The astronomical amount the NHS could lose to fraud this year exposed

Parliamentary update on free prescriptions

Health minister James Frith has set out the government’s position on medical exemption certificates in a parliamentary reply to Liberal Democrat MP Ian Roome, according to reporting carried by the Evening Chronicle, Kentlive, Bristol Post, Cambridge Evening News, Daily Post, Teessidelive, Surrey Advertiser, Gloucestershire Live and Plymouth Live. Roome had asked whether officials routinely review the certificates that allow people with qualifying conditions to obtain NHS prescriptions free of charge, and what factors guide those decisions.

Frith replied that the government keeps all policies under regular review. He added that ministers are also taking steps intended to ease costs for those who do pay. In a statement quoted across those outlets he said: “This Government is also continuing to take action to make prescriptions more affordable for everyone, including freezing prescription charges for the 2026/27 financial year, both for single prescriptions and the three month and annual prescription prepayment certificates commonly used for long-term conditions.”

A valid medical exemption certificate must be held before free collection of NHS prescriptions on medical grounds. People with certain medical conditions and those receiving qualifying benefits may be entitled to free medication, the same cluster of reports notes.

Current charges and the freeze

The standard NHS prescription charge in England stands at £9.90 per item. That rate applies across 2024/25 through 2026/27 under the freeze announced by Frith. By contrast, NHS prescriptions are free of charge for everyone in Scotland, Wales and Northern Ireland, the regional outlets report.

Daily Express reporting separately records the price of an NHS Prescription Prepayment Certificate at £32.05 for three months or £114.50 for twelve months. The certificate covers all dispensed drugs for a fixed fee, producing savings once a patient receives more than three items in three months or eleven items in a year.

How costs have changed

Several years of incremental rises mean the English charge is higher than earlier in the decade. According to the multi-outlet parliamentary coverage, the charge stood at £9.35 per item in both 2021/22 and 2022/23 (when it was frozen), rose to £9.65 in 2023/24, and reached £9.90 from 2024/25 onward. Relative to five years earlier the item charge is 55p higher. For a patient needing four items a month that equates to an extra £2.20 a month, or £26.40 a year. Looking back a decade, the charge was £8.20 per item—£1.70 less than today’s figure.

Those arithmetic illustrations appear consistently in the Evening Chronicle and the other regional titles that covered Frith’s reply, framed as practical information for readers who pay.

Medical exemption certificates

Eligibility for a ten-year medical exemption certificate rests on a defined list of conditions. As set out in the same parliamentary-coverage cluster, a person qualifies if they have any of the following: a permanent fistula (for example caecostomy, colostomy, laryngostomy or ileostomy) requiring continuous surgical dressing or an appliance; a form of hypoadrenalism such as Addison’s disease for which specific substitution therapy is essential; diabetes insipidus and other forms of hypopituitarism; diabetes mellitus except where treatment is by diet alone; hypoparathyroidism; myasthenia gravis; myxoedema (hypothyroidism needing thyroid hormone replacement); epilepsy requiring continuous anticonvulsive therapy; or a continuing physical disability that means the person cannot go out without the help of another person.

Five-year certificates are available for people undergoing certain treatments, though the full treatment list is only partially detailed in the source material. Holders must still present a valid certificate when collecting free prescriptions.

Fraud exposure and Counter Fraud Authority warnings

A separate strand of reporting, carried by the Daily Express, focuses on financial risk to the NHS from misuse of exemptions and related schemes. Analysts cited by that outlet put the sum vulnerable to patients abusing the system through exemption fraud at £230.2 million. Services that normally require upfront payment include prescriptions, dentistry and ophthalmology.

The NHS Counter Fraud Authority is quoted at length on several patterns it regards as highly likely. On the onward trade of prescription medication it states: “The onward trade of prescription medication for personal gain remains highly likely in this area. This can involve selling unwanted or unused medications as well as intentionally obtaining controlled medications via deception (by) feigning illness or injury to specifically obtain and sell prescribed items for profit, particularly in lucrative markets abroad. An emerging trend identified was the onward trade of prescriptions relating to weight-loss.”

The Daily Express notes that as many as two million people in Britain are using weight-loss drugs, the majority purchasing them privately because of strict NHS eligibility rules. NHS weight-loss medicines named in the report include the injections tirzepatide (Mounjaro), semaglutide (Wegovy) and liraglutide (Saxenda), together with the tablet orlistat—all prescription-only.

Identity theft used to register for NHS services or medication is likewise described by the authority as highly likely. Its quoted assessment links the method most commonly to individuals who have entered the United Kingdom unlawfully and who use false, stolen or borrowed identities to avoid detection, sometimes under the misconception that they are entitled to no free NHS treatment or out of concern that details might be shared with immigration enforcement. The authority also records links between repeated false identities or addresses and claims for state benefits such as Universal Credit alongside NHS registration.

Patient charge evasion—deliberately avoiding charges for prescriptions, dentistry or optical services—is characterised as remaining highly likely. The NHS low-income scheme offers a means-tested route to exemption, yet the authority states it is a realistic possibility that some patients withhold information in order to qualify.

Policy context

Taken together, the material presents two concurrent strands of public information. On one side, ministers have confirmed a freeze on English prescription charges and prepayment certificates for 2026/27 and have restated that medical-exemption policy is kept under regular review, while regional reporting supplies detailed cost histories and the clinical criteria for long-term free prescriptions. On the other, the Daily Express account of Counter Fraud Authority assessments and the £230.2 million vulnerability figure underscores institutional concern about exemption abuse, identity misuse and the secondary market in prescribed medicines, including weight-loss treatments. Both strands concern the same system of charges and exemptions, yet they emphasise different pressures—affordability for legitimate patients and financial leakage through fraud.

Readers who believe they may qualify for free prescriptions on medical or income grounds are directed by the regional coverage to check their status, given that cumulative charge increases have raised annual outlays for those who pay. Separately, the fraud warnings highlight the enforcement and integrity challenges that accompany a charging regime with multiple exemption routes.