To ask the Secretary of State for Health, what the penalties are for incorrect prescription charge exemption claims; what appeal mechanisms are in place to contest those penalties; and if he will make a statement.
11 February 2015
The National Health Service (Penalty Charge) Regulations 1999 set out that where a person fails to pay a NHS charge which they are liable to pay, they may be issued with a penalty notice. The penalty charge is a civil fine – it is five times the amount a person should have paid, up to £100. This is on top of the original prescription charge, currently £8.05 per item. Where a person fails to pay the penalty charge within a period of 28 days, the penalty charge will be increased by 50%.
The NHS Act 2006 (section 194) allows for a fine of up to £2,500 (level 4 on the standard scale, Criminal Justice Act 1982) for those found guilty of knowingly making a false claim to exemption from prescription charges.
A person who wishes to challenge the request for payment of a penalty charge by the NHS Business Services Authority (NHSBSA), may explain their circumstances to the NHSBSA and if they can demonstrate to the NHSBSA’s satisfaction that they did not act wrongfully, or with any lack of care, they will not be subject to a penalty charge. The NHSBSA also has discretion to waive the penalty charge where the person concerned provides compelling reasons for making an incorrect claim for exception. A person who is not satisfied with the handling of their case may use the NHS complaints process to make a complaint against the NHSBSA. Ultimately, this can be escalated to the Health Service Ombudsman.