ABOLISHING CHARGES FOR CHECK-UPS WITHIN NHS SCOTLAND: TWO CASE-STUDIES

The NHS was founded in 1948 with the broad premise of treatment being free at the point of delivery. However, various charges have been levied since the inception of the NHS for both dentistry services and ophthalmic services including those for check-ups. The purposes of charges are to generate revenue while at the same time influencing an individual’s behaviour away from unnecessary demand that a zero-price service may generate. To ensure a charge is not a barrier to those who are requiring the service, exemptions are commonly used to allow an individual to access the service for free. Such exemption schemes can be categorised within three broad areas: financial status, age and/or a medical condition. The Scottish Government (formerly Executive) has taken the decision in recent years to review the use of charges for both dental check-ups and eye examinations. Both policies replaced a charge for the respective service unless the individual was within one of the relevant exemption categories. Researchers at the Health Economics Research Unit have been involved in analysing the impact of the total abolition of routine eye-examination charges and dental check-up charges in Scotland and we present these as case-studies.