Room 317 Richmond House    
  
79 
Whitehall 
 
 
 
London SW1A 2NL    
 
 
Telephone: 020 7210 5000 
 
 
Direct Line: 020 797210 5028 
 
 
Email: [email address] 
 
To : [FOI #8829 email]
 
 
 
 
 
 
 
 
 
 
 
 
23 April 2009 
 
 
Dear Mr Booth, 
 
OUTCOME OF A REQUEST UNDER FREEDOM OF INFORMATION [FOI] 
ACT 2000 FOR INTERNAL REVIEW: CASE REF: DE 395783R 
 
Thank you for your email of 9 March in which you requested an internal 
review of the Department’s reply to your email of 5 March concerning  
information about prescription charges under the Freedom of Information Act 
(our reference DE00000395783).  This letter provides you with some further 
information in relation to your original request. 
 
You asked why the total cost associated with the collection of prescription 
charges was not separately identifiable.  The administration costs for 
administering prescription charges are, in fact, very small as a percentage of 
the revenue raised from prescription charges.   Professional fees and 
allowances are paid to community pharmacists for dispensing of drugs and 
appliances. These fees would be paid to community pharmacists regardless 
of whether a prescription charging system was in place or not. There is no 
identifiable element within these payments that relates to the exemption 
status of a patient, nor to the need to check the validity of the declaration 
signed by the patient on the reverse of the form.  
 
There are additional costs not directly related to the collection of the 
prescription charges, but which relate to the administration of the system of 
prescription charges and exemptions.  Costs arise from issuing prescription 
pre-payment certificates by the NHS Business Serves Authority (BSA) to 
those who want to cap their expenditure (over a 3 month or 12 month period) 
and exemption certificates to those that are exempt on the basis of a medical 
condition or pregnancy.  This is the only direct cost of the system that can be 
identified and that cost came to £4.5m in 2007-08.  
 
In addition, local counter fraud specialists are based in local health bodies and 
undertake proactive exercises if an area of the health body’s work is at risk of 
fraud.  The costs associated with the pursuit of prescription charge fraud 
similarly cannot be isolated from the cost of tackling other types of NHS fraud. 
 
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The NHS BSA also assess applications for the NHS Low Income Scheme and 
issue exemption certificates for those eligible who are in receipt of Tax 
Credits. However, this cost cannot be eliminated as both schemes provide 
exemption for NHS dental treatment, sight tests and provision of optical 
vouchers, and reimbursement of the cost of travelling to receive NHS 
treatment.  I hope this further explanation has clarified the position. 
 
If you are not content with the outcome of your complaint, you may  p
a ply 
i
d rectly to the Information Commissioner (ICO) for a decision. Generally, the 
ICO cannot make a decision unless you have exhausted the complaints 
procedure provided by the Department. The ICO can be contacted at:  
   
The Information Commissioner's Office  
W c
y liffe House 
Water Lane  
Wilmslow 
Cheshire  
SK9 5AF 
 
Yours sincerely, 
 
 
 
 
O
T NY DOOLE 
Senior Casework Officer 
Freedom of Information   
 
 
 
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