Health authorities across England are piling the pressure on GPs to limit the number of drugs dispensed per prescription, in what some are calling a 'stealth tax on the sick' designed to cut costs rather than boost efficiency.

Reports of regular prescriptions being cut from 56 days' supply to just 28 are growing, after some Primary Care Trusts reportedly issued new guidance to GPs encouraging them to dish out smaller batches of medicines to certain patients, effectively forcing them to pay more for their treatment.

The Patients Association has slammed the move. It claims that, with the recent rise in prescription charges in England of 20 pence to £7.40, many patients who need multiple prescriptions long term will have to shell out more and more often, and those who are particularly frail will have the added burden of extra visits to the pharmacists to pick up their medication. 

"We were told by the government that the National Health Service would need to make savings and this would not affect frontline services and patients. But here we have an example of where patients who are the most ill and vulnerable are being hit with extra costs," the Association said.

Patients at risk

The group said it is concerned that some patients may be put off going to their doctor or even ration their medication so they don’t have to get as many prescriptions. This, it warns, could put patients’ wellbeing at risk. 

David Stout, director of the Primary Care Trust Network, has defended the plans, denying that they constitute a back-door means of cutting costs. 

"The idea is to avoid waste. A parliamentary accounts committee estimated something like £100 million a year is wasted on medicines that never get used," he explained, according to BBC.

The move has also reignited the debate over the fairness of prescription charges in England, which pull in more than £450 million for the NHS, equivalent to the salary costs of nearly 18,000 nurses, while patients living in Wales, Northern Ireland and Scotland do not have to pay.

The Department of Health argues that the majority of prescriptions - around 90% - are free anyway, because of the extensive list of exemptions.

Scrap charges

But the British Medical Association has called for charges in England to be scrapped, given that the current system is "a chaotic and unfair mess" which "contributes only a modest amount to the NHS budget and does not offset the unfair disadvantage of asking the ill to pay for their medicine." 

The Patients Association has now also urged the government to rethink the increase in prescription charges, and has called on PCTs to stop reducing the length of time prescriptions can be provided for, as "these moves are having unintended consequences that are detrimental to patients".