[Help] Advice - NHS penalty charges

[Arthritic Toe]

Asking for a friend (seriously).
A friend of mine was receiving tax credits and then, towards the end of last year, they insisted that she switched over to universal credit. She always received free prescriptions under tax credits, but it turns out that under universal credit, not only does she receive less, but she also is no longer eligible for free prescriptions. At no point did anyone tell her this and she assumed this hadn't changed. Although it is true that she did not receive a new exemption certificate (this is an annual thing that confirms your eligibility)

Anyway about a month ago she received a notice from the NHS saying that she would be receiving penaltly charges for each of the prescriptions she had wrongly claimed. She has already received one penalty charge for dental treatment and one for the first prescription totalling over £200. Given that she has an ongoing condition that has requires regular prescriptions, there are presumably many more of these to follow, which will run into literally thousands of pounds. Given that she's on benefits because she has little money, obviously this is going to wipe her out. Obviously the NHS not telling her for nearly a year has blatently made it worse.

How can this possibly be fair for a genuine honest mistake? Any advice appreciated that I can pass on.

 

[KZNSeagull]

Sounds ridiculously unfair on the face of it. Surely the pharmacy should have checked her eligibility when she collected the prescriptions? Is her ongoing condition not one that she can claim free prescription?
Sounds like something that should be referred to her local MP to me.

 

[drew]

Citizen's advice and MP.

 

[METALMICKY]

Asking for a friend (seriously).
A friend of mine was receiving tax credits and then, towards the end of last year, they insisted that she switched over to universal credit. She always received free prescriptions under tax credits, but it turns out that under universal credit, not only does she receive less, but she also is no longer eligible for free prescriptions. At no point did anyone tell her this and she assumed this hadn't changed. Although it is true that she did not receive a new exemption certificate (this is an annual thing that confirms your eligibility)

Anyway about a month ago she received a notice from the NHS saying that she would be receiving penaltly charges for each of the prescriptions she had wrongly claimed. She has already received one penalty charge for dental treatment and one for the first prescription totalling over £200. Given that she has an ongoing condition that has requires regular prescriptions, there are presumably many more of these to follow, which will run into literally thousands of pounds. Given that she's on benefits because she has little money, obviously this is going to wipe her out. Obviously the NHS not telling her for nearly a year has blatently made it worse.

How can this possibly be fair for a genuine honest mistake? Any advice appreciated that I can pass on.

Sorry but she hasn't a leg to stand on. My old job was issuing NHS dental penalty charges. Her mistake is to assume. I've attached the form she should have signed and read at the dental practice.

The good news is that they wont dig up any previous incorrect claims. She needs to negotiate a payment plan with the NHSBSA

 

[METALMICKY]

Citizen's advice and MP.

Wasting your time. I had to write a to Ed Balls telling him that the penalty charge would still need to be paid by his constituent.

 

[Westdene Seagull]

Mrs WS had a similar experience but with the dentist. She was on Contribution based JSA. The form the dentist gave her just asked if she was on JSA - not what type. So she ticked yes and got the free treatment. Months later which ever government department manages this wrote to her and demanded the cost of the treatment because apparently it was only available to income based JSA recipients. Needless to say we ignored all the threats and they went away. Been over seven years now and haven't heard a thing.

 

[scooter1]

Sorry but she hasn't a leg to stand on. My old job was issuing NHS dental penalty charges. Her mistake is to assume. I've attached the form she should have signed and read at the dental practice.

The good news is that they wont dig up any previous incorrect claims. She needs to negotiate a payment plan with the NHSBSA

View attachment 189807

Sadly this.
I lost my job earlier this year and assumed that I would be eligible for free NHS dental treatment. I filled out the forms at the dentist, but was never warned about 2 different types of JSA. It turns out I wasn’t eligible, and received a retrospective fine. I explained the situation and happily offered to pay for the treatment well within the allotted time, but this fell on deaf ears And I had to pony up an extra £100. Very frustrating that there is simply no negotiation, and I’m still pissed off but it is what it is. When I suggested to the dental receptionist, that it might be a nice idea to ensure their patients were aware of what benefits they may be entitled to(just make sure they read the small print), she looked at me with such disdain and said that it wasn’t their job. Never assume….

 

[scooter1]

Mrs WS had a similar experience but with the dentist. She was on Contribution based JSA. The form the dentist gave her just asked if she was on JSA - not what type. So she ticked yes and got the free treatment. Months later which ever government department manages this wrote to her and demanded the cost of the treatment because apparently it was only available to income based JSA recipients. Needless to say we ignored all the threats and they went away. Been over seven years now and haven't heard a thing.

i wasn’t prepared to take the risk, but fair play to you and Mrs WS

 

[METALMICKY]

Mrs WS had a similar experience but with the dentist. She was on Contribution based JSA. The form the dentist gave her just asked if she was on JSA - not what type. So she ticked yes and got the free treatment. Months later which ever government department manages this wrote to her and demanded the cost of the treatment because apparently it was only available to income based JSA recipients. Needless to say we ignored all the threats and they went away. Been over seven years now and haven't heard a thing.

Sorry but you are wrong. The PR form she would have signed and should have read has always explained about the two types of JSA.

As for it not being chased she just got lucky. That's an admin error in Newcastle or they may had resource issues as such they were told to only chase Band 3 cases.

 

[Westdene Seagull]

Sorry but you are wrong. The PR form she would have signed and should have read has always explained about the two types of JSA.

As for it not being chased she just got lucky. That's an admin error in Newcastle or they may had resource issues as such they were told to only chase Band 3 cases.

Well I don't feel guilty regardless. Dentistry should be free under the NHS - it stands for National HEALTH Service - and your teeth are part of your health.

 

[Tom Hark Preston Park]

Well I don't feel guilty regardless. Dentistry should be free under the NHS - it stands for National HEALTH Service - and your teeth are part of your health.

NHS Dentistry isn't any more free than - for most people - NHS prescriptions are. Tho, assuming you can actually find an NHS dentist, treatment was always capped at an arguably affordable level

 

[METALMICKY]

Well I don't feel guilty regardless. Dentistry should be free under the NHS - it stands for National HEALTH Service - and your teeth are part of your health.

That's a whole different debate and I wasn't telling you to feel guilty. Your slightly terse tone reminds me how much crap I used to take on the phone. The system was flawed in that it did not do enough to chase those deliberately defrauding the NHS. It was cheaper and more profitable to chase those who just made genuine mistakes. However, those mistakes did cost the NHS millions. Never assume in your favour and at a simplistic level never put your signature to an official document that you have not bothered to read.

However, it's amazing how many people think NHS dentistry is free. It has only ever been subsided to a degree.

 

[Eeyore]

Asking for a friend (seriously).
A friend of mine was receiving tax credits and then, towards the end of last year, they insisted that she switched over to universal credit. She always received free prescriptions under tax credits, but it turns out that under universal credit, not only does she receive less, but she also is no longer eligible for free prescriptions. At no point did anyone tell her this and she assumed this hadn't changed. Although it is true that she did not receive a new exemption certificate (this is an annual thing that confirms your eligibility)

Anyway about a month ago she received a notice from the NHS saying that she would be receiving penaltly charges for each of the prescriptions she had wrongly claimed. She has already received one penalty charge for dental treatment and one for the first prescription totalling over £200. Given that she has an ongoing condition that has requires regular prescriptions, there are presumably many more of these to follow, which will run into literally thousands of pounds. Given that she's on benefits because she has little money, obviously this is going to wipe her out. Obviously the NHS not telling her for nearly a year has blatently made it worse.

How can this possibly be fair for a genuine honest mistake? Any advice appreciated that I can pass on.

I can't help you with the back dated stuff, but going forward, do ask your friend if they have a pre-paid NHS certificate.

My cupboard resembles that of a chemist with all the stuff I am prescribed. I pay just over £11 a month on direct debit and it covers the lot. I just tick the 'pre-paid' box in the chemist.

NHS Prescription Prepayment Certificate (PPC) | NHSBSA

A PPC could save you money if you pay for your NHS prescriptions. The certificate covers all your NHS prescriptions for a set price. You will save money if you need more than 3 items in 3 months, or 11 items in 12 months. The prescription charge in England is £9.90. A PPC costs:

www.nhsbsa.nhs.uk

With regard to previous stuff, chemists etc generally don't check these things. Mine went to a DD and each time they say they have no record. I just say it's coming out the account and they just put it through. If someone is wrong it will be picked up. Sorry to hear of your friend's situation, but do check the above with them. It will save a lot of money.

 

[Pevenseagull]

Very sorry to hear about the OP's friend. Had me scurrying to double check my circumstances. First checked regarding type 2 diabetes and saw that this needs to be certified, which I've never done. Fortunately I haven't been moved over to UC and am still on ESA (thankfully income related).

Don't know how far back it goes but if it was 5 years I would be looking at a fine of over £80,000 for prescriptions and a grand or so for dentistry. It's entirely possible that I wouldn't have realised this as I haven't signed an exemption at the pharmacy I use for years.

 

[Thunder Bolt]

@Arthritic Toe get your friend to sign up for the Prescription Season ticket asap. £11.16 a month for 10 months.

@METALMICKY is it possible this person can make an arrangement to pay these charges off gradually?

 

[The Clamp]

Another vote for the pre-paid certificate.

Another money saver they don’t tell you about.

I was paying £50 a month until I happened across a paragraph in a newspaper article last year which mentioned it.

Saved me a fortune.

 

[METALMICKY]

@Arthritic Toe get your friend to sign up for the Prescription Season ticket asap. £11.16 a month for 10 months.

@METALMICKY is it possible this person can make an arrangement to pay these charges off gradually?

Obviously policy can change but we definitely used to allow instalments. You will need to provide details of your essential outgoings to justify the instalments level you think you need. We used to have a crappy in house form we sent out. It may be that they now need something a little more robust and detailed and supplied by someone like Citizens Advice.

 

[Bodian]

What is the ongoing condition. Some of them entitle you to free prescriptions forever - such as some thyroid conditions. https://www.nhsbsa.nhs.uk/check-if-...dical conditions,help with other health costs

 

[Arthritic Toe]

Thanks folks for the informative replies, not least @METALMICKY for the nhs perspective. It doesn’t seem unreasonable though that if your circumstances haven’t changed when transferring to UC, it wouldn’t change your eligibility for prescriptions.

Where I think the nhs is at fault though is in the delay in letting her know. I mean would it be reasonable of them to wait 10 years and then fine her 50 grand or whatever? Surely not.

 

[METALMICKY]

Thanks folks for the informative replies, not least @METALMICKY for the nhs perspective. It doesn’t seem unreasonable though that if your circumstances haven’t changed when transferring to UC, it wouldn’t change your eligibility for prescriptions.

Where I think the nhs is at fault though is in the delay in letting her know. I mean would it be reasonable of them to wait 10 years and then fine her 50 grand or whatever? Surely not.

My area of expertise was NHS dental penalty charges so I can't really comment on prescriptions. Additionally, the whole benefits landscape has changed with so many benefits being absorbed into Universal Credit.

That scenario you mention never happens. Additionally, think about how practically your suggestion would work? The NHS does not have the resources to blanket check X million exemption claims of which millions might be legitimate and then simply warn all those that are incorrect.