AGE UK: Scrapping free prescriptions for over-60s "a kick in the teeth both for poorly older people and the NHS"

• Charity launches new campaign to save free prescriptions for 60-65s, warning it will put older people’s health at risk and pile pressure on the NHS if government plans go ahead

The Charity is launching its new ‘Save Free Prescriptions’ campaign in response to a new consultation that was pushed out by the Government last month and closes in just over two weeks’ time.^[iii][iii] It is extremely disappointing that a policy that could have such a significant impact on millions of older people is being consulted on over August and that it was published without much fanfare. The consultation puts forward proposals to increase the qualifying age for free prescriptions from 60 to the State Pension age, which is currently 66 for both men and women but is on track to rise further.

The Charity argues that this move is a #BitterPillToSwallow and could affect millions of people reaching 60 in the future unless they qualify for certain benefits or have a medical exemption,^[i] as well as those already aged 60-65 if the Government decides not to protect them. People will be particularly affected if their income is modest but takes them just above the benefit line. It also penalises people in poor health and in need of multiple medicines because they are managing several serious long term health conditions, like heart disease or hypertension – one of a number of conditions which are more prevalent among Black African and Black Caribbean ethnic groups^[iv][iv] - though surprisingly the Government’s Impact Assessment fails to look at whether their proposed policy will have a disproportionate impact on ethnic minority groups.

Age UK is worried that scrapping free prescription charges for 60-65 year olds is likely to exacerbate existing health inequalities and have a devastating impact on many people’s health, especially if they are hard up but have incomes above the benefits line. The Charity is deeply concerned that this is the age at which the chance of living with one or more long-term conditions significantly increases, so people are much more likely to need to take multiple medicines. With many already struggling to meet basic living costs, this levy on poor health could prevent them from managing their conditions.

The Charity fears that some in this position may be reluctant to act on symptoms, seek medical advice or get a diagnosis, for fear they will be unable to afford long term, symptom relieving or even in some cases lifesaving medication.

The Government’s response is that these people could buy a certificate to cut their costs, at £108.10 a year.^[v][v]However, this ‘Prescription Pre-payment Certificate’ (PPC) requires either up-front payment or setting up a direct debit, something which many older people may not be able to afford. Age UK is concerned that awareness of the PPC is already low with 27 per cent of ‘high users’ aged 55-59 – those who need more than 12 prescriptions a year – currently not using a PPC. If the same percentage is assumed for the 60-65 age group, this equates to 240,000 people who would be paying too much for their prescriptions.^[vi][vi]

The Charity argues that it is also not helpful for older people that experience short, unexpected episodes of illness, during which they may need multiple medicines, to recover and subsequently face a large bill for their prescriptions. Additionally people may panic-buy a PPC and ultimately not need it. In the 55-59 age group 15 per cent of ‘low users’ – those who need less than 12 prescriptions a year – have bought one unnecessarily and wasted money. If the same percentage is assumed for the 60-65 age group, this equates to a further 210,000 people who would be over-paying.^[vii][vii]

Sandra, in her 50s, contacted Age UK this month to raise her concerns about the Government’s plans. She said: “I will soon be 60. I spend £9 odd on one item of medication. At the moment I am afraid to tell the doctor of my added illness as I cannot afford the prescription price and barely manage my health issues with the medication I have.”

Barry, in his early 60s, also got in touch with Age UK to express his concerns about the proposals. He said: “Having been forced into retirement seven years ago due to a stroke, my income dried up and my savings have long-since gone, without free prescriptions I would almost certainly opt to miss some medicines thereby possibly making myself ill.”

In its impact assessment, though not in the consultation document itself, the Government says that its preferred option is to introduce the policy change gradually so anyone currently aged 60-65 when it comes in will not lose their entitlement to free prescriptions. But the Charity is concerned thateven if the Government sticks to this, and there’s no guarantee it will, many millions of future 60-65 year olds will still have to pay for their prescriptions, unless they qualify for an exemption. The current list of exemptions is quite ad hoc and protects people with some conditions, such as diabetes, but not others, such as asthma.

Caroline Abrahams, Age UK’s Charity Director, said: “This proposed policy is a kick in the teeth, both for poorly older people and the NHS. It is also extremely ill-judged, because the money the Government will save by scrapping free prescriptions for 60-65 years olds will almost certainly be outweighed by the additional costs to the NHS, if people fail to take their medication because they can’t afford it and become ill.

“We are already hearing some older people on multiple medicines saying they will have to choose which ones to drop, and others are expecting to ration how much they take. The problem is that treatments don’t work like that: if the prescribed dosage says one tablet every day it may not work at all if you only take it every two or three days.

“This policy proposal seems all the more unfair because prescriptions are free for everyone in Scotland and Wales. There’s a strong public health case for heading in that direction here in England too. Instead, our government wants to do the opposite: make many more people pay for their medicines, and at an age when it’s all the more important they take them, to control conditions that left untreated can lead to really serious medical problems, piling more pressure onto the NHS. If ever there was a self-defeating policy this is it, and we know that many medical experts agree with us.

“If someone in this age group decides their best option is to buy a Pre Payment Certificate every year it would cost them more than £600 in their run up to retirement, so from that point of view this really is a stealth tax on older people. However, it’s also clear that some could end up paying a lot more than that, because awareness of these Certificates is quite low, and that others could buy one and then find they would have been better off without it. This seems really unfair.

“Essentially we think this is a terrible proposal that deserves never to see the light of day. We hope that thousands of people will respond to the Government’s consultation and tell them so in no uncertain terms. Ministers definitely need to think again.”

Dr Eva Kalmus, Co-chair, British Geriatrics Society GeriGPs Group, said: “People aged between 60 and 65 are often prescribed medication for long-term conditions which they will take for many years. Introducing prescription charges for this group is likely to result in some of this age group not taking their medication and will deliver minimal savings for the NHS. It may even cost the NHS more in the long term when complications or disease progression occur which medication might have prevented.”

Age UK is urging people of all ages to save free prescriptions by responding to the Department for Health and Social Care’s consultation – visitwww.ageuk.org.uk/savefreeprescriptions

-Ends-

Notes to editors

^[viii][i] ONS mid year population estimates for 2020 show that there are 3.8 million people aged 60-65 in England (accessed here:https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/populationestimatesforukenglandandwalesscotlandandnorthernireland). The Government’s Impact Assessment (accessed here:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/996781/impact-assessment-upper-age-prescription-exemption.pdf) says that 95% of people aged 60-65 use at least one prescription a year, equivalent to 3.6 million people, and that 34% of these prescription users would retain exemption from prescription charges following the proposed policy change. We therefore estimate that 2.4 million people aged 60-65 (66% of prescription users) will need to pay for prescriptions following the proposed policy change.

^[ix][ii] https://www.gov.uk/government/consultations/aligning-the-upper-age-for-nhs-prescription-charge-exemptions-with-the-state-pension-age

^[x][iii] Ibid.

^[i] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/996781/impact-assessment-upper-age-prescription-exemption.pdf

^[xi][iv] People from Black African and Black Caribbean ethnic groups have a higher risk of hypertension than the general population (See here: https://www.gov.uk/government/publications/health-matters-combating-high-blood-pressure/health-matters-combating-high-blood-pressure)

^[xii][v] https://www.nhs.uk/nhs-services/prescriptions-and-pharmacies/save-money-with-a-prescription-prepayment-certificate-ppc/

^[xiii][vi] Age UK estimate based on ONS mid-year population estimates for 2020 and data from the Impact Assessment. We assume that the same proportions of 60-65 year-olds as 55-59 year-olds do not buy a PPC which would help them to save (27% of ‘high users’). We estimate that there would be 1 million ‘high users’ subject to prescription charges in the 60-65 group and we are therefore able to estimate that 260,000 ‘high user’ 60-65 year-olds would not buy a PPC that would have helped them to save.

^[xiv][vii] Age UK estimate based on ONS mid-year population estimates for 2020 and data from the Impact Assessment. We assume that the same proportions of 60-65 year-olds as 55-59 year-olds buy a PPC when this will not enable them to save (15% of ‘low users’). We estimate that there would be 1.4 million ‘low users’ subject to prescription charges in the 60-65 age group and we are therefore able to estimate that 210,000 ‘low user’ 60-65 year-olds would buy a PPC that would not enable them to save, in addition to the 260,000 ‘high user’ 60-65 year-olds who would not buy a PPC that would have helped them to save (as above ^vi). Subsequently there would therefore be an estimated 470,000 60-65 year-olds paying more than they needed to for their prescriptions.