Prescription charges being increased to £10 is just one of many ideas put forth by a think-tank as a way to raise billions of pounds for financially struggling NHS services. Reform, an independent centre-right think-tank want to raise prescription costs from the current charge of £7.85 to £10, and introduce charges to groups currently exempt from paying. The elderly and pregnant women would therefore have to pay for prescriptions with Reform’s new controversial suggestions. In England an estimated 90% of prescriptions are dispensed free of charge, whilst Wales, Scotland and Northern Ireland have no prescription charges in place. Prescription charges in England generate around £450 million a year, with the total government spend on prescription services standing at around £7.9 billion. However, the British Medical Association have said they believe the system is “unfair” and believe England should be like other countries in the British Isles and abolish prescription charges. Reform say that increase of the cost of certain health services are vital though to fund improvements NHS services; surgeries opening at weekends being one example. They say increasing prescription charges from £7.85 to £10, in addition to the cost of a Prescription Prepayment Certificate (a way for patients to obtain prescriptions in bulk to save money) rising from £104 to £120, would help to generate £134 million annually. Reform also suggest the possibility of mimicking the French system, whereby there is a low prescription charge of £3, and only 20% of prescriptions are dispensed without charge, could raise £1.4 billion annually. Other ways to generate money that Reform have suggested include bringing in a flat rate charge of £10 for GP consultations or £10 fines for each missed hospital appointment. They estimate this could raise £1.2 billion and £55 million a year, respectively. Controversially, Reform also want to introduce a means-tested system for end of life care, forcing most dying patients to pay for any pain relief and nursing care they require. Thomas Cawston, research director at the think-tank, attempted to defend Reform’s ideas, which are likely to cause outrage amongst millions of people. He said: “The Government must find a way of generating more money for the NHS. “We currently have a system which is very generous. A lot of people who are reasonably well off wouldn’t mind paying £10 for a GP appointment on a Saturday morning, for example. Few will want to debate higher NHS charges but the funding outlook for the service makes it unavoidable. Prescription charges are the easiest route to new revenue, with exemptions for people on low incomes built in.” Earlier in the year, a survey found that around half of GPs agree that patients should be charged for appointments, with figures of between £5 and £25 a time being put forward. Dr Shailendra Bhatt, a GP in Hemel Hempstead in Hertfordshire, commented: “I work in a walk-in centre. The amount of people who come through the door for practically no reason at all and say “I was out and saw this sign for a walk-in centre where one can see a doctor, so I came in.” People don’t value the things if they get it cheap, worse still if they get it for nothing.”