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Penalty charge notices in healthcare inquiry


Some people are exempt from paying for prescriptions and/or dental treatments if they have a valid reason which can include: age, medical conditions, maternity, or because they receive certain benefits or have a low income. Those who claim a free prescription or dental treatment without a valid reason – whether fraudulently or in error – could be issued with a penalty charge notice (PCN).

The NHS estimates that it lost around £212m in 2017-18 from people incorrectly claiming exemption from prescription and dental charges. However, the value of PCNs has risen significantly: the value of prescription PCNs, for example, has risen from £12bn to £126bn between 2014-15 and 2018-19. Overall, since 2014 PCNs have generated £133m for the NHS.

A recent National Audit Office (NAO) report found that the rules around entitlement to free prescriptions and dental treatments are complicated, and that this is leading to genuine mistakes and confusion for many people. Eligibility is a significant cause of this confusion: people’s eligibility can change rapidly and there are differences between the eligibility rules for prescriptions and dental treatments. While the number of eligibility checks has increased significantly (prescription checks for example have risen from 750,000 in 2014-15 to 24 million in 2018-19), communication to help people understand PCNs only started in September 2018.

On 1 July at 4.00pm, the Public Accounts Committee will question the NHS and Department of Health and Social Care about the effectiveness of current PCN arrangements. It will challenge the Department on the complexity of the eligibility rules for PCNs and the impact on vulnerable people. It will also use the session to question the NHS Business Services Authority, who are responsible for issuing the PCNs, on the steps it is taking to improve the system.