The government has rejected calls for people in England who suffer from long-term conditions (LTCs) to be eligible for free prescriptions.

The call came in Parliament from Sir Bob Russell, the Liberal Democrat MP for Colchester, who pointed to the "terrible unfairness" faced by people with LTCs who have to pay prescription charges for drugs to treat their conditions. The cost of prescribing their treatments for free would be modest compared to the "huge sums" involved in treating "self-inflicted body abuse" such as the consequences of smoking, alcohol abuse and illegal drug-taking, said Sir Bob, and he asked: "why does the NHS treat those who are guilty of abusing their body better, in financial terms, than those to whom mother nature has given serious health conditions?" 

It is also a matter of considerable concern that many people with LTCs are not collecting to taking their medicines effectively, largely because of cost, he went on.

Many patients are having to split tablets in half, miss doses or substitute "cheaper but less effective alternatives to eke out medication until pay day," said Sir Bob, adding: "inevitably, individual health suffers and there are numerous knock-on effects."

A recent survey found that more than one third of patients who pay for each prescription had not collected at least one item because of the cost, he said, and the Royal Pharmaceutical Society (RPS) has reported that pharmacists are often asked: "which of these prescriptions can I do without?"

However, Health Minister Anne Soubry responded that "the simple truth is" that extending the exemptions to all LTCs would cost a considerable amount of money, "and there is no money."

"We have to be completely realistic and honest about the situation in which we find ourselves," she said, and also pointed out that, in 2011, about 94% of all prescription items were dispensed free of charge, and that some 60% of people in England are exempt from charges. Also, the cost of the annual prescription prepayment certificate has now been frozen at £104 for the past four years, and the cost of the three-monthly certificate at £29.10 for two years.

Ms Soubry, who is Conservative MP for Broxtowe, also told the House that she is an asthma sufferer and that her "outstanding" GP has made sure her medication is at such a level that she does not now need a prepayment certificate, "because we are managing my condition."

Sir Bob also suggested that the 28-day prescribing limit for people with stable LTCs on regular maintenance medication should be scrapped immediately.

'Having to make monthly trips to the doctor and pharmacist for repeat prescriptions is a further and unnecessary inconvenience that means extra cost and additional distress," he said, and urged clinical commissioning groups (CCGs) to consider carefully the need for individual prescribing for optimal treatment plans and “avoid the rigid 28-day limit."

He added: "please may we have central guidance from the Department of Health?"

But Ms Soubry responded that ultimately, decisions regarding prescribing, including repeat prescriptions and the duration of prescriptions, have to remain with GPs and other doctors.