The Government fears that patients falsely claiming free prescriptions could be costing the exchequer pounds 30m a year, and Health ministers had hoped doctors could be persuaded to provide information on patients which would make detection of fraud easier and cheaper. But when members of the British Medical Association's GPs' committee meet Health minister Gerry Malone later this month, they will tell him GPs will not co-operate.
Their reaction is bound to embarrass the Secretary of State for Health, Virginia Bottomley, who announced tougher checks on prescriptions at the Conservative Party conference earlier this month.
The BMA committee argues that it is not a GP's job to police the law by checking who should be paying. Family doctors are not prepared to act as 'state police' for the Government because their principle concern is to treat patients.
Dr Brian Goss of the doctor's negotiating committee said: 'If we are asked to provide information on patients it could destroy the doctor-patient relationship, which is founded on confidentiality.'
This could scupper Mrs Bottomley's plans to actively pursue fraudulent claims. Without the help of GPs, detection costs would make the proposals uneconomic.
Attempts at detection have so far proved unsuccessful, partly because entitlement to free prescriptions cannot be easily checked. While several categories of patients are exempt from paying - including pensioners, the unemployed, and the chronically sick - not all have exemption certificates issued by the local health authority.
As a result, policing the system has, up to now, involved either random checks on individual forms or scrutinising the thousands of prescriptions returned to health authorities by pharmacists. Some health authorities have also run spot checks with the help of the Benefits Agency.
Where fraud has been uncovered, prosecution has been ruled out on the grounds of cost which has left officials little option but to demand full payment from the patient.
The Government's latest proposal is that GPs use a bar code on prescription forms, containing a record of certain patient details such as age and reasons for exemption to help verify claims for free medicines.
Dr Goss said: 'Helping fight fraud would involve taking time going through medical records, but that isn't our principle objection. Our relationship is with the patient, and doing this on the Government's behalf is not a function of being a doctor.
'It is the Government that makes the law and really it is up to them to enforce it.'
Only 30 per cent of patients have to pay for prescriptions but despite this low proportion, the Department of Health says abuse is commonplace. The current pounds 4.75 prescription charge raises pounds 280m a year towards the annual NHS drugs bill of pounds 3bn.
Mrs Bottomley said: 'Our exemption arrangements are among the most generous in the world, but there is a responsibility on those who can afford to pay to do so. When people duck that responsibility it has got to stop.'
Pharmacists have also indicated they are unwilling to co-operate with checks on patients. Mike King, a spokesman for the pharmacists' negotiating body said: 'Pharmacists are normally busy making-up and dispensing prescriptions.
They simply haven't got time to start asking lots of questions. We rely on people honestly signing the back of the prescription declaring they are exempt.
'The only other possible way it could work would be to issue ID cards to those who are eligible for free prescriptions, and that would obviously have cost implications.'
A spokesman for the Department of Health said: 'We don't know why doctors and pharmacists are objecting, as the proposals haven't been formally put to the two professions.'Reuse content