UK Prescription Charges and Dementia

Alzheimer’s Disease International posted the following on Twitter on Wednesday:

“ADI calls for placement of anti-dementia drugs on WHO Model List of Essential Medicines after French Ministry of Health announces end to reimbursement of four anti-Alzheimer drugs. ADI calls for fair and equitable access to Dementia care.”

Along with this Link.

This got me thinking, I have Dementia and I pay for a Pre-Payment Certificate for my prescriptions. So I looked into it more, as when I rang last year, I was told I didn’t qualify for medical exemption. This is what I found:

In England, Scotland and Northern Ireland, you can get free NHS prescriptions if, at the time the prescription is dispensed, you:

  • are 60 or over
  • are under 16
  • are 16-18 and in full-time education
  • are pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx)
  • have a specified medical condition and have a valid medical exemption certificate (MedEx)
  • have a continuing physical disability that prevents you going out without help from another person and have a valid MedEx
  • hold a valid war pension exemption certificate and the prescription is for your accepted disability
  • are an NHS inpatient

You’re also entitled to free prescriptions if you or your partner – including civil partner – receive, or you’re under the age of 20 and the dependant of someone receiving:

  • Income Support
  • Income-based Jobseeker’s Allowance
  • Income-related Employment and Support Allowance
  • Pension Credit Guarantee Credit
  • Universal Credit and meet the criteria.

If you’re entitled to or named on:

  • a valid NHS tax credit exemption certificate – if you don’t have a certificate, you can show your award notice; you qualify if you get Child Tax Credits, Working Tax Credits with a disability element (or both), and have income for tax credit purposes of £15,276 or less
  • a valid NHS certificate for full help with health costs (HC2)

People named on an NHS certificate for partial help with health costs (HC3) may also get help.

Looking into the Medical Exemption Certificate I found:

You can apply for a medical exemption certificate if you have one of the following medical conditions:

  • a permanent fistula (for example, caecostomy, colostomy, laryngostomy or ileostomy) which needs continuous surgical dressing or an appliance
  • a form of hypoadrenalism (for example, Addison’s Disease) for which specific substitution therapy is essential
  • diabetes insipidus and other forms of hypopituitarism
  • diabetes mellitus, except where treatment is by diet alone
  • hypoparathyroidism
  • myasthenia gravis
  • myxoedema (that is, hypothyroidism which needs thyroid hormone replacement)
  • epilepsy which needs continuous anticonvulsive therapy
  • a continuing physical disability which means you cannot go out without the help of another person
  • cancer and are undergoing treatment for either:
    – cancer
    – the effects of cancer
    – the effects of cancer treatment

These are the only conditions that entitle you to a medical exemption certificate. If you’re not sure about the name of your condition, speak to your doctor.

Source: NHS Choices Website

So, Dementia is not covered. But in Wales, since 1 April 2007 prescription medicine has been provided free in Wales. All patients registered with a Welsh GP who get their prescriptions from a pharmacist in Wales are eligible.

“We firmly believe by providing people with the medication they need helps to keep them well and out of hospital, thereby reducing the overall cost to the NHS. It should never be the case that people with serious chronic conditions can not afford to collect their prescription.”
 
“Ensuring patients have the medication they need not only improves their own health and wellbeing, it also benefits the health service as a whole by reducing hospital attendance and placing fewer demands on general practitioners.”
 
“It is socially irresponsible to charge people with serious chronic conditions for the medication they need. Free prescriptions are progressive and an integral part of our health services in Wales.”
Source: Welsh Government
Dementia is a chronic disease as is Cancer, Diabetes, Myasthenia Gravis but the above terms for exemption may go against the Equality Act 2010, which makes it illegal for people to be treated less favourably because of a range of conditions including disability and the UN Convention on the Rights of Persons with Disabilities (CRPD) recognises Dementia as a Disability.
The UN Convention defines persons with disabilities as including ‘persons with
disabilities include those who have long-term physical, mental, intellectual or sensory
impairments which in interaction with various barriers may hinder their full and
effective participation in society on an equal basis with others.’ There can be little
doubt that persons with dementia are addressed by this definition and are hence
intended beneficiaries of the Convention.
In Harnessing the United Nations Convention on the Rights of Persons with Disabilities to improve the lives of persons with dementia
Neil Crowther, 1 March 2016 writes
The Convention is broad in scope. Of particular relevance to the situations
experienced by persons with dementia are Articles concerning:
• Awareness-raising: The Convention requires that States take action, including at
the family level, to foster respect for the human rights of persons with disabilities.
This includes action to combat stereotypes, prejudices and harmful practices
including those based on age and to promote awareness of the capabilities and
contributions of persons with disabilities. This is particularly relevant to
addressing the stigma, discrimination and social isolation that is a common
experience of many persons with dementia and which acts as a major barrier to
their participation in society and in achieving the social change necessary to
secure their inclusion and wellbeing.
• Equality and non-discrimination, including the obligation to provide
‘reasonable accommodation’
The Convention requires that States ensure that persons with disabilities enjoy equality before the law and to guarantee legal protection against all forms of discrimination. This may include unlawful discrimination by healthcare and other service providers, driving license authorities, insurance companies and employers.
Discrimination includes the failure to provide ‘reasonable accommodations’
– that is, modifications and adjustments that enable persons with disabilities to enjoy or exercise their human rights on an equal basis with others.
I understand reader that you may have to pay for your medicines but in the UK we have the NHS supposedly free from the cradle to the grave.
It is an unequal system and this is just one example where you may have a chronic terminal disease but depending on the disease you may not get free prescriptions, funding and services that you should be entitled to and your own individual taxes have contributed to.
Would you consider this a fair system reader, or one that discriminates, for some diseases against others, the abled against the disabled, I’ll let you decide.

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