Monday 6 February 2012

NICOLA STURGEON WAS RIGHT TO SCRAP THE PRESCRIPTION CHARGE


There was considerable criticism of the government's policy of scrapping prescription charges last year.

It had been a long term aim of the SNP administration to make prescriptions free, as the Labour/Plaid government had done in Wales, and reductions on the price inherited from the Labour/Liberal administration in 2007 had been made, but there was criticism from some people that the policy handed free medications to people who could easily afford to pay for them, and that, in any case, those who couldn't were already covered by free medication.

Of course that wasn't actually correct, as people on contribution based benefits had to pay full price. Amazingly, that included people who were in receipt of Incapacity Benefit. In some cases that meant multiple prescriptions every few weeks. And of course people on low wages (and there are plenty of them in Scotland) often couldn't afford to get what the doctor ordered, which often led to longer absence from work than would otherwise have been necessary. 
Far from being a gift to the rich, it was actually a lifeline (literally in some cases) for the poor. Not taking prescriptions is a fast track way for some people to land in hospital, an altogether more expensive option.

Now I read on Left Foot Forward that there has been research in England, where prescriptions have risen ever year for the past 15 years, showing that around a third of people with some serious conditions can't always afford to buy all the drugs prescribed for them. Neil Churchill of Asthma UK, which is trying to get the English government to scrap the charges, writes:

"There are 15.4 million people in England with long term medical conditions and with dramatic increases to the cost of food, energy and transport, many are now struggling to afford their prescriptions and putting their health at risk by reducing or rationing their medicines.

"An Asthma UK survey found that 34 per cent of people who pay for their prescriptions sometimes chose not to get some of their medicines because of the cost. Non-compliance with medication is a leading cause of avoidable and costly hospital admissions for asthma.

"Research published by Rethink Mental Illness showed that 38 per cent of people with severe mental illnesses like schizophrenia have had to choose between paying household bills and paying prescription charges. People with long-term conditions are a significant voter population and many feel passionate about prescription charges."

  • The current prescription charge in England is £7.40 per item, although 3 month and annual exemption certificates can be purchased.


44 comments:

  1. There used to be a system in which a annual or four monthly voucher could be purchased for a fixed sum and this greatly helped those who required numerous medications.

    I'm not sure if the free prescriptions is such a success. A local pharmacist says the waste level of medicines is much higher now than it used to be but he also said the old payment system was badly managed and needed an overhaul.

    I don't see a problem with people paying for medication if they can afford it, same as I don't see a problem with folk paying for the use of buses if they can afford it.

    Nothing is free - everything has to be paid for somehow.

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  2. Subrosa

    As the piece says, folk on IB had to pay full whack. In my wife's case that would mean about £22.20 a time

    Actually with the ESA system coming in, or rather not for most folk, that would mean more people paying full whack with no money

    Add to that that the price of prescriptions has gone up way over inflation since charges were introduced and I'm glad that this Tory/Labour tax on the sick is gone here

    Let me and others pay for it in our taxes

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  3. "Nothing is free - everything has to be paid for somehow"

    Christ, there's a wee Thatcherite/Neo-liberal mantra

    That's why good lefties believe in state provided aid through taxes, it helps us all in the end

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  4. Subrosa, I pay a lot of tax and national insurance, more than I can really afford. I don't have kids so get nothing directly back in terms of services such as schools, libraries, tax credits, etc.

    In the past, I have had to choose between my medicine and a loaf of bread. Most of the time, I chose the bread, making my illnesses worse. Of course, if I had chosen the medicine, and not eaten, I would have made my illnesses worse. A real catch 22.

    Unless you're actually in that position, you really don't know what you're taking about. This SNP government has been a godsend to the likes of me and I dread the day that they're no longer in power. The alternative, Scottish Labour, have got it into their heads that, somehow, providing free medicine for anyone not on a means tested benefit is a right wing policy, regressive and a waste of sparse funds. The fact that it cost just about as much to administer the collection of prescription charges is forgotten about.

    So, what do I get for my taxes if it doesn't include the health care, in the form of medicine, that I desperately need?

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  5. Good health should be a freely available commodity in this day and age and this society, if it comes to a choice between bankers bonuses/MP's pay and free prescriptions I know what I would vote for...(oh and that is not to mention the Olympics,millennium domes or any of the other truly wasteful excesses of government including the NHS database!

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  6. SR. Surely if unneeded medicine is being issue, that is the fault of the doctors for prescribing it in the first place?

    A Pharmacist has every right, and I would think actually a DUTY, to talk to a doctor who is prescribing willy nilly, medicine that is inappropriate, or not needed. And if the doctor continues, the pharmacist should report him/her to the local health board.

    Of course, even at the £7 that the English pay for their prescriptions, they are being heavily subsidised.

    To make it fair we would have to have a situation where prescriptions were charged at maybe £50 per item, and make anyone who couldn't afford them apply for some sort of discount on a sliding scale. It would be embarrassing for less well off middle class, but it's what the poor have to do most of the time if they want any discount, so that would be tough.

    And with all of these things that people get for free, I've always said that they needed accept the "charity" if they don't want it or need it.

    Of course the cost of the prescription drugs can be found, probably from the pharmacy, and a similar amount donated to an associated health charity, or local old folk's home/children's home could be made for those who are rich and find it offensive to receive charity.

    In the case of bus fares, one can always pay one's fare. There is no need to apply for the free bus pass. And the heating allowance paid to old people can be channelling to do some good somewhere; an elderly poor person, or old folk's home. I'm sure that that is what many richer older people do.

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  7. Anon 1: Yes, they raised the prices every year, often by more than inflation. In short it has become more and more expensive to be sick.

    Subrosa is right that there was a 4 month and an annual tariff that could be paid in advance, but that involved you being able to afford to pay in advance and many people couldn't...although for those who could it was a good system. Unfortunately it favoured, once again, those who had enough spare cash to buy a year's medicine in advance... and you couldn't get the money back if you got well after 5 months!

    It's always the poor who do so badly out of things.

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  8. Anon 2: I believe very firmly that in certain areas the state has a responsibility to pay. Health is one; education another and the utilities yet more. The idea of profit being made out of these things is abhorrent to me.

    Thatcher was plain wrong to privatise these things. She must have been idiotic to think that the shares which were sold off would be kept by the small shareholders. In general they were bought up by large shareholders and then the companies were sold... and mainly to France, Germany, China.... The only motive being how much money they could lay their chubby little trotters on.

    Lord knows what we will do if there is a war and some of the countries which own our utilities are on the other side.

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  9. Don Mc:

    First of all welcome to Munguin's Republic. Thanks for your comment.

    Yep, it's sometimes very hard to know what you get for the taxes you pay London. I'll help you out shall I?

    Bombs, weapons, submarines, charity to countries that could buy and sell the UK (and who have their own foreign aid schemes!!!!!), golden jubilees, Olympics games where it's illegal to hold up our flag, the second of two high speed railways which serve Edin... oh no, wait...London, Crossrail, a new airport in the Fort...sorry Thames, ambassadors with palaces and Rolls Royces, in almost every capital in the world, a seat on the UN Security Council, the G8, a HUGE number of royal houses, for the vast royal family, country estates for the First... no sorry Prime Minister... The list is endless. Taht's what it means to be British. It brings a tear to the eye.

    But I don't mean to be frivolous... You make a very good point about having to chose medicine or food, and knowing whatever you chose will make your illness worse.

    I'd rather some rich people got a few pounds more in supplement from the government than they do in England than people like you had to make that choice.

    So, it seems, would the SNP, and I'm proud of that, because that's the kind of country I COULD say I was proud of, instead of all this hogwash about being proud of the Queen or the Epsom Derby.

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  10. Hello Nomine...

    Yeah bang on. They waste money on Olympics and Domes, Jubilees and wars, like it it was sand in the Sahara, and then they cheese-pare on the things that actually matter.

    As I said, give me a country where people come first. That's my kind of society.

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  11. Tris

    I used to work in the pharmaceutical trade in Scotland and England.

    Every pharmacist will tell you that there was hardly a day went by without someone asking which items were least needed as they could not afford all of them.

    I would rather 20 people who could pay getting their prescriptions free, rather than one person who needed the medicine having to do without.

    It has always struck me as an anomaly that people who support the NHS standard, free access at the point of delivery, should then want to tax a part of the treatment needed after the free access consultation.

    Where would you draw the line on extra charges? If the medicine should be charged, why not the access to the doctor in the first place if people could afford it. Why if you go to hospital and need a plaster for a broken leg, no charge for the plaster, but a charge for the painkiller you need as well.

    Keep free prescriptions, a tax on the sick is a tory tax, supported by their little helpers, the Lib Dems and Labour.

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  12. As you've already highlighted Tris, wasted medicine is the fault of the prescriber, not the prescribed. I had tonsillitis recently, and as well as the anti-biotics, I was prescribed a big box of paracetamol (which came in handy recently, actually). I found this a bit weird really, as paracetamol is an over-the-counter drug, and as someone who generally avoids doctors like the plague (arf arf), I had always assumed the whole point of prescription drugs was that you couldn't buy them over the counter.

    I don't know if this is a general rule - that a doctor includes anything you need in the prescription - or if it was just inexperience (she was a student doctor). I feel there's an argument for both sides here though: on the one hand, you can say that it would defeat the whole purpose of free prescriptions if we left out vital medicine, saying "you can buy that in the chemist yourself"; but on the other hand, unless folk are taking over-the-counter drugs to get their jollies, then the very existence of over-the-counter drugs which are not free undermines the whole point of free prescriptions in the first place. Maybe it just needs the doctor to say "have you got paracetamol at home?" before adding it to the prescription.

    Perhaps the solution is as simple as making the boxes smaller, so there is less chance of some being left over at the end? I think doctors can be in a hard position sometimes though - a lot of people are unsatisfied unless they leave with a prescription. They seem to think they're being fobbed off otherwise. Maybe we need to change our own preconceptions?

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  13. And I'm right behind you in regards to the state having a responsibility to pay for certain things. People should not be forced into a situation where they have to choose between one thing they need to live, or another. We would not dream of charging people to pay for policing directly (well, not yet, anyway), but we're happy to leave people at the mercy of energy companies deciding how much energy you can afford to use ("pick a room to heat up", in some cases), transport companies effectively deciding where we can afford to work in relation to where we stay ("you've got a job in another city? Congratulations! Give us half your pay and we'll get you there, as long as you don't mind being treated like cattle"), and down in England of course, universities decide where we can afford to get educated and pharmaceutical companies decide what medicine we can afford to buy.

    Countries thrive based on the development of education systems, transport networks, health provision and access to electricity & other utilities. These are arguably the four most important things for a community to flourish, and the foundation upon which we help developing countries raise their living standards. So at what point do we suddenly decide that a country is developed enough that it no longer needs to guarantee universal access to these things?

    I would suggest that the real answer is "it never is".

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  14. Agree completely, Dubs... I've been used all my life to paying for prescriptions, so until I started working with people who live in poverty I never thought about why a service, supposedly free at the point of delivery, should actually be taxed.

    You make an excellent point about treatment in a hospital, visits to the doctor, and what next.... food in hospital? If you can pay for it why should you get it free?

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  15. A good point Doug. I understand that, before someone thought that they could stop people committing suicide by restricting their purchase of paracetamol to 32 at a time (not that they can't then go to another chemist/supermarket/garage/newsagent and buy an endless number of them), you could buy 100 paracetamol for about 80p.

    I think doctors started to prescribe them when they started being dispensed in small numbers. If you are ill, you don't want to have to go out every 2 days to buy a packet of pain killers.

    When I was talking paracetamol as part of my pain killing regime after a bullectomy, I had to buy them myself, but when they upped the prescription to Dicloflex I got them on prescription.

    It seems to depend on the doctor.

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  16. I think you make excellent points on the supply of necessities, Doug.

    Unfortunately much of what has been privatised has become unaffordable, because it more or less remains a monopoly (with a toothless regulator supposed to keep it in check without doing so).

    Transport, even within a town has become prohibitive. I was just thinking that the other day, that although we give people £67 a week to be unemployed, we can take £3-£6 of that away because they need to get to the nearest town, or to the town centre, to sign on.

    It's heart breaking to think of people sitting with outdoor clothes on, in one room of a house, so that electricity or gas companies can make obscene profits and their directors take home vast bonuses.

    That's not what the supply of essentials is supposed to be about... Unfortunately it is in the UK, thanks to Mrs Thatcher.

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  17. PS: I hope your throat is better now Doug!

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  18. well I never Subrosa talking some kind of sense tis true those who can afford should pay............Thus allowing the unwasted money to be used for those in Scottish society who need more help.

    But the snp have said screw you we want to buy some votes to the least able in Scottish society..A most antiscottish thing to do.

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  19. I have noticed a big difference when I go to the chemist now for my methado....er I mean my prescription. Only kidding!

    It is a lot better now that you do not have to find proof that you do not have to pay etc. There was so much fraud going on with the old system anyway and the cost involved in trying to track that down, or not as the case may be, is probably balanced out now with the savings being made with regard to this.

    We either have a free healh service or we don't and that includes our medicine.

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  20. A Niko

    You torys are all the same, tax the sick. Blue torys Yellow torys or Red torys, makes no difference.

    Who said "the prescription charge is an immoral tax on the sick" then proceeded to raise the immoral tax on the sick every year he was the chancer that destroyed the exchequer.

    I will give you a clue he hides out in North Queensferry North Briton.

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  21. You get sillier by the day Niko. There were people who had to choose between their medicine and their food. What kind of society allows that?

    The cost of the scheme was quite high, as prescriptions had to be sorted, checked and costed. People filed to take medicine that they had been prescribed and ended up in hospital costing to country far more money.

    And rich people with a conscience can always donate what money they would have spent had they lived in England or Australia or Saudi Arabia.

    But as I said earlier, why stop at £7. That's a subsidy too. Many of these drugs cost £50 or £100, and in the case of some cancer drug far far more. So the really rich are being highly subsidised at £7 an item.

    Would you agree that they should be charged £100, £200, £500... per item? Or do you just want to do everything the way England does it?

    I seem to remember that it was Mrs Thatcher who said "People want to pay for their eye tests". She must have had you in mind, because as sure as eggs is eggs she wasn't speaking for me.

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  22. Yes I agree, Billy.

    It's paid for in taxes. No one should ever have to go short of medicine in a rich country that can afford a nuclear deterrent.

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  23. LOL Dubs... I think he spends most of his time earning money and promoting his book. I don't think Queensferry has much of his company these days.

    He certainly doesn't bother his big fat backside making any attempt to represent the people of his constituency in the House of Commons, for which we pay him the princely sum of £66,000 a year.

    Still nice work if you can get it...

    And yeah, for a man who thought it an immoral tax, he did a lot of increasing of it.

    Hypocritical Tory.

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  24. tris
    To some in Scottish society Brian souter for instance £100, £200, £500... is the equivalent of £7 to them a paltry sum of money.

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  25. Absolutely Niko. but do you think that he should pay £7 rather than nothing... or because he's indecently rich should he pay £500 a pop?

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  26. Niko is miffed as his best buddy Ffoulkes has ditched him for his new best friend Forsyth as they connive devious schemes on the red benches. It was last century when I last saw a doctor or got a prescription which was for antibiotics it went up in flames as a scalpel was the medicine, homoeopathy my way. Health needs to be 'free' at the point of call no matter income as a progressive tax system is how it is funded.

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  27. Forgot that I believe that a queenie jubilee stamp has 1966 depicted should go down well.

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  28. Niko

    Do you support Labours position of privatisation of the NHS.

    You do know that 32 Scottish (North British)MPs voted in the commons supporting the motion backing further privatisation of the NHS in England. Where were the other eight? or maybe seven as we know Broon is never there.

    Since the Scottish MPs now report to Lamont, this must now be London Labours position in Scotland.

    How more tory can Labour get? The 23% share that Labour had in the last opinion poll will look like the good old days after May.

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  29. This comment has been removed by the author.

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  30. SNP, making the poor pay, so the rich don't have to.

    That is why the Unionists will defeat the separatists.

    Bring it on.

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  31. So Dean, do we stop at £7, which is highly subsidised and NOTHING for the rich to pay, or do we make the rich pay MORE than in England... £10, £20, £30, £50, £100...

    I mean the English are subsidising the rich by letting some of them have cancer drugs worth a vast amount more than the £7 they pay.

    What about drugs in hospital. Should the rich pay for their morphine? Or their sleeping pills? And why should they not pay for their meals. Why are we subsidising people who have £1 million houses, by buying them 4 meals a day?

    Because the rich pay more tax... we don't expect them to pay more for everything else.

    The NHS is funded by tax. That is how it should be.

    But I see you and Niko have come to a cosy understanding.

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  32. Yes CH Forsyth and Ffoulkes a couple of swells.... working out how they can stuff their country by stealth.

    Good fair open argument not for the likes of them.

    I knew that that old people's home was good for something. It keeps the likes of those two old dears off the streets and frightening the public.

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  33. So, Dubs, Lamont has ordered her troops to vote for the privatisation of the health service in England. If they ever get in here will they privatise the NHS?

    Can you answer that Niko?

    PS. No wonder Brown never turns up to the Commons these days. He'd have to be a bit embarrassed taking his orders from lamentable.

    Did Vinegar Face Curren vote for this too?

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  34. Why not copy what every survey says is the best health system in the world - the french one, closely followed by german dutch & danish models. Funnily enough, the one thing they do not have is monolithic top down admin. If we want the best health service possible, why don't we adopt what is proven elsewhere to work better, or are we more interested in political bickering. Unfortunately for certain positions, they all charge for seeing the doctor, getting prescriptions etc, all reclaimable of course, but it illuminates what the real priorities are for those in this debate. Finally check out comparative cancer diagnosis & survival rates, then ask yourself where do i want to be if I'm diagnosed.

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  35. Nessimersion:

    Hi, thanks for dropping in to Munguin's Republic, and for your interesting contribution.

    I agree that if I were ill in any way at all, but specially seriously, I'd rather be in France than anywhere else in Europe (well maybe Switzerland, where an uncle of mine was working when he had a stroke. He said the treatment was absolutely amazing).

    But the admin costs of paying for stuff and reclaiming it from the social security is wasteful. I think we could look at the French system and then streamline it so that the worst of French bureaucracy is eliminated. They do spend about twice what we do on it though and their ratio of doctors to patients compared to ours is fantastic.

    But yes, treatment times are much much better than Scottish ones, and this is reflected in the survival rates. Of course their hospitals are cleaner than ours, which helps.

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  36. Anonymous, some people who claim IB also claim other benefits. Under the old system they would have had free prescriptions.

    What's a Thatcherite/Neo-liberal mantra? Goodness me, if saying those who can pay do so doesn't suit you, please don't attach ridiculous labels.

    Don McC, if any doctor left you in that position then they should be reprimanded. I thought the whole idea of the welfare state was to give help where needed. It has certainly let you down if you had to choose between vital medication and food.

    Tris, the French, German, Swiss etc systems do not claim from social security. All their healthcare is provided by health insurance companies and from my experience they're very efficient. The cost of health insurance varies and there is plenty scope for helping those in need. I'd prefer to be treated in any of these countries because, as Nessi says, their results are far superior to ours.

    As for the NHS being free at the point of delivery I'm all for that, but I still think medication should be paid for by those who can afford it.

    Oh Anonymous, how can a pharmacist decide if a medicine isn't needed? I'm intrigued.

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  37. That's the thing, subrosa. Scottish Labour have a very narrow definition of who can afford to pay for prescriptions, i.e. anyone not in receipt of a means tested benefit. The fact that I work and don't receive any tax credits, income support or jobseeker's allowance means that, as far as Scottish labour are concerned, I can well afford to pay for my prescriptions. That's not my doctor's fault, that's Scottish Labour's hatred of the SNP that has led them to take such a position.

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  38. SR: The French system is largely social security funded. I know because I've used it. You pay the doctor and you pay the pharmacist, and then you reclaim from social security. It's a waste of money doing it that way, but my impression of France is that it was ever thus. The bureaucracy is famous, or rather infamous and second only to the Belgian one. (There is a system in place for low earners who can't afford to pay up in front.) [In fairness I would say that it was some years ago that I worked in France and it may have been streamlined.]

    There is (or was) a top up available in private health insurance, as of course there could be here.

    I know you know about the German system as you have lived there and I'm sure you know about the Swiss one, which is probably similar.

    Yes, there's nothing wrong with doing it that way if it's properly regulated, which under current arrangements it would never be in the UK, including, unfortunately Scotland. The regulators are toothless, which is why we can have 20% increases in fuel charges and the regulators say nothing, whereas the same gas and electricity can be capped at 2% and 0% in France.

    Perhaps under independence we could go that way with proper regulators who had the power and the will to act.

    The French social security taxes are far higher, but then they get much better health care.

    Pharmacists do check and query prescriptions with doctors. It's part of their job. They are trained in the effects of medications, and the doses that should be prescribed. They also know if sometimes inappropriate medication is prescribed that will, for example, react adversely with some other medication on the script. As you said in your first comment "A local pharmacist says the waste level of medicines is much higher now than it used to be..."

    He could only say that if he monitored what was being prescribed and knew whether or not it was "waste".

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  39. Don: it seems that the Tories have the same view, although in fairness in Scotland that isn't as important as what Labour thinks as they could never be involved in government.

    It was ridiculous that a person on £67 JSA Contribution (ie which had been paid for by "stamps") could not access free medicine, and a person on £67 JSA means tested (ie which was not paid for by NI contributions) could.

    Likewise a person working part time and taking home only £67 a week couldn't access this free medicine.

    My argument is that the fee paid by the English is already highly subsidised, and when you take the admin costs out of it, and factor in the unfairness, and the fact that some people have to go without... the £7 was hardly worth the bother.

    Why is this highly subsidies figure of £7 considered reasonable? Because the English government deems it to be so?

    If we are going to charge for medicine, should we not charge at a more reasonable cost for those who can afford it, whether that be 20 30 or 40 pounds per item. Steven Hester, Alex Salmond, the Queen could easily afford to pay that kind of money. George Osborne could buy a hospital if he wanted. Why does he only pay £7.

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  40. Afterthought SR.

    You say that a doctor should be reprimanded for leaving Don in a situation where he had to choose between medication and heat?

    First I'd ask, by whom?

    I'm afraid the welfare system doesn't run to that kind of care. A doctor has 10 minutes to see a patient, including the time it takes to get from the waiting room to the office. In that time (s)he has to hear the symptoms, examine, diagnose, prescribe, explain, comfort sometimes. There isn't time to look into the financial situation of the patient. And even if there were, what can the doctor do?

    Nothing. They have no power over social security; they have no spare medicine in the surgery for such cases. The only thing they could do is pay for the prescription out of their own pocket. Bad idea.

    It's tough, but that's the way it is. And in a town like Dundee there are thousands of people making these choices, or there were until Nicola introduced her measures.

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  41. Subrosa

    No. You can easily be on IB and not get other benefits.

    Believe me, I know, and IB is getting killed off

    Under the labour/ConDems ESA plans, many who should be on support through ill-health will be forced onto JSA or worse nothing.

    ESA does not guarantee free prescriptions, curiously enough, neither does "nothing"

    Again, believe me, I know. Thanks the Appeal system came to the rescue

    Medical need has no part in this. The information from both GPs and Specialists is ignored.

    I was seen by a physiotherapist, not a doctor. Now, nothing wrong with a physio in their field, but not to assess whether or not my condition renders me able to work

    The fairer way to do this is through general taxation. Means testing prescription charges would waste money

    Unless, of course, you go by the Ron Paul doctrine that if you are poor and sick you should die though not having the wherewithal to buy private health insurance

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  42. Full list of Labour MPs who voted,

    The following 32 Scottish Labour MPs voted on Monday 16th January 2012

    Sarwar, Anas - Deputy Leader of Scottish Labour
    Curran, Margaret - Shadow Scottish Secretary
    Alexander, Douglas
    Bain, William
    Banks, Gordon
    Begg, Dame Anne
    Brown, Russell
    Clark, Katy
    Clarke, Tom
    Docherty, Thomas
    Donohoe, Brian H.
    Doran, Frank
    Doyle, Gemma
    Gilmore, Sheila
    Greatrex, Tom
    Harris, Tom
    Jamieson, Cathy
    Joyce, Eric
    McGovern, Jim
    McKechin, Ann
    McKenzie, Iain
    Morrice, Graeme
    Murphy, Jim
    Murray, Ian
    Nash, Pamela
    O'Donnell, Fiona
    Osborne, Sandra
    Robertson, John
    Roy, Frank
    Roy, Lindsay
    Sheridan, Jim
    Teller - David Hamilton

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  43. I know about the French Health service and use it.

    It is funded though central Gov funding.

    However the French bureaucratic tendency means that there is a charge at the point of delivery which is refunded. This was designed to make the patient aware of the concept of cost. Hithertoo the patient could consult as many doctors as they wished, demand specialist opinion ad nauseum and was a hypochondriacs heaven.

    Mutual Insurance is necessary to pay for the bits that the French NHS don't pay for; like a single room at hospital or a taxi back home (honestly). Those who have had an operation are given a chit for a bus/ambulance usually provided under contract by, taxi firms!

    I cut my thumb on the 22nd of December cutting some vegetables using a ceramic knife and no. I was not drunk or even had any alcohol. I managed to bandage it v=but had difficulty stemming the flow but after 20 feet of bandage and a surgical glove there was no more blood gushing over the kitchen. Next morning I tried to change the dressing and found that it just restarted to gush blood again. Now the 23rd and no doctors' surgeries open so, off the local clinic (actually a mid sized hospital, and after 4 hours faffing about (yes in France too) I was seen by a Doctor and a nurse cleaned the coagulated blood, stemmed the flow and dressed the wound.

    They didn't have the necessary terminal to accept my Carte Mutuelle (AXA) so they just said they would give me credit and bill me. An invoice for €21.00 followed and the special plasters, Betadine gel and rinsing liquid set me back another €20 but was covered by the Carte Mutuelle automatically at the Pharmacy.

    I pay €110 per month for the Mutuelle cover which is 12.5 % more than last year because Sarko needs to bail out his mates at Credit Agricole, Societe Generale and BNP (bank not the racists in England). Every year my Mutuelle goes up because I get older and the permitted medicines list covered by the State is being rolled back, more and more.

    The Pharmacists do not know what is permitted and what is not as the rules seem to change hourly. My medicines bill since November until the end January was, according to my organisation who control my State health insurance says I cost them about €0400. That might explain why some people think it is all provided privately. It is run for various organisations for the State based on what you do for a living. Farmers pay next to nothing, as do self employed plumbers, electricians and roofers (for example) but anyone with a qualification (lawyers, doctors, consultants etc) pay big, big €.

    Teachers, who have a strong Union also pay a reduced tarif.

    What I haven't yet worked out it why Pharmacists seem to be the richest people I have met. My Doctor told me of selling hgis Mother's house after her death and being offered a sum, over €800,000, right there and then by a cheque from a current account.

    The biggest supplier of generic drugs in France is run by a brother of Sarko and is the supplier of choice of Pharmacist who have a right wing view of politics. I think there is a clue here as why the Pharmacists seem to have very large cheque books.

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