Leaders: Prescription charges not tax on ill-health

The bill for the policy of free NHS prescriptions now stands at nearly 900m. Picture: TSPL
The bill for the policy of free NHS prescriptions now stands at nearly 900m. Picture: TSPL
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The National Health Service was founded in the UK in 1948 after the contentious issue of public health care had been debated for almost 100 years, despite it being recognised there was a clear need.

There had been fairly widespread state provision of health care in Scotland prior to this, but it was not universal. The key to the National Health Service was it was universal, available to all and free at the point of need.

It has grown to become the envy of much of the world and rightly so, because it delivers a fantastic service to people in need by dedicated expert professionals. In Scotland it employs around 150,000 people. The relief from suffering and the quality of life they can deliver is a direct benefit to millions.

But the world is a very different place today to it was in 1948. The advances in medicine and technology have proceeded at a faster rate than any could have forecast with beneficial effects on mortality and mobility. But this success is in itself the creator of a pressure on the NHS.

NHS Scotland chief executive Paul Gray, in his annual report for 2013-14, identified the demands his organisation faced and recognised that they will grow over the next few years as people live longer, with more complex conditions.

That means that difficult decisions have to be taken as there can be no endless supply of money. But it also means that every pound sent to the NHS can help in the alleviation of suffering.

Yesterday it was revealed that the cost of delivering the SNP’s government’s flagship policy of free NHS prescriptions increased by more than £30 million. The bill for the policy now stands at nearly £900m. The figures also showed a surge in the take-up of prescribed medicines since the SNP ended the charges in April 2011, when about 67,000 items were handed out.

Now, health secretary Shona Robison is right that people should not be denied prescription drugs because they cannot afford them and used the ­example of people paying up to £82 if they need at least ten prescriptions a year.

But that is missing the point. The point is that many families could afford that quite easily. It would make no noticeable dent in their annual income. And instead that money could go back in to the NHS.

SNP MSP Bob Doris, deputy convenor of Holyrood’s health committee, said the Scottish government’s free prescriptions policy was widely accepted by the Scottish electorate. Of course it is – give people something for nothing and they are generally in favour. But that is not responsible government.

Means-tested prescription charges are not “a tax on ill-health”. In many ways they are a very good way of taxing those who can best afford it and a way of leaving money in the National Health Service that will better benefit those in need.

Searching questions need answers

For police officers engaged in the difficult and often dangerous task of protecting the public and halting crime, the ability to stop and search is no doubt very valuable, and something that most officers in the front line would wish to keep.

The problem now, however, is that the over-use of stop and search – and the over-use of consensual stop and search, where people, sometimes children, are asked their permission for the search to take place – has caused controversy.

And that controversy was compounded when it was revealed that police officers continued to carry out consensual searches on children under 12 despite assurances that the practice had been stopped.

The bottom line is that the public need reassurance over police use of the power. So Police Scotland’s statement that there will now be a ban on using the practice on children under the age of 12 is to be welcomed.

Saying that there will now be “a presumption” against consensual stop and searches needs a ­little more attention. The difficulty with that is it leaves discretion down to the officer on the street, and there is no real idea what that would mean in practice.

Another worry, of course, was Her Majesty’s Inspectorate of Constabulary in Scotland saying that it lacked confidence in the data held by Police Scotland. ­Confidence in data must be high if it is to formulate controversial policies on the back of it.

So, given the controversy around this tactic, the statutory code of practice to be brought in – and the removal of stop-and-search targets – should be good moves, and hopefully will restore public confidence in this tactic.


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