Patient care must not suffer as a result of changes to prescription charges and exemptions, a GP has warned.

Under proposals unveiled this week, state pensioners below the age of 75 will lose the right to free prescriptions, eye tests and dental treatment - in a move that will save £1m-plus a year.

Others who will no longer be exempt from making a contribution to charges will be women who are pregnant or who have given birth in the past 12 months.

Patients with specific medical conditions such as epilepsy and diabetes will no longer be able to apply for an exemption.

And for those who will have to pay, prescription charges are also going up, as is the cost of dental treatment, while ’free’ eye tests will now be every two years - and you will have to pay a £10 contribution.

But while children, the over-75s and those on benefits will still get free prescriptions, sight tests and dental treatment, there are concerns that the changes will impact on struggling pensioners and other vulnerable people.

Dr Alex Allinson, GP and Ramsey MHK, warned of unintended consequences.

He said: ’Charges should not be used as a barrier to access.

’If people delay seeing their doctor, dentist or optician when they have a genuine problem this will delay diagnosis and treatment which could cause long term medical problems and disability.’

’The changes are not intrinsically fair, but are the first step towards an honest system of means testing. It will affect people on low incomes but not receiving benefits and struggling pensioners.

’It is essential that DHSC monitor the effects of any changes to make sure that patient care doesn’t suffer.

Dr Allinson said he was concerned the proposal does not give pregnant women free prescriptions.

But he said he supported the ending of the ’unfair and arbitrary’ exemptions on medical grounds. ’These gave someone with an underactive thyroid free prescriptions not just for Thyroxine but for everything. Diabetics got free prescriptions but asthmatics didn’t,’ he explained.

He added: ’GPs recognise the financial pressures the NHS here is under.

’It is inevitable we will need to introduce a robust and fair way of means testing.’

Ramsey MHK Lawrie Hooper tweeted: ’I’ve no issue asking those who can afford to pay for prescriptions, it’s those struggling but not on benefits I’m concerned for.

’Low income groups need to be protected.

’I’m sure people would prefer income tax up by 1 or 2 percent and abolishing a shedload of these "stealth" charges.’

The changes form part of a public consultation on proposals to make the law governing how the health service works more flexible to meet current and future needs.

Prescriptions for everyone would increase from £3.85 to £5 per item.

The contribution towards the costs of dental treatment would also increase, from between £18.50 and £219 to between £20.60 and £244.30.

Health bosses are urging people to buy an annual pre-payment certificate to cover the costs of all their prescriptions .

These certificates will increase in price under the proposals from £19 to £20 for four months and £54 to £60 for 12 months.

Health and Social Care Minister Kate Beecroft said: ’There is no new money and if we want to provide services such as the pressing need to introduce a 24-hour thrombolysis service for people who suffer a stroke, then something has got to give.’

She added: ’This is not just about charging people to make up a deficit. This is about improving the service we provide.’

Mrs Beecroft said the saving would be ’£1m-plus’ but it was difficult to give a figure until it was known how many would use the pre-payment certificates.

She added: ’If you are in particularly difficult circumstances there is an appeal process.’

Prescription charges do not apply to contraceptives so these don’t require any specific exemption.

In the UK, over-60s get free prescriptions and free sight tests but there isn’t an exemption for the elderly for dental charges.

Prescription charges have not increased since September 2010 and even with the proposed rise to £5, that’s still well below the £8.60 per item charged in England.

Mrs Beecroft pointed out that the cost of many medicines far exceed the £5 per item being proposed.

More than £17m was spent on prescriptions last year, funding more than 1.6 million items.

Of these, 90 per cent was issued free of charge. Less than £700,000 was recouped in fees.

The public consultation runs to September 12.