The NHS could soon stop providing gluten-free foods and some over-the-counter drugs in an attempt to get better value for money.
Simon Stevens, the chief executive of the NHS, said GPs will be told to stop prescribing for coeliac disease sufferers, people with haemorrhoids and travel vaccines, as well as several other conditions and treatments.
I find this deeply worrying. Doctors prescribe what their patients need to get well or to stay well and the NHS has to support that.
While many readers will assume his comments mean that the NHS will merely stop supporting trendy food fashionistas who have made a choice to eschew gluten, in actual fact it is going to hurt people who have a live-long, unavoidable condition.
Food is treatment
I have a friend who has coeliac disease, as do two of her children. The family need gluten-free alternatives to staples such as bread and pasta – even ingesting a few crumbs left on a chopping board can leave them feeling unwell.
They are not following a foodie trend; they have an ongoing lifelong condition.
Unless they avoid gluten for the rest of their lives, they will experience long-term health problems and cost the NHS money as a result.
Their medication is their food. They need it, but it is far more costly than normal food, as well as coming in much smaller packets.
Just as other people require regular pills to stay healthy, they need gluten-free alternatives.
And if our NHS is truly free at point of use then it will provide them with the treatment they need, even if that treatment is bread and pizza bases.
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The cost of gluten-free food
Unless you have had to buy gluten-free food every day, you'll be amazed how much it costs.
Yes, in restaurants and other eateries you might spot ‘gluten-free roll 30p extra’ and think it’s not so bad.
Yet people who cannot eat gluten face a lifetime of enhanced costs.
The campaign group Coeliac UK warns that, without a gluten-free diet, sufferers face serious health complications including osteoporosis, infertility and even bowel cancer.
Access to prescriptions has been shown to help maintain the diet.
Sarah Sleet, chief executive of the organisation, says: “I am very concerned that vulnerable and elderly patients today will be waking up to the headlines that prescriptions for the breads and flours that they rely upon as part of a healthy balanced diet will be removed in one fell swoop.
“The worry and distress this will cause should not be underestimated.”
And although it has been said that the price of gluten-free alternatives has come down substantially, that is not supported by the actual evidence.
Coeliac UK has monitored industry data for years and highlighted that, since 2008, gluten-free bread has cost six times as much as the standard variety, and it has not reduced in price in all that time.
And while it’s tempting to suggest that coeliac sufferers eat alternative cheaper foods, that’s not an answer.
Rice has 96% less iron and 90% less calcium than bread, while potatoes have 71% less iron and 93% calcium.
People need these prescriptions to stay healthy and stay out of hospital. They should not face higher food costs because they have a medical condition.
What about everything else?
Today’s debate is not just about gluten-free food, of course. It’s about sun-cream and painkillers and other items described as ‘low value’.
I fear that actually these are just the areas where NHS England believes the public will approve of cuts.
We can be scathing of people getting such items on prescription when we have to pay for them ourselves.
However, in actual fact such items are prescribed where there is a real need.
I can’t get sun-cream on the NHS, however, my friend’s daughter has a painful skin condition and requires the most expensive and long-lasting sun-cream.
She gets that on prescription, as should all parents in a similar situation. No one needs to be working out whether they can afford to top up their child’s sun protection!
This might be interpreted as a clampdown on chancers who want to avoid spending money if they can get the taxpayer to cough up.
But, in actual fact, it is about providing people with the correct treatment to keep them well and to avoid longer-term health issues arising.
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With a great NHS comes great responsibility
Of course, I do understand that some people abuse the system. Back in 2015 a mother’s Facebook post went viral after she explained that under the Minor Ailments Scheme parents can get free Calpol, plasters, anti-histamine and more.
The story was covered by the press as if it was a way for parents to stockpile medical kit for their kids, when actually it was intended as a way for people to get treatment without visiting their doctor.
NHS Choices explained: “The scheme is designed to offer medication to meet an acute need.
“It is not an opportunity for parents to stock up on free children's medications – if a pharmacist thinks someone is trying to abuse the system, they can refuse any request for treatment at their discretion,” but the damage was done.
As a writer who covers money saving, I still get emails from readers suggesting I cover this way to get ‘free’ Calpol.
That clearly is abuse of the system and it is right that we crack down on parents who are simply exploiting it to fill their cupboards with medicines in case they need them.
However, that is a very different thing to people with long-term health conditions being prescribed the treatment they need to stay healthy.
We shouldn’t assume that, because some people abuse the system, the answer is to tear down the system entirely!
Today it’s gluten-free food, tomorrow it could be asthma medication.
Once we accept that the NHS does not have to pay out for chronic disease treatment we start down a slippery slope that undermines everything we value about our healthcare system.
What do you think? Should there be restrictions on what can be prescribed? Do you disagree with our writer? Maybe you routinely receive a prescription that is now under threat. Have your say in the comments section below.
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