Changes to prescription charges and exemptions could bring in millions of pounds of extra revenue.

Controversial proposals from the Department of Health and Social Care include pensioners under the age of 75 losing the right to free prescriptions, eye tests and dental treatment. The prescriptions exemption would also be removed from pregnant women and patients with specific medical conditions, such as diabetes or epilepsy.

In addition, prescription charges are set to increase from £3.85 to £5.

The DHSC has come under fire for the proposals, but it has pointed out those on income-based benefits would still be exempt and that a pre-payment certificate option of £60, equated to £5 a month.

David Ashford, in a written Tynwald question, asked Health and Social Care Minister Kate Beecroft how much extra revenue was expected to be raised by the increases in prescription charges.

She said the amount recouped for the year ending March 2017 was £692,481.

’It has been estimated that the proposed changes to the prescription charges and the changes to exemption categories included in the National Health and Care Service General Scheme could potentially increase the amount recouped to approximately £3.86 million,’ Mrs Beecroft said.

’However, the department stresses that it is also anticipated that many more people will take up the option of purchasing pre-payment certificates, which could significantly reduce this figure.’

Mr Ashford also asked how, if current exemptions were retained, but higher prescription charges were increased, that would affect revenue.

The minister said, based on the number of chargeable prescriptions in 2016/17 - 180,418 - an increase to £7 would result in income of £1,262,926 (an increase of £570,445).

At £9, that would be £1,623,762 (£931,281 increase) and, at £10, it would be £1,804,180 (£1,111,699).

But she stressed the figures were an estimate and ’very dependent on the take-up of pre-payment certificates’.

Mr Ashford queried how the age of 75 was arrived at for the point at which free prescriptions would be allowed under the proposals. Mrs Beecroft said it was ’based on the age agreed by Tynwald at which people become eligible for free television licences’.

In a further question, Mr Ashford wanted to know how exemptions would be consistent, if made on a case by case basis, as has been suggested.

Mrs Beecroft said the scheme was drafted with the aim of reducing the amount of people who would need to appeal, ’so ensuring consistency between claims should be relatively straightforward by simply comparing one case against previous ones’.

She added: ’The scheme, as drafted, continues the policy of exempting those who are on the lowest incomes and have applied and been approved for income-based benefits.

’It is anticipated that the majority of people who are not on low enough income to claim benefits will make use of the existing pre-payment certificate option whereby they can pay in advance for all of their prescriptions.

’Under the scheme the cost of a pre-payment certificate will be £60, which equates to £5 per month.’

Replying to a question from Juan Watterson (Rushen), Mrs Beecroft said the department was working on direct debit and online payment methods for the pre-payment certificates.