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22 November 2017

The Universal Credit flaw forcing patients to risk a £50 prescription fine

The NHS has not caught up with the sprawling nightmare that is Universal Credit.

By Julia Rampen

You go to the doctor, and she gives you a prescription. You go to the chemist, and hand it over, like usual. But this time you realise there’s a problem. As a welfare recipient, you’re entitled to free prescriptions, but you recently switched onto a new benefit, Universal Credit. And there’s no box for you to tick.

When this happened to a woman in Halton, Cheshire, the pharmacist advised her to tick one of the existing boxes. She followed the advice, and was later fined £50 for an incorrect claim. 

“Someone who is struggling is suddenly whacked with a £50 fine,” Nick Atkin, the chief executive of Halton Housing Trust, where the woman is a tenant, told me. It was not a one-off glitch. In October, Left Foot Forward reported on the case of a single mum who, after transferring onto Universal Credit, received a letter informing her she owed money for dental treatment and a prescription, and would be fined as a result. 

The NHS prescription leaflet

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The mother’s case was highlighted after she turned to the single parent charity Gingerbread for help. “It seems there is a problem with the system not catching up,” Sumi Rabindrakumar, a Gingerbread researcher familiar with the case told me. “People are slipping through the net and it has a pretty significant impact for people with chronic conditions.” The Patients Association, a pressure group, confirmed its helpline staff had received a call from someone experiencing a similar problem.

The fact that NHS prescriptions have not caught up with the sprawling nightmare that is the Universal Credit roll out may not be surprising. What is shocking, however, is the lack of any clear interim solution, despite the fact the issue was identified as far back as 2013

The NHS Business Service Authority is responsible for auditing claims for free prescriptions and dental treatment, and can fine transgressing patients up to £100 (when I contacted the NHS BSA I was referred to the Department of Health). It has advised medical professionals that Universal Credit should not be taken as an automatic entitlement of free prescriptions. Rather, the patients’ earnings must be “£435 or less”, unless there are special circumstances, like responsibility for a child, in which case it is £935 or less. Once this has been established, the patient should be encouraged to tick the “income-based Jobseeker’s Allowance” box until the form is updated (there is an updated dental form, but it appears to be yet to reach many dental practices). 

A Department for Health spokeswoman said: “The Department is aware of this issue and we’re working with contractors and stakeholders to ensure a new prescription form is introduced.”

Back to the patient’s perspective. If your doctor writes you a prescription, you’ll need to turn up at the chemist with not only that, but your latest Universal Credit paperwork, showing how much you received, plus any evidence of parental status, inability to work etc. Then the pharmacist advises you to tick a box that has no connection to the benefits you receive, and you have to hope you won’t get fined, because if you are, it could be more than you receive in Universal Credit for a week. 

According to Gingerbread’s Rabindrakumar, claimants are unlikely to be reassured by this. For some, the choice may seem to be “either owe money, or go without their medication”. This was the case for Matthew Smythe, a job seeker interviewed by the Liverpool Echo, who had a prescription for an ongoing condition. Faced with the prospect of ticking an incorrect box and risking a fine, he left without taking his medicine. 

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