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The Guardian - UK
The Guardian - UK
Business
Anna Tims

Cancer could kill me, but I face an NHS fine over prescriptions

An NHS prescription charge medical exemption certificate.
An NHS prescription charge medical exemption certificate. Photograph: Jeffrey Blackler/Alamy

You recently reported on pregnant women being fined for claiming free prescriptions without having received an exemption certificate. I am very worried, because I was diagnosed with stage 3 inflammatory breast cancer in early 2020 and was told I was entitled to free prescriptions for five years (if I lived that long!).

I’ve therefore not paid for one since, but now realise that I never received a certificate. Other women in my cancer support group say they never got one, either. Treatment lasted 16 months, including chemotherapy, mastectomy and radiotherapy. I have a comorbidity and have prescriptions every 30 days, plus other prescriptions from time to time.

NHS Business Services Authority (NHSBSA) told me to get a form from my GP and to appeal against any fine once I had the certificate. However, it seems I’m no longer eligible for one, since my treatment has finished and I’m in remission. If I’d been given the certificate at the outset, I’d have two more years of free prescriptions.

It seems cancer patients are expected to chase a form and signatories, as some hospitals help with this but most don’t. This makes it deliberately hard for patients to get something they are being told they are entitled to. The survival rate for inflammatory breast cancer is 50%, so there’s half a chance it’s going to kill me. I don’t need this hassle or worry.
BB, Lyme Regis, Dorset

You would think that, on diagnosis, a hospital consultant or nurse could register a patient for a certificate online. Not so. A suitable NHS practitioner has to sign a form and post it to NHSBSA, which then issues a certificate. These are now digital, but the application process is not. According to the Department of Health and Social Care, it should be the healthcare professional who completes and posts the application. In practice, it seems that hospitals dole out the forms to patients still reeling from a diagnosis, and require them to slog to their GP to get them signed.

You say you were not given one and, even if you had been, your diagnosis was during the first Covid lockdown, when cancer patients were told to shield at home. NHSBSA checks random batches of free prescription claims every month and issues inquiry letters and fines to those without a certificate.

You may get away with it; but since you no longer qualify for a certificate you could face retrospective charges of up to £100 per prescription, plus the prescription cost. If that happens, I would want to hear about it. Rules aren’t interested in the fact that you can prove your qualifying treatment. It’s a scandal. In the meantime, if you’re still on regular medication for your other condition, your best bet is a ­prepayment certificate to reduce the cost.

Email your.problems@observer.co.uk. Include an address and phone number. Submission and publication are subject to our terms and conditions

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