Tuesday, 3 July, 2001, 10:57 GMT 11:57 UK
Poor people with chronic health problems are failing to get drugs they desperately need because prescription charges are too high.
The National Association of Citizens Advice Bureaux (NACB) say around 750,000 people in England and Wales fail to get their prescriptions dispensed because of the cost.
The NACB has called on the government to scrap prescription charges or institute a whole scale reform of the charging system to make sure the poor are not penalised by pricing the pre-payment certificates on a sliding scale.
Prescriptions now cost £6.10 per item in England and 80% of those aged 18 to 60 have to pay the full cost.
People on income support, or with an equivalent income get free prescription, but if their income exceeds this level - even by a few pence - they lose all help with payments.
Pre-payment or "season tickets" allowing unlimited prescriptions cost £87.60 for a year or £31.90 for four months, but the NACB said this was too much for many people on low incomes to pay upfront.
GPs have already expressed their concern about the system and a recent poll of doctors showed that one in five admit breaking the prescribing laws to make sure poorer patients get their medicine.
A survey by the NACB of 1,029 of their clients who had paid prescription charges within the last year found that 28% had failed to cash all or part of their prescription because of the cost.
Half said they had difficulty affording the payment and 20% of those with problems were on incapacity benefit or disability or sickness benefits.
The NACB said that people with long term health problems were the worst hit, with 37% failing to get all or part of their prescriptions dispensed.
They found that people with asthma were rationing their own medication to keep their costs down and that people with mental health problems were having to make difficult choices between living below the poverty line or taking their drugs.
A single mother with glaucoma, who is registered blind, was told she would lose what little sight she has unless she takes her prescription eye drops.
But she told the NACB that she cannot afford the eight items a month, or to pay for a pre-payment certificate.
Another woman with multiple sclerosis said she had to pay between £30-42 a month for her drugs out of her income support and disability living allowance.
She had applied for free prescriptions but was told her income was 15 pence over the limit.
David Harker, NACB chief executive said: "The experience of CAB clients shows that prescription charges can seriously damage your health, and the impact is felt most severely by people on low incomes and with long term health problems.
"It is hard to see what purpose prescription charges serve when so many people do not have to pay, but so many of those who are required to pay can literally ill afford the cost."
Deborah Jack, Chief Executive, National Asthma Campaign said: "This new research reinforces what callers to our Asthma Helpline tell us everyday.
"Prescription charges are an unfair tax on people with asthma.
"It is ludicrous that some people with long term medical conditions are exempt from paying for prescriptions whilst others - including people with asthma - are burdened with the cost of their life-saving medication.
"People with asthma who cannot afford to pay prescription charges and therefore limit their asthma medication to control their asthma are putting their health at risk.
A spokesman for the Department of Health said that 85% of all NHS prescriptions were dispensed free, with a further 5% going on pre-payment certificates.
But they said they would be studying the NACB report closely.