Bridget Phillipson column: Inquiry into penalty charges for prescriptions and dentist treatment
One of our most recent inquiries was into penalty charge notices (PCNs) in the NHS for prescriptions and dental treatment.
We have been looking at how current rules for claiming free prescriptions or dental treatment have led to honest mistakes and unnecessary fines for many vulnerable people.
This issue has affected many local people, some of whom have been in touch to raise personal cases with me.
Dental and prescription charges are a significant cost for the NHS, so it is only right that PCNs are issued in cases of fraud. But the rules on eligibility are far from straightforward – meaning it can be very easy for people to make genuine errors when ticking a box.
Almost a third of PCNs are overturned as incorrect when challenged, because the patient has a valid exemption.
It is vital that the rules on claiming are simple, clear, and easy to understand. I raised concerns about the how the ‘fines first’ approach risks putting off vulnerable people from seeking treatment. We know that there has been a significant fall in low-income patients attending the dentist in recent years. Only around half of all adults in Sunderland saw an NHS dentist in the last two years, and we face oral health outcomes that are significantly worse than the national average – with almost 1 in 3 children in our community suffering from tooth decay by the age of 5.
Prescription forms are also a major problem – they still don’t include a Universal Credit option despite its roll out beginning six years ago. But even when the forms are finally fixed later this year, it will still be far from clear to the patient whether their monthly earnings fall below the necessary level to make them eligible for exemption.
PCNs involve a large penalty fee on top of the original prescription charge, which comes as an extremely heavy-handed punishment for those who have made a first-time mistake. It would be far better if people were given the chance to put things right rather than being fined upfront. The government indicated that they’re going to move towards this approach, but this needs to happen quickly.
The system remains unnecessarily complex, and some minor changes could reduce the needless distress, confusion and hardship experienced by so many older, vulnerable or low-income patients.
No one in our community should miss out on the healthcare to which they’re entitled, or pay more than they’re required.
That’s why it’s time for a fairer and more straightforward system – one that works for everyone.