NEWS
PRESS RELEASE
29 January 2007
Charge for some NHS procedures - but make most prescriptions free, say Public Health doctors
Most prescription charges in England should be scrapped, say public health doctors. But some treatments now free, like tonsil removal and varicose vein surgery, should be charged for, they say.
Dr Tim Crayford, President of The Association of Directors of Public Health, said:
"Medicine and treatment that people need for health reasons should be free. But things that people want , where there's little proof of clinical benefit, ought to have a price tag attached.
"The NHS has always struggled financially to meet public expectations, and this proposal would help the NHS ensure that the most people in most health need get the treatments they require.
"89% of prescriptions are free as it is, and there's no logic on health grounds to charge people for the remaining 11%, except for everyday medicines like aspirin and paracetamol, where charges should remain. It seems unfair to charge for highly effective drugs like Statins to lower cholesterol and prevent heart attacks, whilst not charging for some treatments that offer much smaller benefits to people.
"Taking children's tonsils out, for example, makes very little difference to how many days they have off school or how many sore throats they suffer from. And there's strong evidence that, for many people, it's better to avoid surgery on uncomplicated varicose veins.
"If people had to contribute to the cost of these things, they would think twice before going ahead. There's often an alternative, which is much less costly. For heavy menstrual bleeding, for example, a coil can often be effective and, if so, it's far preferable to a hysterectomy.
"There's no consistent approach to this across the country. Every primary care trust makes its own decisions. Let's have a public debate about what should be charged for and then apply a common framework across all 150 PCTs.
"The savings to the NHS by charging for doubtful procedures could easily compensate for the revenue lost by making most prescriptions free."
The ADPH considers that the following procedures are too widely used given their clinical effectiveness:
- surgery on minor skin lesions
- tonsillectomy and adenoidectomy
- varicose vein surgery
- carpal tunnel surgery
- hysterectomy for heavy menstrual bleeding
- homoeopathy.
Evidence is contained in work conducted by The London Health Observatory working with London PCTs.
ENDS
Note to Editors:
The Association of Directors of Public Health (ADPH) is the representative body for Directors of Public Health in the UK . It seeks to improve and protect the health of the population by facilitating the sharing of good practice and presenting the views of Directors of Public Health on public health policy to national governments. www.adph.org.uk .
To interview Dr Tim Crayford, or for further information, call Ron Finlay, ADPH Press Office, on 020 7544 3011 or 07779 013093 or email ron.finlay@fishburn-hedges.co.uk.