Observation (CEACR) - adoptée 1995, publiée 82ème session CIT (1995)

1. Article 9 of the Convention (free pharmaceutical aid). In reply to the Committee's previous comments concerning the participation by victims of industrial accidents in the cost of pharmaceutical products prescribed for out-patients, the Government reiterates that it has no plans to extend automatic exemption from prescription charges in cases of industrial accidents because of the risk of adversely affecting the relationship that exists between patient and doctor, the latter having to decide not only which medicines should, or should not, be dispensed free of charge, but also whether or not a particular ailment was a consequence of the accident. Moreover, the Government states it would be unfair to single out one particular group for such exemption when there may be others in similar circumstances, such as the innocent victims of road accidents or assaults, who might equally feel that they too should be exempt. Furthermore, extending automatic exemption to victims of industrial accidents would not necessarily direct help towards those most in need, since only those people whose income is above the qualifying threshold for charge remission would benefit from such a change. In this respect, the Government continues to believe that the manner in which the National Health Service defrays the costs of medical aid in cases of industrial accidents is best targeted on those who are likely to have the greatest difficulty in paying, with a view to ensuring that adequate protection is provided to those that need it.

Notwithstanding these explanations, the Committee notes that the prescription charge has been increased from 2.80 on 1 April 1989 to 4.25 from 1 April 1993. It recalls, however, that no charge is made for pharmaceutical aid whilst a patient is resident in hospital as well as for those out-patients whose income is below a certain threshold. It also notes that, as stated by the Government, about 80 per cent of prescribed items (89 per cent in Northern Ireland) are now dispensed free of charge due to extensive arrangements for prescription charge exemption and remission which protect vulnerable groups in the community, including old and young people of a certain age, pregnant women and mothers who have had a baby in the previous 12 months, war or Ministry of Defence disablement pensioners, and people who suffer from certain medical conditions. In the light of these extensive exemptions, the Committee considers that it should not be difficult for the Government to include victims of industrial accidents, irrespective of their income, among the categories exempted from the prescription charge so that, if treated at home or after leaving hospital, they may benefit or continue to benefit from the free pharmaceutical aid as is recognized to be necessary in consequence of accidents. In this respect, the Committee wishes once again to draw the Government's attention to the fact that any provision laying down participation by victims of industrial accidents in the cost of pharmaceutical benefits is contrary to the Convention. It therefore once again hopes that the Government will reconsider its position so as to ensure full application of the Convention on this point.

2. The Committee notes the comments made by the Trades Union Congress, supplied by the Government with its report, according to which, since 1979 most of the previous benefits of the Industrial Injuries Scheme have been steadily abolished by the Government and in 1986 entitlement to the most significant of benefits, Disablement Benefit, was drastically restricted. In the light of these comments, the Committee hopes that the Government's next report will contain full information in reply to the TUC comment, specifying the legislative changes that have taken place with reference to the application of the Convention. The Committee also asks the Government to provide the detailed statistical information requested in point V of the report form adopted by the Governing Body.

[The Government is asked to report in detail by 1 September 1995 at the latest.]