Tuesday, 5 April 2011

Unfair taxes and the myth of a “National” Health Service.

For most people in the UK there is the myth of a National Health Service when in fact there are 4 nation’s worth of health services. This subtlety is wasted on Jo Public for as long as they get to see a doctor for free they cannot be bothered (ar*sed) by the politics.

One of the first NHS charges to be introduced was the prescription charge and one of the team who is quite old remembers hearing a doctor talk about the early days of the NHS when everything was free saying that doctors would actively conclude with patient’s requests for medicines because no-one had to pay for anything then. The story we recall was someone asking for a bandage for a limb injury and then because this was a common injury could they have 9 more just in case and the doctor said they used to give in.

An item on the BBC News reminded us of the fact that English prescription charges will go up to £ 7.40 per item from the 1st April this year while in the other 3 nation health services you do not pay the tax.

However how many people actually pay the tax? The BBC report says that 90% of prescriptions are dispensed for free anyway and from memory this has in one of our professional lifetimes increased from 80% to 85% so 90% was an eye opener.

So who doesn’t pay? Well the 19% of the population under sixteen and the 16% per cent over 65 (should be 60 and over) eliminates at one fell swoop at least 35% of the population. Add in those on low incomes, those on benefits of various types, those between 16-18 in full time education, those with certain medical conditions and pregnant do not and the number available to tax falls very rapidly indeed.

It is a very fair tax as the full time GP writing this is exempt from the tax while the medical students with us with huge debts in their final year are paying it. No tax is fair but clearly some taxes are fairer than others based on the ability to be charged not on the ability to pay or on clinical need. We are sure this was one of the NHS founding principles.

We are currently being governed by a Party committed to a “market” of some description in healthcare but do those who pay the prescription charge get a free market choice?

The answer is an emphatic No you don’t for two good reasons.

One you get no choice as to where you can get your NHS prescriptions dispensed. You can take it to any NHS pharmacy pay your tax to the Government tax collector, the pharmacist, who then pays the Government and you get your drugs.

Reason two is because this is a State monopoly the price is fixed. We are grateful for some colleagues who work in a dispensing practice for the following prices which we have rounded up to the nearest 10s of pence.

Suppose you have a chest infection and are given a prescription for an antibiotic called Amoxycillin for a week you now pay £ 7.40 for your treatment. The pharmacist can buy the drug for £ 0.40 wholesale.

Now let us say the chemist could do as used to be done add 100% mark up and a £ 2.00 dispensing fee to cover the costs of bottles, labelling, staff etc. you could push the cost up to a hefty £ 2.80 as a commercial transaction but for the Party this is a steal at a mere £ 7.40.

Supposing you have a heart condition and are on the following drugs: Aspirin, Amlodipine and Simvastatin the wholesale cost of all 3 would be about £ 1.80 but the Party will be screwing you for £ 23.20 a month although you would if you have more than 2 items per month be better off with the prepayment option which comes from this website site euphemistically called NHS Business Services Authority or should it be the State Servicing its own Business Authority?

Many years ago doctors in some parts of the UK used to write private prescriptions for their patients so that they could get the same drugs cheaper than the then prescription charge. Now no Party, however benevolent it is to its tax payers, likes losing revenue currently about half a billion creamed off the 10% of prescription charge taxpayers (like our medical students) and they made it so that if you as a doctor treat a patient under the NHS you have to issue them with a NHS prescription regardless of the cost of the drug.

So GPs who know the cost of drugs (look at your doctors prescribing screen where wholesale costs may pop up) are actually issuing patients with expensive prescriptions for a few pence worth of drugs. We like the NHS free market here at ND Central it is so fair and free just like the NHS Internal Market.

Jo Stalin’s boys in all political parties have kept the red flag and Soviet market system going in all its glory for the benefit of those 10% in England allowed to pay this tax.

So if next time you pay for your NHS prescription why not ask your pharmacist how much the drugs actually cost to buy and then ask your MP to explain the “market” within the NHS. Go on have a laugh there could even be a competition for the best MP’s explanation.

If any of them understood it in the first place.

Praise be to the Party for unfair taxes, the truth about the “National” Health Service and “free” market economics. They are all so good at all three.


Witch Doctor said...

Perhaps GPs could programme their compputers to write a little sum at the end of each prescription in large font, bold red print, indicating the cost price of the individual drug to the pharmacist / dispensing practice. Or maybe a handout the patient could keep for annual audit purposes of personal medications would be better.

It would work both ways. The patients on “free” treatment would become aware of the benefit they were receiving and the others would be able to decide for themselves whether they were being fleeced.

Yes, this would be a witch’s approach to prescribing! No government could ever object to GPs initiating such a transparent endeavor.

Could they?

HyperCRYPTICal said...

I pay for my prescription. My copy of the BNF (2008)would indicate that I am not being fleeced (now). However, the suprise of the pharmacist that I actually pay(!) and admissions that dressings I purchase (for my old fart) are available for a lot less than quoted in my (old) BNF would indicate that I am!

Dearly beloved (the old fart) receives a carrier-bag full of drugs per month. If not for a condition that entitles him to free prescriptions - total monthly bill would run at £44.40.
This despite the fact that he cannot work through a chronic (eventually) terminal condition.

Praise be to the Party for allowing conditions that exempt him from prescription charges.

Anna :o]

eye lift said...

So informative blog, it actually exposed that unfair taxes on eye health department issues.

Anonymous said...

well I guess that's why many pharmacists see a prescription for aspirin or other drugs that may be sold without a prescription will offer to sell it instead (75p) and dispense the other items on the prescription if you pay.

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