Supplementary memorandum from the Citizens
Advice (CP 20A)
Further to our appearance on 2 February, there
were certain additional points we would like to make the Committee
aware of. Much of the CAB advice work which takes place in over
1,000 healthcare settings across England and Wales focuses on
tackling problems of low income and debt, thus helping relieve
the stress and anxiety which often underscore patients' clinical
symptoms. Typically the CAB adviser will run regular sessions
in the GP surgery or other health setting to see patients referred
by their health professional. A fundamental part of the work will
be to ensure patients have claimed all the benefits to which they
are entitled, and so helping with claims under the NHS Low Income
Scheme would be central to this work. The presence of CAB advisers
in the health setting also means they are well placed to encourage
the general promotion of help with health costs through the display
of publicity material and claim forms.
For example, one bureau working in a mental
health venue noticed that patients were being asked to attend
psychotherapy sessions in the evening, at a time when there was
no facility open to enable them to get refunds of travel costs.
Following intervention by the bureau, this has been rectified.
One of the fundamental purposes of DWP is the
alleviation of poverty, so issues around the cost of health charges
and take up of the Low Income Scheme (LIS) must be of concern
to them. In addition a key strand of their current plans is to
provide greater support to people with health conditions and disabilities
seeking to move into work. Ensuring that this group, many of whom
are on incapacity benefit, are not prevented by financial reasons
from accessing the healthcare they need, should therefore be a
The MORI figures we quote in our report Unhealthy
Charges suggested that some 750,000 people are failing to get
their prescriptions dispensed because they cannot afford the charge.
We understand that the Department of Health believes that some
44,000 have benefited from the April 2004 easement on entitlement.
This suggests that significant further reforms are still needed.
One option would be to extend exemption from prescription charges
to anyone receiving a means tested benefit (ie housing or council
tax benefit as well as IS/JSA). This would be a better way of
ensuring people on Incapacity Benefit and on a low income receive
the help they need, than relying on them claiming under the LIS.
It would also have the effect of extending help further up the
In addition, one way to promote take up of the
Low Income Scheme (LIS) would be to develop greater links between
DH and DWP, in order to take advantage of DWP benefit delivery
mechanisms. For example Jobcentre Plus is moving to a "Standard
Operating Model" in which applications for incapacity benefit,
income support and jobseeker's allowance are taken in a single
phone call which is intended to capture the applicant's circumstances
and to establish entitlement to benefits. This would provide an
excellent opportunity to identify claimants entitled to help under
LIS, as on the one hand much of the information required for the
HCI is common to that required for IS/JSA, and on the other hand
a key group to target is people claiming incapacity benefit but
not entitled to IS/JSA.
Please do let me know if you would like any
13 February 2006