The official population of Wales is 2.9 million, but 3 million people are now registered with general practitioners in the country, as English people living near the border register with Welsh doctors in order to avoid paying the £7.10 prescription charge, Welsh Conservatives have claimed.

Welsh National Health Service prescriptions have increased 5% since the national Assembly abolished prescription charges in April 2007, and opposition Assembly Members claim this has led to what they term “medical apartheid” or “prescription tourism” from England.

But First Minister for Wales Rhodri Morgan defended the policy stoutly during a heated Assembly debate on the issue last week, telling the Conservatives that their claims were “lunatic” and that the policy was not being abused. To Liberal Democrat health spokeswoman Jenny Randerson, who has also strongly opposed the policy, Mr Morgan said: “Accept that free prescriptions has happened. It's a success. You didn't like it, you continue not to like it, but for God’s sake use some sensible arguments.”

Assembly officials said the discrepancy in the population figures was a long-standing problem and due mainly to people registering with a new practice before deregistering with their old one.

Of the four UK nations, only England seems set to retain its current system of prescription charges and exemptions, despite calls for change. In April, after English prescription charges rose 25p, the Royal Pharmaceutical Society of Great Britain described the present system as “illogical and unfair” and called for an urgent review. There is also a case for abolishing prescription charges altogether, although the implications of doing so would be considerable, said Paul Bennett, chairman of the Society’s English Pharmacy Board. However, the Department of Health says that prescription charges provided a “valuable” £430 million to the NHS in 2006-7, and that abolishing them would significantly reduce the money available to deliver other health priorities.

Northern Ireland froze prescription charges this April and Health Minister Michael McGimpsey says he is considering “a range of options” for their future. Also in April, Scotland reduced the charges 25% as part of a gradual process towards abolishing them altogether by April 2011, and has set aside £20 million for this year, £32 million for 2009, £45 million for 2010 and £57 million for 2011 to cover the cost of the increase in prescriptions, which is expected to be 1% each year until 2011, when a 5% increase is forecast.