,000 in 2021 to 361,000 in 2022—a 35% rise in a year. That surely reflects the scale of the problem.

It is appalling that people have been rationing their own medication simply because of cost. It is not just a matter of fairness; skipping medication risks costing the NHS more money in the long term and putting even more pressure on primary care if that person’s health deteriorates. Indeed, last year, when looking at the impact of potentially increasing prescription charges, the Government’s own impact assessment raised several concerns, including that some people towards the lower end of the income distribution may struggle to afford all of their prescriptions, which can result in future health problems for the individual and subsequent cost to the NHS. That is worrying. What estimate has the Minister made of the number of people in England who are currently unable to afford medicine, and what assessment has she made of the knock-on impact on NHS services, which are already at breaking point? Research published by York Health Economics Consortium in 2018 found that removing prescription charges for IBD and Parkinson’s alone could save the NHS up to £20 million a year. What assessment has the Minister made of the economic case for looking at this again?

Labour recognises that the cost of prescriptions in England, currently £9.65 per item, is a burden on many people living with chronic conditions. Prescription charges have risen 34% under this Government, and with costs continuing to rise, there are valid concerns about people being priced out of accessing vital medicines. While I recognise that there is a broad system of exemptions from charges, including for those on low incomes, I hope the Minister has heard the concerns raised and the representations made by the petitioners. No one should be forced to choose between paying for their prescription and risking their health.