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National Health Service (Free Prescriptions and Charges for Drugs and Appliances) (Wales) Regulations 2007

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Exemptions

8.—(1) Subject to paragraph (3), no charge will be payable under paragraphs (2) or (5) of regulation 3 or paragraph (2) of regulation 4 by

(a)a person who is exempt under paragraph 1(1) (a) to (d) of Schedule 12 to the Act(1);

(b)a person who has attained the age of 60 years;

(c)a woman with a valid exemption certificate issued by arrangements in England, Scotland or Northern Ireland on the ground that she is an expectant mother or has within the last twelve months given birth to a live child or a child registrable as still-born under the Births and Deaths Registration Act 1953(2);

(d)a person with a valid exemption certificate issued under arrangements for exemptions from charges for drugs and appliances in England, Scotland or Northern Ireland on the ground that he or she is suffering from one of more of the following conditions—

(i)permanent fistula (including caecostomy, colostomy, laryngostomy or ileostomy) requiring continuous surgical dressing or an appliance;

(ii)the following disorders—

  • forms of hypoadrenalism (including 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

(iii)epilepsy requiring continuous anti-convulsive therapy;

(iv)a continuing physical disability which prevents the patient from leaving his or her residence without the help of another person;

(e)a person with a valid exemption certificate issued under arrangements for exemptions from charges for drugs and appliances in England, Scotland or Northern Ireland in respect of the supply of drugs and appliances for the treatment of accepted disablement;

(f)a person with a valid pre-payment certificate issued under arrangements for exemptions from charges for drugs and appliances in England, Scotland or Northern Ireland.

(2) Subject to paragraph (3) a person who wishes to claim entitlement to exemption under paragraph (1) must provide any declaration of entitlement required under regulations 3(8) or 4(3).

(3) A person who is exempt under paragraph 1(1)(c) of Schedule 12 to the Act or under paragraph (1)(b) of this regulation is not required to provide any declaration of entitlement required by regulations 3(8) or 4(3) where—

(a)an equivalent prescription form; or

(b)an equivalent repeatable prescription,

is issued and the person’s date of birth is printed by means of a computer on the relevant form.

(4) An exemption by reference to age or the validity of an exemption certificate is to be determined by reference to the age or validity on the day on which—

(a)in the case of pharmaceutical services provided by a chemist, the order for drugs or appliances is presented for dispensing;

(b)in any other case, the drugs or appliances are supplied.

(5) Where a claim to exemption has been made but is not substantiated and in consequence of the claim a charge has not been recovered, the Local Health Board or, where the drugs or appliances were supplied by an NHS trust, that NHS trust must recover such charge from the person concerned.

(1)

Sub-paragraphs (1)(a) to (d) of paragraph 1 of Schedule 12 to the Act is replaced by sub-paragraphs (1)(a) to (d) respectively of section 122 of the National Health Service (Wales) Act 2006 with effect from 1 March 2006.

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