Fines issued too readily to patients who claim free scripts, MPs say

A THIRD of patients who are fined for collecting free prescriptions ‘do so by mistake’ as MPs slam the system for causing distress and putting patients off free treatment they are entitled to

  • Some 30% of penalty charge notices since 2014 were mistakenly handed out
  • ‘Presumption of guilt’ means thousands were unfairly issued fines of up to £100
  • Elderly and those with learning disabilities may ‘tick the wrong box on a form’

MPs have slammed the current system of fining people who wrongly claim free prescriptions, arguing it is not fit for purpose.

In a damning report, the Commons Public Accounts Committee said around a third (30 per cent) of penalty charge notices (PCNs) since 2014 were mistakenly handed out.

This ‘presumption of guilt’ means hundreds of thousands of patients were unfairly issued fines of up to £100 ($124).

Vulnerable patients, such as the elderly and those with learning disabilities, may simply tick the wrong box on a form, the MPs argue.

A fear of getting it wrong may even mean some patients are put off seeking the free prescriptions or dental treatment they are entitled to, they added.  

The MPs even accused health officials of ‘justifying their approach’ because of the ‘additional revenue for the NHS it generates’.

MPs have slammed the system of fining people who wrongly claim free prescriptions (stock) 

‘Since 2014, around 1.7 million PCNs (30 per cent of all PCNs issued) have been subsequently withdrawn because a valid exemption was confirmed to be in place following a challenge,’ the report stated.

PCNs are supposed to discourage people from claiming free prescriptions or dental treatment when they are not entitled to do so. 

The MPs argued patients find it extremely difficult to understand whether they are entitled to free prescriptions.

They accused the existing PCN system of being ‘a heavy-handed rush to judgement’.

The NHS offers free prescriptions only to certain groups of people in England – the standard charge for a single dispensation is £9.

In Scotland, Wales and Northern Ireland medicines are free for everybody.

In England the following people can get prescriptions for free if they have an exemption certificate:

  • Over-60s
  • Under-16s
  • 16 to 18-year-olds in full-time education
  • Pregnant women or mothers with babies up to a year old
  • Hospital inpatients
  • People on various benefits, including income support, Jobseeker’s Allowance, Universal Credit or Child Tax Credits
  • Those with a constant physical disability which means they cannot go out alone
  • Cancer patients
  • People with diabetes
  • People with other long-term conditions including myoxedema, myasthenia gravis and Addison’s disease 

To find out more about eligibility or to apply for an exemption certificate visit the NHS Business Services Authority website 

Source: NHS

The MPs added the Department for Health and Social Care (DHSC) and NHS England have been ‘shockingly complacent about the fundamental problems with the PCN process’.

And ‘justify their approach because most exemptions are claimed correctly and the system generates additional revenue for the NHS’.

The NHS Business Services Authority (NHSBSA) came under fire for not attempting to identify those who are entitled to an exemption but mistakenly pay anyway.

The DHSC admits some patients are put off seeking treatment because they worry about fines.

A new system for checking whether a person has a valid exemption at the point they collect their prescription in a pharmacy is a long way off, MPs added.

And a ‘middle ground’ of alerting people they may mistakenly be claiming a free prescription has also not been put in place.

The report added even when there is clear evidence people are persistently committing fraud by making false claims, the NHSBSA has failed to take effective action.

Almost 115,000 people have received five or more PCNs for prescriptions and more than 1,600 have received 20 or more, yet only five cases have been referred to the Crown Prosecution Service.

Committee chairwoman and Labour MP Meg Hillier claims the ‘convoluted’ system needs an overhaul. 

‘The Committee fully support efforts to deter fraud and pursue those who claim exemptions to which they are not entitled to butthe current penalty notice system is cumbersome, inefficient and not fit for purpose,’ she said.

‘The Department should substantially overhaul the system, so that those who are rightfully entitled to free prescriptions and dental treatment get the exemption they deserve.’

The British Dental Association (BDA) said the system sees vulnerable patients, including those with learning disabilities, receive fines for simply ticking the wrong box on a form.

Charlotte Waite, chairwoman of the BDA’s England Community Dental Services Committee, added: ‘A system that’s hurt our most vulnerable patients and treated millions who’ve made honest mistakes like fraudsters requires more than tweaks.

‘Ministers shouldn’t be profiting from patient confusion. Families across England will keep paying the price until we get a fair and focused way to protect NHS finances.

‘Dentists call on the Government to do right by our patients, and follow these recommendations in full.’


A prescription prepayment certificate (PPC) is essentially a season ticket for prescription medicines.

A patient can pay £104 for a whole year or £29.10 for three months and, for that fixed price, they could get as many prescriptions as they need.

Anyone can buy one of the certificates and they simply have to show their details to a pharmacist when picking up a prescription.

After a price rise in April this year, prescriptions now cost £9 each. So the PPC pays for itself after 12 individual prescriptions.

To buy a PPC go to the NHS’s website by clicking here. 

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