Popular myth has it that Aneurin Bevan resigned as health minister in response to chancellor Hugh Gaitskell introducing a prescription charge of 1 shilling per item. In truth, his 1951 resignation speech suggests his departure probably owed more to his fierce opposition to NATO's planned rearmament programme.
Either way, Gaitskell's break from the NHS's free-at-the-point-of-service philosophy had been motivated by the twin beliefs that many were abusing the system, and that costs had to be contained to help pay for weaponry.
Predictably, the charge has risen, albeit unevenly, by over 10 per cent a year to the current£5.90. These increases have been accompanied by an ever-growing proportion exempt from payment, the most recent expansion resulting from the European Court ruling on sexual equality. Now only 15 per cent of prescriptions involve money changing hands.
If there were no exemptions, but everyone had to pay the price of five cigarettes per item, the NHS would receive the same£5bn revenue. For many not exempt, medicines would cost significantly less if purchased over the counter. Sympathetic pharmacists frequently suggest this to customers, while others less scrupulous doubtless seize the opportunity to perpetrate lucrative scams.
The architects of the pricing mechanism can't have anticipated that it would eventually degenerate into such a ludicrously skewed pattern. Now might be a good time to reassess it without too much political baggage.
One study has revealed that around 6 per cent of prescriptions are made up and not used. One suspects the bulk were exempt from charges, suggesting that a meaningful price tag is needed for socially responsible behaviour.
The waste would build a new 1,600-bed hospital each year. Two other disturbing statistics emerged from this study. One in six prescriptions were never even made up, which might suggest that the charge is considered excessive by some obliged to pay.
More worryingly, 38 per cent of patients failed to complete what was judged to be an appropriate course of treatment. The waste from that would fund over 10,000 new beds a year. But more important, it will have contributed to the growth of resistance to antibiotics.