Belfast Telegraph

Bill for free prescriptions soars to £440m in Northern Ireland

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By Gareth Fullerton

Health officials have been urged to review free prescriptions in Northern Ireland, after the cost of meeting demand spiralled to £440m last year.

Over 40 million items were dispensed in 2015 - a staggering 111,000 every day.

The bill has risen by over £30m in the past three years alone.

All primary care prescriptions have been free in Northern Ireland since April 2010, a move that was hailed as "an end to taxing the sick".

But while patients continue to benefit from the service, some have warned that a combination of free prescriptions and rises in drug prices is contributing to a significant cost to the taxpayer.

In the last three years the cost of free prescriptions topped £1.2bn - rising from £409.02m to £440.44m between 2013 and 2015.

The figures were released by Health Minister Michelle O'Neill after an Assembly question from UUP MLA Jo-Anne Dobson.

Ms Dobson said: "The cost of prescribing, sitting as it does at over £440m for 2015, is greater than the yearly budget of some Stormont departments.

"A rise in the cost of prescriptions in the last three years of over £31m is significant and I encourage the Health Minister to continue to promote and fund alternative therapies to prescribing - therapies which in many cases deliver better results."

Ms Dobson said her party remained "fully committed" to free prescriptions for the sick, but called for a review into the list of eligible items available to patients.

More than £2m was spent in Northern Ireland on prescriptions for paracetamol in 2014, while in 2013 more than 32,000 prescriptions were dispensed for nappy cream Sudocrem - costing the taxpayer over £122,000.

"The Ulster Unionist Party remain fully committed to free prescriptions as we believe that a charge on the sick, as was previous advocated, to pay for the sick, would be unfair," she added.

"There should, however, be a review conducted into the list of eligible items for prescription to ensure that only those items which are medically needed are those which are being prescribed."

Former Health Minister Jim Wells believes there is "no easy answer" to the issue of prescription charges.

The DUP MLA had called for the reintroduction of charges in January 2015 when he was Health Minister, with money raised helping to pay for a new specialist drugs fund.

And while he admits the latest figures represent a "huge amount of money", he believes the cost of giving out free prescriptions could be far greater [for the taxpayer].

"The number of free prescription items being dispensed is increasing, but I think the overall cost isn't as high as many people predicted," Mr Wells said.

"But it is still £440m. It is a huge commitment each year which has to be met.

"I advocated a small charge for prescriptions when I was Health Minister.

"That was put under consultation and then Simon Hamilton became the minister and there appeared to be concerns over the reintroduction of charges, so the department then didn't go ahead with the proposals."

Mr Wells said he believed charging a small fee would make people think twice about asking for prescriptions.

"The idea was that if you put a value on something, then it makes people think twice," he added.

"An example is the plastic bag charge, which saw an 80% reduction in the use of plastic bags after a 5p charge was introduced.

"Healthcare is far more important than plastic bags, but it gave an indication that when something has a price on it then demand is reduced.

"I think there was concern among doctors and GPs that if you charged for prescriptions, then some people wouldn't pay for their medication, which would be detrimental to their health, and they could end up in hospital.

"There was the worry that people would miss out on vital medicine. The flip-side of the argument is that if prescriptions are free, then there is always the threat of people abusing the system.

"The other danger with free prescriptions is that there can be a lot of waste. People end up with various medicines and tablets which they don't use and run out of date, and they end up being thrown out.

"So there are a lot of pros and cons with regards to free prescriptions, and there doesn't seem to be an easy answer. The key is trying to keep the cost under control.

"The healthcare budget will continue to rise, and the current Health Minister, Michelle O'Neill, has said that if that continues then by 2020 health will take up 20% of the entire budget.

"That won't be allowed to happen, but it shows you the direction the figures are heading."

Despite the concerns, a leading doctor believes the introduction of free prescriptions in 2010 has proved a success in Northern Ireland.

Dr Tom Black, chair of the British Medical Association's NI General Practitioners Committee, said doctors were mindful of the cost.

"GPs have been working incredibly hard over the past couple of years to constrain the costs of free prescriptions," he said.

"They have been looking at ways of providing the most cost-effective medication to patients, and I think it has been very successful. Is it sustainable? Yes, I think it is.

The figures represent 10% of the health budget and it is proving to be effective. It is our duty to make sure costs are controlled as best we can, and I think we are doing that.

"When people had to pay for prescriptions there were a large number of exemptions anyway, and you start delving into issues such as equality and maybe some patients not being able to access free treatment."

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