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Outrage as hospital charges for A&E drugs


10:00 am - August 21st 2012

by Shantel Burns    


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The University Hospital of North Staffordshire (UNSH) has been criticised after it was discovered it started charging A&E patients for any drugs they needed.

Health campaigners say the charges breach the NHS founding principle which says that care is free at the point of delivery and are set to seek a ruling on the legality from the Ombudsman.

Ian Syme from North Staffordshire Healthwatch told This is Staffordshire:

the hospital has never charged for [medication] since the creation of the NHS in 1948 and we challenge them (the UNSH) where in the constitution it is now allowed to do so […] the bureaucracy it will need to administer could cost more than it will bring in.

The new charges, introduced last month, were brought in even though chief executive Julia Bridgewater said just a few months ago that the hospital had “no plans to charge for drugs”.

It is now charging £7.65 for each drug.

A joint statement from UNSH and North Staffordshire Primary Care Trust said that: “More than three-quarters of patients don’t pay prescription charges” and if they [the hospital] “did not levy charges” they would face reductions in their budgets and therefore have “less money available for other services”.

However, money collected from the forced prescription charges will not go directly back into the hospital; instead it will be passed on to central Government.

Labour MP for Stoke- on- Trent, Rob Flello, who is to raise the issue with UNSH managers, asked whether it was just another way, “for the Government to take money from people?”

With the looming prospect of widespread privatisation seeping into the NHS, will this become standard practice across England, or is this just the start of something much worse?

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About the author
Shantel Burns is a News Editor at Liberal Conspiracy, and a publishing and journalism student and current affairs nerd. Blogs at: ramblepolitics.blogspot.co.uk too.
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Reader comments


The hospital chief executive was appointed under Labour in 2007.

Her claim to fame on the hospital website is “successfully signed off the major PFI project for a single site hospital”. I think that has more to do with the reason for them needing to find extra cash, not coalition policy.

Will Labour be apologising for this?

http://www.uhns.nhs.uk/AboutUs/TrustBoard.aspx

2. the a&e charge nurse

Not sure I understand this – drug prescribing in A&E depends on pharmacy opening times.

‘In hours’ (Mon 9-5 or weekends 9-12:00) patients are usually given a prescription to take to pharmacy (and are charged if non-exempt)

‘Out of hours’ A&E keep a limited stock of essential drugs (antibiotics, pain killers, steroids, inhalers, etc) – these are given without charge, presumably because the the bureaucratic cost of administering charges is greater than handing out what are mostly very cheap drugs.
Ideally ALL prescribing should go through pharmacy if only to reduce the number of prescribing errors – as the number of prescriptions rise, so does the scope for mistakes.
http://www.telegraph.co.uk/health/healthnews/6709590/Mistakes-made-in-one-in-ten-hospital-prescriptions.html

Any chance of clarification – is UNSH being berated for charging out of hours?

Thank god I live in Scotland.

Of course paying for treatment in the NHS is not really new. Until Scotland (and Wales) got rid of them, there have been prescription charges for many years, dental treatment has had to be paid for and mad Mrs Thatcher brought in sight tests charges, because “people wanted to pay for their eye tests”.

But with the privatisation of services up and down England, and now this, what is the next step?

And what happens if the person doesn’t have any money? Is the drug withheld? Are you left in agony with the dihydrocodeine or morphia tantalisingly in sight?

If the government is that short of money, why is this not being rolled out over all of England?

Alternatively, Osborne could ask some of his tax dodging billionaire mates to cough up what they would owe if they couldn’t afford tax dodging lawyers.

4. Silversapphire

I was charged full rate A&E prescription charge by Medway Maritime Hospital in Kent about 6 years ago so its nothing new. Whether it was right for them to do so then (and probably since) remains to be seen. Personally I think its disgusting. Perhaps if the NHS went back to being a National service instead of an International one such measures would not, in all likelihood , happen.

Consider this some people will abuse a system, rather than go to their GP and get a prescription knowing they will have to go to a chemist and pay for each item, will turn up in the A&E because medication is FREE.
The whole problem with the NHS is the abuse by many. Let’s charge the drunks, drug addicts and self-abusers, ooops sorry they probably are unemployed & prescription exempt.
I was undergoing as a day patient intense drug therapy for Hodgkins Lympoma. During the treatment I was diagnosed with a chest infection, guess what, from the Hospital pharmacy I had to PAY FOR the antibiotics!! and various ones since it didn’t clear \ due to the chemotheraphy THAT WAS TWENTY YEARS AGO.

6. Chaise Geuvara

I could use a clarification too. £7.65 sounds about right for a prescription charge. Is it usual for patients to get drugs free at hospitals where they would pay for them at a pharmacy? If so, what’s the justification for this inconsistency? If not, what’s the problem here?

7. Chaise Geuvara

@ 5 Sandra

“Let’s charge the drunks, drug addicts and self-abusers, ooops sorry they probably are unemployed & prescription exempt.”

Well, the fact that someone is drunk on arrival to A&E doesn’t mean that their injury is self-inflicted. I don’t know what you mean exactly by “self-abusers” (pretty sure you don’t mean what that phrase normally means), but if you’re talking about people who self-harm, then they have a genuine mental health problem. And drug addicts (including alcoholics) have a genuine health issue too.

If A&E do give drugs away for free to people who would otherwise pay, that’s a loophole we should probably fix. But I don’t think we should make a list of easy targets to deny treatment to.

In the London district where I live, there is a history of NHS claims that a percentage of attendees at the A&E department of the local hospital are not genuine emergency cases, requiring instant attention, but could easily go to their local GP clinics without compromising their healthcare.

Were they to do so and their GPs prescribed medication or appliances, the patients would be charged £7-95 on each item by their pharmacist unless the patients were in one of the prescription charge exemption categories: pensioners, children and those with chronic conditions. The government claims that no charge is made for about 90 pc of prescription items because of the exemptions. In my experience, the presciption charge may often be about the same or greater than the cost of paying the full retail price for the item.

If the A&E department doesn’t routinely make the prescription charge for medication and appliances, the effect is to create an incentive to increase calls on A&E departments even for minor healthcare issues when afflicted patients could attend their respective GP surgeries. It is a misallocation of NHS resources for A&E departments to maintain full clinical specialist cover to treat minor ailments. A&E departments are needed for emergency care.

9. Chaise Geuvara

@ Bob B

“In the London district where I live, there is a history of NHS claims that a percentage of attendees at the A&E department of the local hospital are not genuine emergency cases, requiring instant attention, but could easily go to their local GP clinics without compromising their healthcare.

[…]

It is a misallocation of NHS resources for A&E departments to maintain full clinical specialist cover to treat minor ailments. A&E departments are needed for emergency care.”

Agreed in principle, but in practice this relies on there being fit-for-purpose non-emergency infrastructure. I once went to A&E with tonsillitis. I would have preferred not to, and felt guilty about doing so, but my local GP wouldn’t give me an appointment for about a week, in which time a treatable infection could have killed me.

Possibly there were other services I could have used, like walk-in centres, but I hadn’t heard of them, had never seen one, and the GP surgery didn’t suggest one when I called them.

You’re right Chaise, but I don’t think Bob was talking about cases such as yours (and A&E should look for an apology from your surgery, not from you).

In any case, if the system works properly, you wouldn’t do it again unless (again) you had to:

a) You’d be near the back of what might be a long queue,
b) You’d be charged the normal rate for any prescribed medicine.

I’m not sure what the outrage is here.

We are still a very rich country and still richer than we have been for centuries. Yet the money flow of the country is stagnant. It’s stuck in the few’s many interests rather than the majority of the population. It’s there but how does a Government tap into it without upsetting the very few?

Chaise: “Agreed in principle, but in practice this relies on there being fit-for-purpose non-emergency infrastructure. I once went to A&E with tonsillitis. I would have preferred not to, and felt guilty about doing so, but my local GP wouldn’t give me an appointment for about a week, in which time a treatable infection could have killed me.”

My local hospital has a wide catchment area so what has been suggested is an unacceptable regular flow of patients with minor ailments to its A&E department can’t be attributed to a malfunctioning appointments system of one local GP – as I’ve learned, GP receptionists can be a positive manace to patient wellfare.

Health economics wasn’t much of a personal interest until lately but I’ve being learning about a worrying series of issues relating to bad practices by both GPs and by NHS administration.

I’ve mentioned before about my being presented with a consent form just prior to hip surgery two years ago which specified the wrong hip. The form had to be changed in manuscript before I would sign – and that amended form is now part of my medical records. Since then, I’ve been keeping a look out for similar news stories, such as the man who had the wrong kidney removed and is now dependent on dialysis to stay alive, the woman who had the wrong fallopian tube removed and is now unable to conceive naturally, a toddler with a broken leg who was sent home with the wrong leg in plaster. Links available. But then I’ve also been learning about the failings of GPs which tend to stay covered over because patients are reluctant to pick fault with their GPs for fear of the consequences and because of the difficulty in changing GPs. Btw whatever happened to those epidemics of Satanic Abuse and Munchausen’s Syndrome By Proxy?

My substantive point surely remains: if A&E departments don’t make regular prescription charges for treating minor afflictions which could be treated by GPs, the effect is to create an incentive for patients to bypass their local GPs and visit A&E departments with minor ailments.

Seems have to been covered by other commenters, but just to throw my experience in there – I thought it was already this way everywhere and I don’t see the problem. I have had scrips at A&E at least twice, and had to pay both times (which was fine by me, as I would’ve had to pay had they been prescribed to me by a GP).

The times I remember are 2009 at Selly Oak Hospital in Birmingham and recently at the New QE, also in Birmingham. At Selly Oak (daytime, weekday) I was asked to go to the on-site pharmacy and get it filled and pay, whereas at QE it was a weekend. They gave me the meds and had me a sign a promise to pay within 14 days.

14. Daniel Braven-Giles

Abolish prescription charges like they did in Scotland and Wales. There. Problem solved.

That wasn’t so hard, was it?

15. tigerdarwin

@ 1”The hospital chief executive was appointed under Labour in 2007”

Means nothing NL far too readily accepted the private philosophy in the NHS


Reactions: Twitter, blogs
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  98. Wildly Different

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  102. Hugh Pfeil

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  103. A&E Reg

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  107. TonyCross

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/GtB0SbYn via @libcon – So it begins

  108. Jacqui.

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/iOmTo04q via @libcon

  109. FiveDee's Cats

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/iOmTo04q via @libcon

  110. step

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/7ZIbRs9V via @libcon

  111. Shantel Burns

    Basic principles now in pieces. RT @sunny_hundal: An NHS hospital has started charging for A&E drugs http://t.co/WvINm8eA (by @shantel121)

  112. Sir Deffo

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/6oUPopta via @libcon

  113. Still The Torch

    Outrage as NHS hospital charges for A&E drugs | Free At the Point of Delivery? | Safe In Their Hands? http://t.co/ylraTl5u

  114. Donna Pasquill

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  115. Mr Finch

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  116. caroline oakshett

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/iOmTo04q via @libcon

  117. Shantel Burns

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  118. michelle maher

    Outrage as NHS hospital charges for A&E drugs | Free At the Point of Delivery? | Safe In Their Hands? http://t.co/ylraTl5u

  119. punkscience

    HAAAAAAAAAAHAHAHAHAHAHAHAHAHAHAHA #ToldYouSo #NHS >> RT @libcon: Outrage as NHS hospital charges for A&E drugs http://t.co/F6kP3dwF

  120. Nancy Farrell

    Outrage as NHS hospital charges for A&E drugs | Free At the Point of Delivery? | Safe In Their Hands? http://t.co/ylraTl5u

  121. angela

    Basic principles now in pieces. RT @sunny_hundal: An NHS hospital has started charging for A&E drugs http://t.co/WvINm8eA (by @shantel121)

  122. James Smith

    General Election now, please. RT @sunny_hundal Amazing – an NHS hospital has started charging for A&E drugs http://t.co/1ZFLeK5y

  123. Alex Sunderland

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  124. PinkParrot

    Outrage as NHS hospital charges for A&E drugs | Free At the Point of Delivery? | Safe In Their Hands? http://t.co/ylraTl5u

  125. Susan

    General Election now, please. RT @sunny_hundal Amazing – an NHS hospital has started charging for A&E drugs http://t.co/1ZFLeK5y

  126. Bob Ellard

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  127. Bob Ellard

    Amazing – an NHS hospital has started charging for A&E drugs http://t.co/RqvdpaL6 (by @shantel121)

  128. Simon Bell

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/suYHFJF6 via @libcon

  129. Nathan Constable

    Amazing – an NHS hospital has started charging for A&E drugs http://t.co/RqvdpaL6 (by @shantel121)

  130. NC

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  131. Bob Ellard

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/suYHFJF6 via @libcon

  132. Gemma Finch

    Amazing – an NHS hospital has started charging for A&E drugs http://t.co/RqvdpaL6 (by @shantel121)

  133. Peter Pink

    Outrage as NHS hospital charges for A&E drugs http://t.co/iNY0upIz via @zite

  134. Kayleigh Mason

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  135. Colin-Roy Hunter

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/suYHFJF6 via @libcon

  136. Foxy52

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/A9BNYr9o it going to get a lot worse it here USA care

  137. andy hughes

    Outrage as NHS hospital charges for A&E drugs http://t.co/iNY0upIz via @zite

  138. Phil

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  139. Kim Blake

    Outrage as NHS hospital charges for A&E drugs | Free At the Point of Delivery? | Safe In Their Hands? http://t.co/ylraTl5u

  140. mizzlizwhizz

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  141. Martin Milan

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/Tl6041FB via @libcon

  142. Brian Tomkinson

    Amazing – an NHS hospital has started charging for A&E drugs http://t.co/RqvdpaL6 (by @shantel121)

  143. Bonnie Greer

    Amazing – an NHS hospital has started charging for A&E drugs http://t.co/RqvdpaL6 (by @shantel121)

  144. Stuart White

    Amazing – an NHS hospital has started charging for A&E drugs http://t.co/RqvdpaL6 (by @shantel121)

  145. Natacha Kennedy

    North Staffs "#NHS" is now charging A&E patients for their drugs http://t.co/aPmckchf What if they can't afford them, will it let them die!?

  146. Paul Hood

    North Staffs "#NHS" is now charging A&E patients for their drugs http://t.co/aPmckchf What if they can't afford them, will it let them die!?

  147. Chris Schofield

    NHS hospital charges for A&E drugs http://t.co/FMIVzlva #FutureIsHere

  148. Harry Clarke

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/suYHFJF6 via @libcon

  149. Christopher Paterson

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  150. wicatty

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/7ZIbRs9V via @libcon

  151. Libby Miller

    You are fucking kidding me http://t.co/i4wRik3w http://t.co/ogkSqpdH #NHS

  152. Collin Whittaker

    Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/suYHFJF6 via @libcon

  153. Soupy One

    NHS Hospital starts charging for A&E drugs. Disgusting but not wholly unexpected http://t.co/Pbz4rl0i

  154. GMB Milton Keynes

    Amazing – an NHS hospital has started charging for A&E drugs http://t.co/RqvdpaL6 (by @shantel121)

  155. saramo

    Outrage as hospital charges for A&E drugs | Liberal Conspiracy http://t.co/X2tfE9GG via @libcon

  156. Deb Hazeldine

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  157. Cookie Monster

    Hospital in North Staffordshire has started charging A&E patients for drugs. Costs now move to patients… http://t.co/8WIi13fy

  158. CrawleyKeepNHSpublic

    Incredible: an NHS hospital in Staffordshire has started charging for A&E drugs – http://t.co/iP79lEar (via @sunny_hundal)

  159. rodmckie

    Hospital in North Staffordshire has started charging A&E patients for drugs. Costs now move to patients… http://t.co/8WIi13fy

  160. Outrage as NHS hospital charges for A&E drugs « Darren Fower

    […] on liberalconspiracy.org Share this:TwitterFacebookLike this:LikeBe the first to like […]

  161. Chris Fowler

    Outrage as hospital charges for A&E drugs | Liberal Conspiracy http://t.co/AGS7JbFF via @libcon

  162. Tristram Wyatt

    My piece from this morning (shameless plugging) // Outrage as hospital charges for A&E drugs http://t.co/blAF6Ywy via @libcon

  163. BevR

    My piece from this morning (shameless plugging) // Outrage as hospital charges for A&E drugs http://t.co/blAF6Ywy via @libcon

  164. John Jackson

    My piece from this morning (shameless plugging) // Outrage as hospital charges for A&E drugs http://t.co/blAF6Ywy via @libcon

  165. Catherine Brunton

    My piece from this morning (shameless plugging) // Outrage as hospital charges for A&E drugs http://t.co/blAF6Ywy via @libcon

  166. Dave Brown

    Imagine – you got to A&E – you get treated…and then you get A BILL. Awful US health system? Er no, Staffordshire http://t.co/mOqEVCis #nhs

  167. Les Tricoteuses

    http://t.co/0bzbMR7h http://t.co/nMRCY7I8

  168. Rebecca Devitt

    Outrage as hospital charges for A&E drugs | Liberal Conspiracy http://t.co/D79FKFhD via @libcon

  169. Suska Masson

    My piece from this morning (shameless plugging) // Outrage as hospital charges for A&E drugs http://t.co/blAF6Ywy via @libcon

  170. McDave

    Outrage as hospital charges for A&E drugs | Liberal Conspiracy http://t.co/D79FKFhD via @libcon

  171. Carol Burns

    Hospital in North Staffordshire has started charging A&E patients for drugs. http://t.co/71acOz4I via @libcon

  172. Linda Burnip

    Outrage as NHS hospital charges for A&E drugs http://t.co/GauwHznf

  173. Tyler Burton

    Imagine – you got to A&E – you get treated…and then you get A BILL. Awful US health system? Er no, Staffordshire http://t.co/mOqEVCis #nhs

  174. Guy Dewsbury

    NHS charge A&E patients for drugs… http://t.co/WS03Ws3S

  175. Claire Flatt

    Imagine – you got to A&E – you get treated…and then you get A BILL. Awful US health system? Er no, Staffordshire http://t.co/mOqEVCis #nhs

  176. Ivaylo Stoyanov

    RT @tm_lifestyle Outrage as NHS hospital charges for A&E drugs | Liberal Conspiracy http://t.co/67xrnjZw

  177. Jonathan Davies

    The future?: An NHS hospital has started charging for A&E drugs http://t.co/AfUO7rK4 @AnthonyBarnett @OllyHuitson #saveourNHS

  178. Widow jailed for harassing hospital managers over death of husband « just telling it as it is

    […] Outrage as NHS hospital charges for A&E drugs (liberalconspiracy.org) […]

  179. SuperPleb

    @richiedaw How about charging for A&E drugs? http://t.co/oQi4zWd8





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