Select Committee on Health Written Evidence

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 key concern.

  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 income scale.

  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 further information.

Liz Phelps

Citizens Advice

13 February 2006

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