Something rather bizarre will happen in Wales tomorrow. In a move to see off 'prescription tourism' before it happens, the Welsh Assembly will introduce measures to stop English residents crossing the border to take advantage of the lower prescription charges which prevail in Wales. Only prescriptions issued in Wales will be eligible for the lower Welsh pricing system.
At the moment, prescriptions cost £6.50 per item in England. In Wales they are £4, will be cut to £3 next year and will be free of charge for everyone at point of use from April 2007.
Welsh Health Minister Brian Gibbons says: 'Free prescriptions for all is the simplest and most effective way of resolving inequalities and inconsistencies in prescribing which have existed since the rules were established in 1968.
'To introduce exemptions for certain groups would be complex to introduce and implement. Our proposals are straightforward and effective. This way everyone, be they chronically ill or low-paid, benefits.'
There is 'little evidence of prescription tourism to date', according to the Welsh Assembly, but 'as prescriptions get cheaper, the risks will increase'.
The differential pricing system between England and Wales is another example of the way the devolved governments are managing to offer direct help to their local communities. The provision of free personal care in Scotland (charges are levied for this in England) is another example. Wales would like to offer free care but does not have the legal powers to order this.
Half the population - including people aged 60 and over - already get free prescriptions in England. But because the exempt groups are such high users of prescriptions, only 14 per cent of the 650 million prescriptions written out a year are paid for.
Citizens' Advice is particularly concerned about the fiftysomething age group. While across all ages we average just over one prescription a month, in England that average rises significantly as people get older. So fiftysomethings are the heaviest users who pay for themselves.
Some changes to the prescription charging system last year 'reduced some of the worst injustices', says Liz Phelps of Citizens Advice. But that leaves some people 'struggling to pay and some choosing between medicines'. The National Pharmacy Association, like Citizens Advice, wants England to follow Wales in chopping charges. 'We know that prescription charges deter many people from getting the medicines their doctor prescribes,' says chief executive John D'Arcy. 'Sufferers from chronic conditions such as asthma, cystic fibrosis and multiple sclerosis risk their lives because they cannot afford the treatment.'
Wales has calculated that it saves itself money in the long run by giving free prescriptions to all - since it will avoid the costs to the NHS of tending people who became ill because they could not afford the prescription.
Healthcare researcher Laing and Buisson thinks giving free prescriptions to all at point of use could have a 'big impact' on the number of prescriptions requested. But we can only guess right now. 'There are a lot of complex dynamics,' says L&B.
