Prescription Charges
The next item of business is a statement by Nicola Sturgeon on prescription charges. The cabinet secretary will take questions at the end of her statement; there should therefore be no interventions.
Thank you, Presiding Officer. I am very pleased indeed to have the opportunity to announce the intention of the new Scottish National Party Government to abolish prescription charges within this parliamentary session. I will set out in detail our proposals to phase out prescription charges over the next three financial years; charges will be abolished for all by 2011, one year ahead of our manifesto commitment.
This Government is committed to building a healthier nation. We are determined to tackle the health inequalities that still scar our nation; we want to support people to live longer and healthier lives; and we intend to ensure that people have timely access to the health and social care services that they need.
In August, when we published our discussion document "Better Health, Better Care", we began to set out clearly the actions that will help us to realise our strategic objectives of helping people—particularly those in disadvantaged communities—to sustain and improve their health and of ensuring better, local and faster access to health care. One of the key commitments in "Better Health, Better Care" was to phase out prescription charges for all in Scotland. The reason for that commitment is clear: this Government believes that prescription charges are a tax on ill health. We also believe that prescription charges are a barrier to good health for too many people in Scotland.
More and more of us are living with long-term conditions. Many of those conditions can, with the right support and medication, be self-managed by patients in their own homes, enabling them to go on enjoying a good quality of life. The problem is that many people with long-term conditions who are not already exempt from charges simply cannot afford the right medication.
In October, I attended a conference organised by the Parkinson's Disease Society and spoke to sufferers of Parkinson's disease, who told me that they did not always take their prescribed medication because they could not always afford their prescriptions. That is unacceptable. This Government believes that people should not be penalised financially because they fall ill, and that they should not have to make choices about whether to obtain essential medicines. No one should avoid seeing their general practitioner because they know that they cannot afford the cost of their prescriptions.
I want the national health service to help people to make the choices that are good for their health and well-being. I also want our NHS to be true to its founding principle of health care free at the point of use. That was the principle espoused and defended by Aneurin Bevan, and this SNP Government, by abolishing prescription charges, will be proud to restore it.
Let me set out our plans in more detail. There are two key elements to the proposals that I am outlining to Parliament. From 1 April next year, we intend to deliver the first stage of our commitment to abolish prescription charges by reducing the cost of a single prescription from £6.85 to £5—a year 1 reduction of more than 25 per cent. In April 2009, the cost will reduce again to £4; and then, in April 2010, it will reduce to £3. From 1 April 2011, prescription charges will be abolished and prescriptions will be free for everyone in Scotland.
The second element of our proposals will deliver even greater benefit for people who live with chronic conditions. Currently, people who need a regular supply of medication—this applies to many people with chronic conditions—can reduce their costs by purchasing a prescription prepayment certificate. Prepayment certificates can be purchased for either a four-month or a 12-month period, and they cover all prescriptions that are needed within that period. To provide additional help for people with chronic conditions we will, from April next year, reduce the cost of the four-month and the 12-month prepayment certificates by more than 50 per cent. Next year, the cost of a 12-month prepayment certificate will reduce from £98.70 to £48, with further reductions to £38 and £28 on 1 April 2009 and 1 April 2010 respectively.
Similarly, the price of a four-month prepayment certificate will be halved from the current level of £35.80 to £17 next year, with further reductions to £13 and £10 in 2009 and 2010 respectively. I encourage all those who need regular medication to take up the option of a prepayment certificate. Of course, prepayment certificates will be completely redundant from April 2011, when we abolish prescriptions charges altogether.
I believe strongly that introducing that substantial reduction in the costs of prepayment certificates—in addition to the reductions for single prescriptions—is the simplest and most effective way of providing faster relief from prescription charges for people with chronic conditions.
I shall set out my thinking in more detail. We considered compiling a list of chronic conditions that would have qualified for immediate exemption, but many concerns were expressed to us about the difficulty and delay that would be associated with defining a list that was comprehensive and complete, and which—most important—would avoid simply creating new anomalies. Either the criteria for inclusion would have had to be drawn tightly, in which case too many patients would have been excluded, or we would have had to set the criteria broadly, in which case the list would have had to be kept under constant review to take account of inadvertent omissions and the emergence of new conditions.
It became evident that it would take some considerable time to compile even a workable initial list. Many views would have had to be considered and, given the complexity and sensitivity of the issues, I would not have wanted to rush the process. Our preliminary inquiries suggested that work to extend the categories of medical conditions that qualify for exemption might have taken until 2009. I was anxious to avoid such a delay, particularly since the end result might have been, in the words of one doctor, the "least wrong" list rather than one that was right and fair.
For all those reasons, I decided that the approach I propose today is preferable and will deliver real and immediate benefit for all, especially those with chronic conditions and cancer. Similarly, for full-time students and those in full-time training, there were administrative difficulties in defining those groups and determining how they would show eligibility. In the end, I considered that a more rapid journey towards universal abolition, coupled with larger reductions for those who need regular medication, was the better option for those groups as well.
In summary, everyone in Scotland will benefit from the delivery of immediate reductions in the cost of single prescriptions and a deep cut in the cost of prepayment certificates. I advise Parliament that we have made full provision for the cost of our proposals in the spending review. To phase out prescription charges, we have set aside £20 million, £32 million and £45 million over the next three financial years. We estimate that the annual recurring cost of complete abolition of prescription charges from April 2011 will be £57 million.
As I have indicated, in developing those radical proposals I have listened to many views and suggestions. I have taken great care to listen to any concerns that have been raised. One concern was that abolishing prescription charges might lead to an increased demand for prescriptions. The best available evidence that we have on that issue is from the recent experience in Wales. As members are aware, prescription charges in Wales were phased out and finally abolished in April this year. Parliament will be interested to know that there is not yet any evidence of increased levels of prescribing during the phased reduction in charges, or of increases in general practitioner consultations. However, these are early days after full abolition of charges in Wales and it is important to be aware that the full data, when they are available, may well show some increase in prescribing. In my view, that is exactly as it should be.
Let us not forget that there are two very good reasons why the phasing out and abolition of prescription charges should result in some increase in the number of prescriptions dispensed. First, there are patients who do not take some or all of their prescribed medication because they cannot afford the charges. Those patients will benefit greatly from the changes that I am announcing today. Secondly, research shows that some people do not go to their GPs at all because the cost of prescriptions puts them off. Progressively reducing the cost of prescriptions should—and, I believe, will—encourage patients to see their GPs when they need to.
Those are the patients for whom the changes are designed. That is why it is important to be clear that a modest increase in prescription volume will not be a cause for concern. On the contrary, it will be a sign that the policy is having the desired effect. Indeed, the money that we have set aside assumes an increase in prescribing volume.
Of course, a few patients may opt to visit their GPs for medicines that are available over the counter to avoid having to pay for them. However, it is my view that that group will be small, given the low cost and easy availability of self-care medication in shops and pharmacies. I also have full confidence in GPs continuing to make prescribing decisions according to the clinical needs of individual patients.
I have absolutely no doubt that the abolition of prescription charges will have a positive impact for patients and our national health service. If patients take regular medication as prescribed, their medical conditions will be better controlled, which will lead to fewer problems, fewer complications and fewer emergency admissions to our hospitals.
The proposals will be of real benefit to all the people of Scotland. By removing this tax on ill health, we will make a significant contribution to achieving the healthier Scotland that we all want. Cost will no longer prevent people from consulting their doctor and picking up their prescriptions. The proposals will remove barriers to good health and support people in making healthier choices, improving their health and, ultimately, living longer. They will also deliver real and immediate benefits from April 2008. The deep cut in the cost of prepayment certificates will mean that, from April next year, the financial burden of medicines for patients with chronic conditions will be reduced by up to £50, while the phased reduction in price for single prescriptions—which will lead to universal abolition of prescription charges by 2011—will deliver on the SNP Government's manifesto commitment one year ahead of schedule.
The proposals are right for Scotland. I believe that they will have the backing of the vast majority of people in the country and hope that they will have the Parliament's support as well. Next year, the NHS will be 60 years old. Abolishing prescription charges seems a fitting way to mark that occasion. Therefore, I urge members on all sides of the chamber to join the SNP Government in removing this tax on ill health and restoring the NHS to its founding principle of care free at the point of use.
I commend the proposals to the Parliament.
The cabinet secretary will take questions on the issues that were raised in her statement. I intend to allow around 30 minutes for such questions.
I thank the minister for the advance copy of her statement. I will make a few things clear from the outset. The Labour Party firmly believes that no one in Scotland should be denied the medicines that they need because they cannot afford to pay for them. We completely understand the anguish of those who suffer from long-term conditions and believe that entitlement to free prescriptions should be extended. However, it is imperative that we test the SNP's proposals and that we are all fully aware of their implications for Scotland.
I will set the proposals in context. So far, the SNP Administration has offered simplistic solutions, which often unravel in the detail, to complex and challenging problems. It is vital that the Parliament interrogates the detail and that the minister co-operates fully with that.
To that end, I will ask the minister a number of specific questions. Given that 92 per cent of all prescriptions in Scotland are issued free and that many of the people who will benefit from the SNP's proposal are very well off, who will actually benefit? If money were no object, we would all agree that all medicine should always be free for everyone. Even in better times—I remind members that, for the past five years, health spend increases averaged 7.8 per cent—health spend always required tight management and clear prioritisation. The current settlement, under which the health budget is increasing by 1.4 per cent—and by 0.5 per cent for allocations to boards—is tight. Given the challenge that we face with profound inequalities in health and profound need in our poorer communities, and the fact that resources will be diverted to the better-off and will not be available to help those in need, is the proposal the right priority for Scotland?
The minister estimates that the on-going annual cost will be £57 million after 2011. Will the cost be capped at that level? If the costs prove to be higher, will the minister increase health budgets accordingly, or will health boards be expected to manage within their budgets and squeeze spending on other services?
Does the minister plan to adjust the guidance to boards, and therefore to GPs, on prescribing practices and budgets? If so, will she bring that guidance to Parliament, to ensure that there are no hidden limits on free prescriptions?
As the minister knows, the Long Term Conditions Alliance Scotland has expressed a serious worry. If costs rise on minor ailments, will that mean rationing of more expensive drugs? It is vital that the minister answers that question.
Briefly, please, Ms Curran.
Finally, the minister seems to dismiss the notion that the policy on free prescriptions will lead to people going to GPs for prescriptions when they could buy the medication over the counter. How will she manage demand, how will it be monitored and how will the Parliament be involved in that?
The policy seems to be one for the short term, but we must question whether it will work in the long term.
First, I thank Margaret Curran for her questions. A policy that will lead to the abolition of prescription charges for all time is not a policy for the short term; it is a policy for the long-term benefit of everyone in Scotland.
I will answer each and every one of Margaret Curran's questions. First, she asked about those who currently pay for their prescriptions and she quoted some figures. Let me tell her the exact position. Around 50 per cent of people pay for their prescriptions. Many elderly people get a higher volume of prescriptions, therefore Margaret Curran is right: currently, 92 per cent of prescriptions are dispensed free. Margaret Curran seems to suggest that the remaining 8 per cent of prescriptions are purchased by people who are well off. I point out to her that, of that 8 per cent of prescriptions, two thirds go to people with long-term chronic conditions. That is the reality. Margaret Curran asked who this proposal will help. The answer is that it will help people with long-term conditions who struggle to pay their prescription charges. That includes the people from the Parkinson's Disease Society, whom I mentioned in my statement.
Secondly, Margaret Curran asked about priorities. She is, of course, right—politics is about priorities. We have a tighter settlement over the next three years, thanks to the tight settlement that we got from the Treasury. The average increase in the health budget over the next three years is 4.1 per cent. However, I believe that it is right to give priority to the abolition of prescription charges, which will give relief to some of the most vulnerable people who rely on our national health service. I make absolutely no apology for making that a priority.
Margaret Curran asked about the £57 million that we estimate will be the final recurring cost of the policy, which will fall to be met in the next spending review period. She asked whether that figure would be capped. I say to her, very politely, that the question demonstrates a misunderstanding of how the policy will operate. As I said, all the figures that we have set aside in the next three years and the figure that we estimate as the final recurring cost already have built into them an assumption for growth in prescription volume. That is an important point. Therefore, the issue of a cap does not arise.
Margaret Curran asked about prescribing practices. Unlike her, I have confidence in GPs to deploy sensible prescribing practices. If at any stage we thought that there was a need to issue guidance along those lines, of course we would consider doing so.
Finally, Margaret Curran asked about the Long Term Conditions Alliance Scotland. I cannot speak for the alliance, but I hazard a guess that it will warmly welcome the proposals in my statement. Even if Margaret Curran cannot see it, the alliance will know that the real benefit will be felt by people with long-term conditions throughout Scotland.
Perhaps it was just me, but I missed Margaret Curran advising members whether Labour would vote for the abolition of prescription charges.
I thank the health secretary for the advance copy of her statement, which I confirm was not fully covered by BBC Radio Scotland this morning.
I acknowledge the difficulties in compiling a list of chronic conditions for exemption from charges. There is no doubt that the current system is beset by anomalies, such as patients with epilepsy and diabetes getting free prescriptions but patients with asthma and Parkinson's disease having to pay.
Wastage of drugs is a major issue. How will the cabinet secretary ensure that wastage is not increased when prescriptions are made free to all?
I seek further clarification on a point that Margaret Curran raised. How will the cabinet secretary ensure that the abolition of prescription charges does not lead to rationing of more expensive treatments in favour of cheaper alternatives and that people with diseases such as Hunter disease, which affects only five people in Scotland, and other rare conditions get the drugs that they need?
We hope that there will not be even a modest increase in demand for antidepressants. Will the cabinet secretary give an assurance that therapies such as cognitive behavioural therapy will be made widely available and that there will be shorter waiting times for referral to psychiatrists and psychologists in order to achieve her target of reducing the use of antidepressants in the long term?
What measures will be put in place to monitor the free prescriptions policy to ensure that there are not more prescriptions for over-the-counter drugs such as aspirin and paracetamol? Does the cabinet secretary know the percentage increase in the number of prescriptions in Wales following the reduction in and subsequent abolition of the charge there? I remind the health secretary that many drugs have significant side effects, so this announcement should not be viewed as a pill for every ill. Individual responsibility and lifestyle changes can sometimes be even more beneficial than drugs.
I agree whole-heartedly with Mary Scanlon's final point. When she reads the Government's action plan on health, which will be published in the foreseeable future, she will see that this policy is part of a wide range of policies that are designed to help people in Scotland to improve their health and to improve access to health care, which are the twin objectives for me as Cabinet Secretary for Health and Wellbeing and for the entire Government.
Mary Scanlon raised a number of important points, which I will try to address directly. The issue of wastage of drugs is pertinent. It is an issue regardless of whether we charge for prescriptions. Measures are in place to try to reduce the wastage of drugs and we will continue to take action to drive it down.
On rationing and access to more expensive drugs, the procedures for access to drugs are clear. The abolition of prescription charges will not lead to rationing of drugs but, as Mary Scanlon knows, we encourage the use of generic drugs because that is known to be more efficient and to drive down the costs.
Mary Scanlon rightly points to our manifesto commitment to work towards a 10 per cent reduction in the prescribing of antidepressants. Again, our action plan, which is coming up soon, will say more about that. She is right to say that that will not happen without alternatives being available. Those who were at the Health and Sport Committee this morning or who watched it on television—it would have been riveting viewing—will have heard us discuss these very issues and will know that one of the issues that we have pressed health boards on as we have chaired annual reviews over the past few months is what they are doing to invest in some of the alternative therapies that will allow us to reduce reliance on antidepressants.
Mary Scanlon's last question was about monitoring, and referred to Wales. As I said in my statement, there is no evidence at this time of an increase in GP consultations or prescription volume in Wales. I stress that we must approach the evidence with caution, though, because it is still early days and part of the purpose of the policy is to allow people to access prescriptions that they would not otherwise be able to. We will closely monitor evidence from Wales and evidence of our own as the policy takes effect, so that we can see any unintended consequences that might arise.
I thank the cabinet secretary for the advance copy of her statement. Although it does not appear in my declaration of interests, it would be appropriate, in the context of this statement, for me to declare that I am the beneficiary of an exemption certificate for drugs.
As a Liberal Democrat, I am happy that the cabinet secretary is addressing the issue of long-term and chronic conditions. I note that, in her statement, she refers to the difficulties of categorising those conditions. That was an issue that beset the previous Executive, of which I was a member. It was incredibly difficult to get any agreement on that issue.
However, on the issue of everything becoming free, could the cabinet secretary clarify whether all the items that the NHS currently charges for, and which are included in the list in the statement from the NHS on the matter, particularly wigs, abdominal supports and so on, are to be included?
I am glad that, in your response to Mary Scanlon, you said that the implementation of the policy in Wales is in its early days. Obviously, we will want to monitor that. A piece that appeared in the Western Mail on 5 November—I accept that it is purely a journalist's report and does not represent empirical evidence—seemed to indicate that the prescribing trends in the first five months gave some cause for concern. The concern related not to people getting access to drugs that they had not previously received but to people simply taking advantage of the system to obtain drugs that were perfectly easy to obtain.
On the budgeting that you have made to meet demand, you mentioned a figure of £57 million in the long term. Further, you have put in place a sum of £45 million for the third year. However, the fact that the current revenue income that is brought in by charges is £47 million means that, even by your own estimate, you are putting some kind of pressure on the health boards, which are already under pressure. That might be only a small amount of pressure, but even you—
Mr Finnie, could I ask you not to refer—
So, my question, therefore, is, if that is all that you are doing, are you not already admitting that you are putting the NHS boards—
Mr Finnie, I was not trying to hurry you up; I am asking you not to speak directly to the cabinet secretary but to speak through the chair.
I do apologise.
I thank Mr Finnie for his question and say that I am glad to see that SNP policy is directly benefiting the Liberal Democrats.
I agree with Ross Finnie—who knows about the problem from his experience as a minister in the previous Executive—about the difficulty of identifying and defining a comprehensive list of chronic conditions. There are, literally, hundreds of them. Because of the time that creating such a list would involve and because of the risk of creating more anomalies while solving others, we have decided that the approach that I have outlined is much better and fairer, is more effective and will deliver the complete abolition of prescription charges much more quickly than would otherwise have been the case.
Ross Finnie asked whether everything in the NHS's list will be exempt and specifically mentioned wigs. We intend to phase out charges for NHS-prescribed wigs in line with the phasing out of prescription charges generally. Charges will not be phased out for everything else on that list—I am happy to write to the member to advise him of which items are in each category.
Ross Finnie rightly says that the current income from prescription charges is £47 million but that we have set aside £45 million for year 3. However, in year 3 of the spending review period, prescription charges will not have been completely abolished—at that stage, a single prescription will cost £3. Prescription charges will be abolished from April 2011. We estimate that the cost of that will be £57 million, which will be a recurring cost. That takes account of growth in the income between now and then, and builds in an amount for the anticipated growth in prescription volume that I have already spoken about.
We now come to questions from back benchers. There are 15 members who wish to ask questions, and less than 15 minutes for that to take place. It follows that questions should be short, sharp and to the point. I call Christine Grahame, to be followed by Dr Richard Simpson.
Oh no!
Short, sharp and to the point—George Foulkes will never be that.
Unlike the churlish comments of the former people's party, I welcome the 50 per cent reduction next year in the cost of prescription prepayment certificates, from £98.70 to £48, with further reduction each year until charges are abolished. I understand why the First Minister does not want to compile a list of chronic conditions but, given her remarks about the Parkinson's Disease Society and the hard choices that people currently make about which prescriptions they will purchase and which they will not, will she advise the chamber with which other organisations she has had discussions about charges for prescription prepayment certificates?
I thank the member, as I noticed that she managed to promote me to First Minister in the course of that question—I am sure that it was a Freudian slip. I will not tell him if she does not.
Christine Grahame raises an issue that is at the heart of the debate. We thought long and hard about the approach to take to fulfil our manifesto commitment to abolish prescription charges completely. It is no secret that our manifesto suggested that immediate abolition for people with chronic conditions would be the best first step. The more we looked at that, and the more people we spoke to—people who held different points of view—the more obvious it became that that was a very difficult and potentially lengthy way to go about it. That is why we have chosen the much more direct route that I have outlined today. We have spoken to and heard the views of a range of organisations, including the Long Term Conditions Alliance Scotland, the organisation that represents asthma sufferers and the Parkinson's Disease Society. I am more than happy to make a full list available to members.
My colleague Margaret Curran tried to ask a question about the £57 million—I will concentrate on that. We understand, and can follow, the progress towards that. I restate that the Labour Party believes that nobody should be unable to get medication on financial grounds and that a revision of some sort is therefore appropriate. However, we are talking about priorities. As it is Christmas, I am tempted to ask the cabinet secretary where the money tree is, because we seem to be getting enormous largesse.
At the end of the process, there will be free prescriptions—that is the manifesto promise of the SNP. However, the introduction of the minor ailments service has meant that anyone who is currently on free prescriptions is entitled to register with a pharmacist and have a prescription issued to them for minor illnesses. Although that may benefit those who are currently on free prescriptions, if it is going to be extended to all people on free prescriptions, it will apply to the whole population—and that will mean that people will ask for prescriptions for minor illnesses.
When the member's bill on the abolition of prescription charges was being considered in the previous session of Parliament, the Scottish Parliament information centre estimated that the increased cost from introducing free prescriptions would be between £17 million and £51 million. As that did not take into account the cost of the minor ailments programme, how can the cabinet secretary say that it will cost only £12 million to abolish prescription charges four years from now? That is £4 million on top of the £45 million. We believe that the Government has grossly underestimated the additional cost of prescribing. That is what Margaret Curran was trying to get at. When the Government introduces the policy, it is going to cost much more.
I ask you to be brief.
Will the cabinet secretary guarantee that any new medicines that the Scottish medicines consortium approves will continue to be funded no matter what happens to the prescribing budget and the money that is applied to it?
The answer to the member's final question is yes. I confirm that health boards will be expected to prescribe drugs that are approved by the Scottish medicines consortium when it is clinically appropriate to do so, as is the case now.
On the point about the £57 million, forgive me if I did not quite follow Richard Simpson's question. The difference between the cost of the phased reduction by April 2010 and the cost of complete abolition by April 2011 is indeed the difference between £45 million and £57 million. However, the member should remember that, in 2010, the single prescription charge will already be down to £3, so we will have already paid more than half the cost of getting to that point. I assure Richard Simpson that the figures that I announced today not only cover the lost income from prescription charges but include an assumption for growth in demand.
Richard Simpson's other point was about the minor ailments service. As I think I said in the chamber in response to a question last week, the minor ailments service is a fantastic service and community pharmacies do a great job in implementing it. Clearly, the abolition of prescription charges has implications for the service because it is currently open to people who get free prescriptions. The service was not intended to apply to the whole population, at least not in the short term. We are considering the implications of the abolition of prescription charges for the service and how to make adjustments accordingly. Further announcements will be made on that in due course.
I warmly welcome the cabinet secretary's statement. She mentioned the success of the policy in Wales. Indeed, with the removal of prescription charges in Wales, the review that is being undertaken of prescription charges in Northern Ireland, and the Scottish Government's decision to abolish prescription charges, the good people of England might wish to start lobbying their politicians for a similar change.
Will the cabinet secretary join me in urging members of the Opposition parties, particularly those on the Labour benches, to follow the example of their colleagues in Wales and endorse the actions of the SNP Government to end the tax on ill health, rather than coming to the chamber with pathetic, nit-picking excuses not to support the policy?
I have no difficulty in endorsing those comments.
Richard Simpson asked me where the money tree is. There is no money tree. For the first time in a long time, or perhaps for the first time ever, we have a Government in Scotland that is prepared to spend scarce resources on the people's priorities. That is the difference, and the people of Scotland are realising the benefits of it. I hope that all members will come together to support the abolition of prescription charges, because it will deliver help and benefit to some of the most vulnerable people in our society. I am proud to propose the changes and I hope that other members will support me.
I return to the issue of the future cost of the policy being £57 million. In the previous session, when Colin Fox's member's bill was under consideration, SPICe stated that the total cost of the policy would be £74 million. Is it not the case that the cabinet secretary is underestimating future demand? What action will she take to protect health boards' budgets if the cost exceeds £57 million?
I do not recognise the figure that James Kelly used, but perhaps he can provide it. [Interruption.] Perhaps it is available, but what I am proposing today is not Colin Fox's bill. Believe me, I would never wish to speak for the former Solidarity member. [Interruption.] I mean the former Scottish Socialist Party member.
What I am proposing today is a phased reduction in prescription charges that ends in their abolition. I set out clearly what the costs of that policy will be, including the final recurring cost. James Kelly asked whether I can ensure that health boards' budgets will not be squeezed. Of course I can ensure that health boards' budgets will not be squeezed, as the Government is providing the additional resources to compensate health boards for the loss of income resulting from the abolition of prescription charges.
I congratulate the Government on this fantastic statement today. No longer will we have the spectacle of a patient who requires two essential medicines telling the pharmacist that they can afford only one. It was Lord Beveridge, a Liberal, who founded the idea of an NHS that was free at the point of need. It was Aneurin Bevan, a member of the Labour Party, who tried to introduce it. Has the cabinet secretary budgeted for the vast increase in antidepressants that will be required by the stone-faced members of the Opposition when they realise that it is an SNP Government that is taking this step forward?
I thank Ian McKee for that question, although I can confirm that the demeanour of members of the main Opposition party is not altogether associated with our policy of abolishing prescription charges; there may be other factors at play. Nevertheless, their demeanour is perhaps a challenge to our manifesto commitment on antidepressant prescribing.
It was Lord Beveridge who devised the NHS and it was Aneurin Bevan who espoused, defended and delivered on those principles. However, it will be an SNP Government that restores the principle of health care that is free at the point of use.
The minister says that the policy is directed towards people who live in disadvantaged communities. I ask her to look round at the 129 members, all of whom will get free prescriptions. Then she should look round her constituency or mine at the people who are on income support or who are living below the poverty threshold, who are already exempt from prescription charges. The pensioners and people on incapacity benefit because they have chronic conditions are also exempt from prescription charges.
Question, please, Mr McNulty.
The Government's policy will divert resources towards those who are on middle and upper incomes—is that not correct? Furthermore—
Very briefly, Mr McNulty.
The minister says that the health boards will be compensated for the loss of income. On what basis will they be compensated? Will the reality be that the Government will take money from the very things that are supposed to provide support to improve the health of poorer people living in deprived areas?
The logic of Des McNulty's argument is that wealthy people should pay for their GP appointments and hospital treatment. I cannot believe that a member of the so-called Labour Party has just made that argument. Des McNulty should get out of the chamber a bit more than he does. He should visit my constituency and others where many people who are not exempt from prescription charges and have long-term conditions are struggling to pay for their prescriptions. If he did so, he would know the benefit that our policy will bring. If a few well-off people benefit from the policy, that is a small price to pay to ensure that sufferers of Parkinson's disease will no longer be unable to afford their prescription.
I ask for a brief clarification from the cabinet secretary. Has consideration been given to temporary residents who may be prescribed treatment under the NHS? Will non-domiciled people get free prescriptions as well, or will they have to pay?
At last, a question!
That was a heckle from the back of the chamber. No doubt, Margo MacDonald will get her question in later.
Nanette Milne raises an important issue. Parliament will want to examine the detail of the policy as it goes through the parliamentary process. There are a number of cross-border issues that we need to clarify. The most important principle is that everybody living in Scotland should get access to free prescriptions, but there are some outstanding issues—for example, the situation for people living in England who are registered with a Scottish GP. Such matters will have to be addressed, and I will bring further details on them to Parliament in due course.
I thank the cabinet secretary for providing a copy of her statement in advance. Unlike the cabinet secretary, I believe that the removal of prescription charges will put extra pressure on GP services. What consultation has taken place with GPs?
I consulted a range of interests before deciding how we would fulfil our manifesto commitments. Ultimately, part of the Government's job is to take the decisions that it thinks are right. I never again want to have the experience of standing at a conference being told by someone who suffers from Parkinson's disease that they do not take their prescribed medication because they cannot afford it. As long as I am health secretary, I will strive to ensure that we have a better health service than that. In eight years, the previous Administration failed to deliver that; this SNP Government is determined to deliver it.
I apologise to the three members whom I was unable to call.