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.