Revealed:The chaotic free prescription and dental treatment scandal

An example of an attempt to check whether you are entitled to a free prescription by Trent Valley Surgery

If you are under 60 and over 16 do you know when you can get a free prescription and free dental treatment? No, if you don’t you are in good company and if you claim could even be one of 1.7 million people in England falsely sent a £100 penalty by the NHS.

A absolutely scathing report out today from MPs on the Commons Public Accounts Committee today describes the whole system for regulating free prescriptions and dental services as ” not fit for purpose “.

It reveals that despite a so called 24 page ” simplified ” guide telling you when you qualify most people are completely confused and rightly so.And if you get it wrong you are automatically guilty of fraud and get a £100 penalty fine rising to £150 if you don’t pay it promptly.

The report said :” Exemptions from prescription and dental charges include age, maternity, receipt of certain means-tested benefits, low income, and long-term medical conditions in some cases, although we are told that this list of long-term conditions has not been updated for 50 years [YES 50 YEARS -my point] save the addition of cancer in 2009. “

Worse qualification for a free prescription does not automatically qualify you for free dental treatment. And if you are on Universal Credit your right to claim will vary from month to month depending on your income.

The report says : “There is currently no way of indicating receipt of Universal Credit on prescription forms, resulting in more confusion, and the Department for Work and Pensions does not confirm eligibility when they write to claimants about their confirmed benefit entitlements.”

The result of all this chaos is that since 2014 no fewer than 5.6 million penalty notices have been issued and 1.7 million have had to dropped once the person challenged it because it was found out they were entitled to claim.

Naturally the threat of penalities has made vulnerable people more frightened of going to the dentist for essential treatment in case they were fined and to get prescription medicines.

Worse the policing of the system to prevent fraud has been an abysmal failure. The report found “nearly 115,000 people have received five or more PCNs [penalty notices] for prescriptions, over 1,600 have received 20 or more—yet only five cases have been referred to the Crown Prosecution Service. Only one has been heard in court ” Yes that it right one court case.

And anyway the NHS does not have a proper system for collecting the debt – relying in part on Capita.

The MPs said: “The PCN process generated a net yield of £25 million for the NHS, a pitiful sum compared to the annual cost of prescriptions which is around £9 billion. We do not dispute that it is right to try and deter fraud and recover costs mistakenly paid by the NHS, but the current system is not fit for purpose.

Now there is a simple high tech solution to check prescription entitlement in real time – and the government is committed to eventually introducing a computerised system. It is trialing one now in just four chemists. How pathetic is that.

Meg Hillier, chair of the committee, makes some very pertinent points .

Patients find it very confusing to understand whether or not they can claim free prescriptions or dental treatment because of a convoluted system that causes patients, in some cases, distress.

“A presumption of guilt means penalty charge notices are issued too readily, particularly where vulnerable people are concerned. Yet where there is clear evidence that people are persistently committing fraud by making false claims, there has been a failure to take effective action.

The Committee fully support efforts to deter fraud and pursue those who claim exemptions to which they are not entitled to but the current penalty notice system is cumbersome, inefficient and not fit for purpose.

The Department should substantially overhaul the system, so that those who are rightfully entitled to free prescriptions and dental treatment get the exemption they deserve.”

Over to the NHS to sort out this scandal – one among many. MPs want to call officials back next year to explain how they have solved it.

Theresa May’s mental health act reform: Warm words but scant action

CROSS POSTED ON BYLINE.COM

You may well have missed it under the Brexit deluge but Theresa May announced a major reform of the Mental Health Act this month – the first for 30 years.

Sir Simon Wessely, a tame report on reviewing the mental health act

She had commissioned Sir Simon Wessely, Regius Professor of Psychiatry at King’s College London and president of the Royal Society of Medicine to examine the legal state of Britain’s mental health system.

His report came out earlier this month. Frankly it is full of warm words but proposes scant action and dumps the problem of better treatment for mental health patients on the NHS.

The good part of his report is that it does give better rights for patients held under community treatment orders. and some useful changes when mental patients die in police custody including restoring non means tested legal aid to challenge the authorities.

The bad part of his report is that it fails to offer a solution to what is one of the most glaring problems in the mental health service – the vast number of Afro-Caribbeans who are sectioned compared to the majority white population.

It acknowledges it exists and in his introduction Sir Simon Wessely quotes the view of one ethnic minority person who told him “for a black person, a psychiatric hospital is seen as the place where they drug you up, and at worst even kill you”.

He goes on to confirm that nothing much has changed in 30 years.

“it is sad to record that little has changed. There does appear to be more consensus that this increase is real, and not an artefact, and also that it is related to experiences of discrimination, exclusion and racism. There is also consensus that even taking this into account, the use of coercion is far greater in this population, finding its most painful expression in the statistic that those of black African or Caribbean heritage are over eight times more likely to be subjected to Community Treatment Orders than those of white heritage. In other words, too often and in too many areas the experiences of those of black African and Caribbean heritage is one of either being excluded or detained.”

He then admits institutional racism exists even if it is unconscious but the main body of the 307 page report does not address the issue of why psychiatrists accept that Afro-Caribbeans are eight times more likely to be schizophrenic or suffer from psychosis than anyone else. Nor does it propose any remedies for this particular problem. You can read the report via this link.

institutional racism

As Suman Fernando,a psychiatrist and author of a major work on institutional racism , put it:

Suman Fernando. Pic credit: http://www.sumanfernando.com

” The first question to be asked is whether this report would have had the same approach to ‘race’ if the victims of institutional racism had not been ‘black and minority ethnic’ people but a white minority / majority group?   The issue here is about white privilege and power. And the question arises as to how this systemic failure of an official report has come about.  Second, who carries responsibility for the failure of this report to have race on its agenda for change? “

He concludes:” This Review has raised false hopes in the minds and hearts of many black people “

Consultations on this report will begin in the New Year with legislation to follow. But it will get nowhere without a big commitment to resources and a change of culture and attitudes by psychiatrists treating patients.

As Norman Lamb, Liberal Democrat health spokesman put it: “In the Government’s response to the Review, there must be a commitment to invest more money to support those at crisis point and help people before they reach crisis point. The Conservatives to date have failed to adequately invest in Mental Health. Without strong goals and commitments from the Government, rising detention rates will not be adequately challenged.”

tame conclusions

My conclusion is that both Theresa May and Simon Wessely are speaking from the same song book. They are prepared to speak warm words about the problem but are not prepared to take radical action to solve it. No wonder he can calmly state that no political influence was brought to bear on the report. It wasn’t necessary given its tame conclusions.