The NHS cut down on prescriptions deemed to have low clinical value

[Amp34]

I do actually and my condition is a fair bit worse than just being gluten intolerant.

If you're gluten intolerant then you wouldn't get a description.

Coeliac disease is not an intolerance (for example).

Honestly I don't know much about low fibre diets so i'm not going to comment on that, but at the same time it's not a GF diet.

EDIT: And to clarify, I wouldn't be against the idea of grants for those on low incomes that have other food related medical conditions that are not easily avoided.

 

[Dis86]

My argument was that Avenged's idea of a grant for food was a good idea. I then went further and suggested that it should be means tested so those on low income were the only ones that could get it. That's why I'm using a scenario like that.

Low income doesn't necessarily equate to long hours of low pay.
What about someone who works part time so sits below x threshold even though their rate of pay might be very good?

 

[Amp34]

Low income doesn't necessarily equate to long hours of low pay.
What about someone who works part time so sits below x threshold even though their rate of pay might be very good?

What about it?

How is that going to affect the person that doesn't work part time, that is on a low wage?

Why do we have lots of other benefits? That example you used could equally be used to restrict or remove many other benefits that are provided to people on low incomes.

 

[dowie]

If you're gluten intolerant then you wouldn't get a description.

The point is still the same, I've got a condition that is rather more serious than being intolerant to gluten and I've got to make dietary changes as a result. I know what it is like to have rather severe abdominal pain and I know what it is like to have to be careful with what you eat.

 

[Glaucus]

I'd wager that about a quarter of the staples in your cupboard have some form of gluten in (in some form, even if it's not obvious). For example the base for a lot of sauces and recipes in Chinese and eastern cooking is soy sauce. Do you never use that?

Again, unless you actually have to follow a diet religiously then it's unlikely you'll ever really understand, especially when it's a diet that involves removing a staple ingredient that is prevalent in the majority of produced foods, whether by design (pies, bread etc) or because it's a cheap filler (wheat flour instead of corn flour for example).

Anyway I'll leave it at that. You can go on insisting that it's not true, even though it appears you have never actually had to experience it, at least for a reasonable period of time, even when two people that have actually had to experience it for decades (it's been 15 years for me) have told you that's not the case.

just shows even more of your ignorance, like in this entire thread. Soy sauce is about 60p per 100ml, you can get tamari which is gluten free for around 0.74p per 100ml. It is not hard at all and even with the marginal cost increase on ingredients like that you don't use in large amounts.

With the internet and so many people doing this and that diets, it is so easy doing essentially any specific diet cheaply.

just because you have been doing it for 15 years doesn't mean you know what you are doing, like the soy sauce comment.Al it means if you haven't used the abundance of information available to you and instead have become bitter and stuck in your ways.

 

[Dis86]

What about it?

How is that going to affect the person that doesn't work part time, that is on a low wage?

Why do we have lots of other benefits? That example you used could equally be used to restrict or remove many other benefits that are provided to people on low incomes.

Yes but you're saying lack of available time to prepare food is a justification for providing this benefit yet would give this person who has loads of time the benefit.

 

[Amp34]

The point is still the same, I've got a condition that is rather more serious than being intolerant to gluten and I've got to make dietary changes as a result. I know what it is like to have rather severe abdominal pain and I know what it is like to have to be careful with what you eat.

The comment was based on your argument that GF is an intolerance. It can be, but it's not only. The main reason for prescriptions is Coeliac Disease, which can kill.

If you're making significant dietary changes, which includes base products used in a lot of everyday foods then I would argue (if on low income) you should also have the option of prescription options/subsidies on foodstuffs as well.

just shows even more of your ignorance, like in this entire thread. Soy sauce is about 60p per 100ml, you can get tamari which is gluten free for around 0.74p per 100ml. It is not hard at all and even with the marginal cost increase on ingredients like that you don't use in large amounts.

With the internet and so many people doing this and that diets, it is so easy doing essentially any specific diet cheaply.

just because you have been doing it for 15 years doesn't mean you know what you are doing, like the soy sauce comment.Al it means if you haven't used the abundance of information available to you and instead have become bitter and stuck in your ways.

And another example of a product that is more expensive that the product it replaces.

As I said before, It's not worth discussing individual products, it's the cumulative cost of all those additional costs that add up. That's around 25% more in cost. What if a significant proportion of your shopping basket went up in cost by 25%?

The reality is a lot of products aren't "alternatives", rather they are product ranges, where the cheap products that most people buy are use wheat as a filler/thickener because it's cheaper than the alternative, which is used in more expensive versions of the product. The example came up earlier of OXO cubes. It's just a stock cube, but stock cubes that don't have wheat in them are generally more expensive.

Yes but you're saying lack of available time to prepare food is a justification for providing this benefit yet would give this person who has loads of time the benefit.

The same as many means tested benefits. Again, whats the point? Should we remove all benefits because some people don't need them as much as others, because for example they work less hours but for more money?

 

[Dis86]

But time, or lack thereof isn't a reason for those benefits.
Here you're saying lack of time should be used as a justification because Fred has to work long hours and so doesn't have time to cook from fresh.

 

[Amp34]

I'm talking about the additional cost of produce due to a medical condition being covered in some part by the NHS to help that person deal with said medical condition and have a better life.

You then give examples and suggest that people can mitigate that by spending significant amounts of time in the kitchen to potentially reduce the cost of their new diet. I'm then giving you examples of why it may not be possible for some people to do so, and that it may cause issues for some people on low incomes.

Much like most benefits, some people don't really need them, but they can be vital for others.

 

[dowie]

The comment was based on your argument that GF is an intolerance. It can be, but it's not only. The main reason for prescriptions is Coeliac Disease, which can kill.

I didn't present an argument that gluten free is (always) an intolerance, I merely referred to people who are gluten intolerant - you're really splitting hairs tbh... it isn't particularly relevant either way

If you're making significant dietary changes, which includes base products used in a lot of everyday foods then I would argue (if on low income) you should also have the option of prescription options/subsidies on foodstuffs as well.

And I'd argue that it is totally unnecessary, I'm simply pointing out my personal experience because you've attempted to make the argument previously that "unless you actually have to follow a diet religiously then it's unlikely you'll ever really understand".

Fact is if you need to exclude certain foods for medical, religious or moral reasons then you can generally just exclude them - they don't require gluten free, meat free/whatever equivalents - those are just nice things to have and the idea that the NHS needs subsidise this is just nonsense.

 

[Glaucus]

What if a significant proportion of your shopping basket went up in cost by 25%?

its not as proved by many diets that heavily restrict all sorts of things.
get on facebook join some groups and find out, you appear to be stuck in a world 15 years ago.
you don't even have to restrict yourself to gluten free pages.
most of the paleo/primal/atkins/ketogenic recipes will be gluten free by the nature of those diets, by no means am i saying follow them. But tehres probably interesting recipes in such diets you might want to add to you list.

 

[dowie]

You then give examples and suggest that people can mitigate that by spending significant amounts of time in the kitchen to potentially reduce the cost of their new diet. I'm then giving you examples of why it may not be possible for some people to do so, and that it may cause issues for some people on low incomes.

It doesn't really take very long in the kitchen to cook some rice etc.. in fact you can just chuck some in a saucepan or a rice cooker and you're sorted.

You can do a jacket potato in the microwave even.

People can and should take some personal responsibility tbh.. it isn't necessary for the state to step in just because someone ought to exclude something from their diet.

 

[coolsurfer]

I wondered that too. It was pretty much banned a good few years ago.

I still prescribe it to a few elderly patients who who have struggled to stop taking it. GP has explained the risks and patient wants to continue so I continue signing off the prescriptions.

 

[coolsurfer]

The business behind Liothyronine in this country is pretty criminal. One company has the license to manufacture and sell it, so prices are insane compared to other countries over in the mainland where T3 can be had for very little by comparison.

I am sure there are alternative treatments available for these people that require it. Surely if Liothyronine is on the list, there is an alternative or a plan for these people.

Usually I prescribe Liothyronine (T3) when I get a letter from the endocrinologist saying patients symptoms not controlled by Levothyroxine (T4). It's really out of the GP's hands as both GP's and Pharmacist Independent Prescribers like myself simply follow the instructions of the specialist, which is the endocrinologist in this case.

£400 for a pack of 28 20mcg tabs!!!!!

 

[coolsurfer]

How does that work out if they pay for prescriptions? I can understand unemployed people having an incentive to milk the system but why pay £8.40 for a prescription for bread if he/she could just buy it in the supermarket? It isn't *that* expensive. Unless a single prescription covers several months supply or something?

Usually they buy a prepayment certificate for £104. Not a bad price at all for a patient to get their entire bread, cereal, cracker, cookie, biscuit, pizza base, pasta and part baked roll intake for the whole year!

 

[Luke]

I still prescribe it to a few elderly patients who who have struggled to stop taking it. GP has explained the risks and patient wants to continue so I continue signing off the prescriptions.

That's interesting, I didn't realise anyone still prescribed it. It was the OD drug of choice preceding the change in prescribing levels wasn't it? I've only seen it once in the past 5 years with a patient, and that was very OOD stock.

 

[coolsurfer]

That's interesting, I didn't realise anyone still prescribed it. It was the OD drug of choice preceding the change in prescribing levels wasn't it? I've only seen it once in the past 5 years with a patient, and that was very OOD stock.

Yeah lots of OD's before they withdrew the license. A pharmacy would have to order the item a special as its not readily available from the usual wholesalers and the manufacturer has a high price due to low supply volumes.

Tbh I still get nervous signing the prescriptions even though the GP's have signed off on it in the clinical notes. I guess it would cause too much trouble if we suddenly stopped prescribing it to a 78 year old addicted to them after having taken them for 30 odd years.

 

[Energize]

Didn't realise you could buy class A drugs like fentanyl over the counter...

Since when were travel vaccines considered "low clinical value"? Hepatitis A & B vaccines are still listed as recommended vaccines for otherwise healthy people on the NHS websites.

 

[MooMoo444]

I didn't even know you could get gluten free foods on prescription. That's daft to be honest. You can buy it at almost any shop these days just like 'normal' foods.

 

[Kronos]

This is little more than a band-aid on a gaping wound and as such meaningless.
Far more money is wasted on the way the NHS purchase anything from toilet paper to light bulbs from simple oximeters to CT scanners where the NHS seems to pay a premium rather than a lower price by bulk buying.
Then we have the hospital maintenance has been privatised and a simple shelf installation will cost hundreds of pounds and take months.
Then we have the lack of communication between the various IT systems in a hospital let alone a health board resulting in costly paper records which are often duplicated, triplicated and even quadruplicated.
Then of course you have the constant target based care so beloved by all governments which have done little to improve patient care and much to increase costs.

These are just a few of the ways the HHS wastes hundreds of millions of pounds every year. Yet we have an ever growing army of well paid bureaucrats who have obscure job titles and feel that travelling anywhere other than by taxi is beneath them and on the other hand understaffed wards. Stay away from the Western General in Edinburgh as it is quite scary to be an in patient there.

The NHS is very broken but we do not have politicians with gonads prepared to state this.