The UK Department of Health needs to examine whether increases to prescription charges are preventing patients from obtaining the medicines they need, a senior health official has agreed with Members of Parliament.

“We should look at this,” said Una O’Brien, director of policy and strategy at the Department, when she was asked by the House of Commons Health Select Committee last week to comment on media reports that patients are failing to get their prescriptions filled because they cannot afford the cost.

Ms O’Brien pointed out to the Committee that “relatively small” numbers of people in England actually pay for their prescriptions compared with other countries, but she also acknowledged that health officials need to “make sure that we are not unintentionally exacerbating” the problem of patients failing to take their medicines.

Patient groups have strongly criticised the 25 pence increase to £7.10 per single prescription, to be introduced in England on April 1, particularly in light of Wales having scrapped the prescription charge altogether and Scotland planning to do so. Last month, the national charity Citizens Advice published survey findings which showed that last year, around 800,000 people in England failed to collect a prescription on the grounds of cost, and it has urged the Department to conduct the review of English prescription charging first recommended by the HSC over 18 months ago.

Last week’s meeting, the first oral evidence session held by the Committee as part of its new inquiry into health inequalities, discussed progress so far in achieving the target set in 2003 for the National Health Service, in partnership with other public services, of reducing health inequalities by 10%, as measured by infant mortality and life expectancy at birth, by 2010.

Department officials told the panel that life expectancy now has never been higher. It has increased, year-on-year and across all socioeconomic groups, and cancer and cardiovascular disease survival rates are improving. Infant mortality rates are at a historic low level, also across the board, although the rate of improvement for both measures is greater in the higher socioeconomic groups, they added.

Rich-poor divide growing
Howard Stoate, (Labour MP for Dartford), asked why, although life expectancy is getting better for everyone, the gap between rich and poor appears to be getting wider. Fiona Adshead, director-general of health improvement at the DH, acknowledged that those people who most need help to combat problems such as smoking, alcohol and obesity are still the least likely to get it. “We need to design services which people actually want to go to and use,” she said, while Ms O’Brien stressed that the NHS “needs to be pro-active.”

Dr Adshead also pointed to the need for the NHS to improve its working with other groups, including the private sector and local communities, and to avoid “health imperialism” - issues need to be couched in people’s own objectives, and backed up with “hard-nosed economic arguments,” she said.

Turning to demands for Primary Care Trusts to have ring-fenced budgets for public health, she said that these are a hot subject for debate right now but warned that they could create problems. For example, a finite budget could suggest the ring-fenced amount was all that needed to be spent on public health, nor would it be tailored to local needs or outcomes-based. however, "we have to look at outcomes,” Dr Adshead stressed.