On 1 April this year the NHS prescription charge rose from pounds sterling 4.25 to pounds sterling 4.75. This was an increase of 11.8%, almost six times the rate of inflation, and the 16th rise in the prescription charge since 1979, producing a total rise of over 2000%. A total of pounds sterling300m is raised by prescription charges but the charge is paid for only one in five prescriptions. All the rest are provided to patients in one or other of the exempt categories.1 The burden of this particular form of indirect taxation is falling on a small minority of health service users.

For some reason general practitioners responded to this particular rise in a way they had not done before: they began to issue private prescriptions to non-exempt patients whenever the cost of the medicines was less than the prescription charge. They were supported in this by many community pharmacists.2 Private prescriptions began to be issued on …