Nope, the numbers still don’t add up, do they?

It’s no surprise that NHS bosses are proposing new measures to work within their ever-more-squeezed budgets. We’ve already seen restrictions on non-urgent surgeries for smokers and obese patients in some clinical commissioning groups and cutbacks on IVF treatment. Now, buried over the Christmas break, it emerged NHS England is proposing to cut free prescriptions for over-the-counter remedies, including treatments for conjunctivitis, haemorrhoids, minor burns and back pain. The move would reduce costs by £136m.

It’s sensible to look at how efficient the NHS’s spending is – for example, even as the Patients Association expressed concern about the proposal, it pointed out it was counterintuitive for the NHS to be paying pounds for medication if the individual can buy it for pence – but we should be deeply wary about any move that rolls back healthcare in the name of money saving.

By definition of who currently relies on free prescriptions, cutting this service means largely targeting the very people who need financial help to stay well: from pensioners, disabled people and jobseekers to young people in education. If you haven’t got enough money to feed your children or pay the rent, spending £8.60 on a prescription is a luxury you can’t afford.

Well, yes, quite. Given that you won’t in fact pay £8.60 for a prescription you don’t get or use this does mean that, yet again, the numbers of Frances Ryan do not add up.

41 comments on “Nope, the numbers still don’t add up, do they?

  1. We had all this weeping & wailing & rending of garments when they proposed to cut gluten-free food on prescription. The world didn’t end then, it won’t now.

  2. I get tablets on prescription that is sold over the counter. On prescription I get a hundred at a time, over the counter I am limited by what the pharmacy is allowed to sell me. And I get free prescriptions.
    So rather than free prescription and 100 tablets I would have to have the wife pop in multiple times a month to that or another shop to buy the required number of tablets – and we are both on the same 100 a month.
    So one person buys potentially a day’s worth of tablets every day.

    JuliaM – yes I remember when they cut the gluten free food on prescription. My pensioner father now has to buy the food at considerably more cost than other people buy normal food. His food bill went up quite a bit without his pension going up at all.

  3. If you think the NHS should pay for your father’s food, which bits of the NHS do you think should be cut to fund it?

    Fertility treatment perhaps? Freetreatment for foreigners? You’ll be called a Nazi if you propose those.

  4. I am guessing access to the North Korean Health system is relatively limited and journalists would not be allowed to access it at all which is unfortunate as it would be very helpful to the legions of morons (and frankly there is no other word) saying the NHS is ‘the envy of the world’. Lest we forget also North Korea does not offer an international Health service like the NHS, as it has very limited immigration and I would imagine is not a focus for health tourism, either recorded or unrecorded. It is, however, one of the only systems in the world where the state is still the primary provider through general taxation rather than a system of compulsory insurance. Therefore it offers a glimpse into the future of the NHS if current trends continue….

  5. This is a telling comment:

    ‘Seventy years ago this summer the NHS was founded on the principle of “Free at the point of need” and, as we tackle its modern demands, it’s a sentiment that’s as precious today. ‘

    70 years ago the level of immigration was relatively small (indeed a pressing issue was loss of Labour due to emigration) and life expectancy was not much above 60. The range of treatments available was much restricted and even the ‘glorious’ government of Attlee could not avoid imposing charges for certain services.

    Ye Gods there are some historically clueless buffoons out there. At this rate when the purge begins we’ll be flying hundreds of Frances Ryans to Caracas or Pyongyang for the next decade….

  6. If you are gluten intolerant stop trying to eat ersatz flour products which anyway taste crap. Whole cuisines are gluten free without faking it. Zero sympathy.

  7. The trouble is all those those ill people many of whom are leave voters who eat bacon, and drink beer.

    Obiously it wasn’t designed for them and so the best solution would be to ban them, and leave the NHS and its services, which are the envy of the world, especially now the entire world comes here to enjoy them, to the deserving guadian reading middle classes.

  8. I found my blood boiling whilst reading this article. I know, I know, it’s Grauniad poverty porn and that’s half the point.

    But whether you agree with socialised medicine or not, this is just defending the indefensible. Spending a hundred quid of doctor surgery time and ten pounds on pharmaceuticals that could have cost 50p OTC is stupidity, whether the resources saved are socialised or not.

    It just goes to show you in textbook fashion how much easier it is to approve of the waste resources when it’s other people’s money being used.

    As for gluten-free food; lots of normal food is naturally gluten free, especially these days

  9. “If you haven’t got enough money to feed your children or pay the rent” — Oh my, another person falls back to the unconscionable dilemma, of the form, “Which of our children must we starve?”

    Fertility treatment? (I’d add treatment for “addiction,” self-diagnosed “mental health” problems, and effects of personal indiscipline.) The only thing worse than rationed health care is health care rationed by politicians to pander to voting blocs.

  10. Was that the gluten free bread that the NHS was paying 35 quid a loaf for to give out for free that could be purchased at Tesco for £2?

  11. And Martin, no one is ‘average’ we’re all a little bit different that in some way or another that we need to pay a bit more than off the shelf stuff. I can’t find shirts that fit properly because my arms are short compared to my chest size… should tax payers give me free bespoke shirts and jackets?

  12. “Spending a hundred quid of doctor surgery time and ten pounds on pharmaceuticals that could have cost 50p OTC is stupidity”: suppose you are old, scarcely mobile, and in a lot of pain. You can get paracetamol almost free at Tesco but only 32 pills at a time, which is about a four day supply. Buying OTC would therefore require many trips to the shop that you can’t really manage. Naturally you hope the GP will prescribe you a shedload of paracetamol: the local pharmacist may even deliver them to your door. Problem solved – for the patient.

    It needs sorting out, but what’s for the best?

  13. Dongguan John

    ‘I can’t find shirts that fit properly because my arms are short compared to my chest size… should tax payers give me free bespoke shirts and jackets?’

    In the world of the likes of Frances Ryan – absolutely you should. At least that is the logical corollary of her argument if extended beyond healthcare…

  14. The obvious answer to the paracetamol problem is a little note from the GP saying “this person is allowed to buy more than 2 packs of painkillers”, that they can show at the supermarket till – or the in-house pharmacy, if you want a little more control over it. Job done.

  15. @dearieme
    Then there should be no limit on the number paracetamol purchasable at Tesco. Beats me why there is, anyway. I was told it was to prevent people being able to obtain a lethal dose & top themselves. How does it achieve that? Do they think the suicidal are incapable of shopping at Sainsbury as well.

  16. Pellinor / Dearieme

    What BiS said. No GP note needed. The two packet restrictions was always just the usual authoritarian bollocks. If people want to top themselves, they don’t have to rely on Tescos.

    I’m sure some “believer / state fascist” will be along shortly to say “but people topping themselves is mostly about the spur of the moment, and our wonderful two packet laws do help restrict that”.

  17. Don’t you need only about 10 paracetomol and a few neat gins for the liver to overload so you can do the job on a single packet anyway?

  18. BraveFart said:
    “Don’t you need only about 10 paracetomol and a few neat gins for the liver to overload so you can do the job on a single packet anyway?”

    Ah, but then that would be alcohol-related death, not suicide by paracetamol. Different statistics, different response from the prodnoses.

  19. “cases of children with rickets because they don’t have enough to eat”

    Rickets is primarily kids not getting enough sunshine, for one reason or another. If you want to bring food into it, then it’s quality not quantity that’s the issue. Note that quality does not mean expensive, a tin of sardines is 40p at Tesco.

  20. I have a severe gluten allergy, none of your nanny pamby stuff, and I have no tolerance whatsoever for people who think that they should get free ersatz bread as they are intolerant or coeliac. No sympathy whatsoever. Eat fucking vegetables and meat like we did for thousands of years before organised agriculture came along. I do and am healthier for it. (Says he typing whilst walking home with a £2.99 small gluten free loaf as I fancied a sandwich for a change and can’t be arsed to cook but it’s my money and my choice. No one else had to pay for it)

  21. @Ljh, January 4, 2018 at 1:42 pm

    If you are gluten intolerant stop trying to eat ersatz flour products which anyway taste crap. Whole cuisines are gluten free without faking it. Zero sympathy.

    Agree on both points. I bought a couple of packs of “Reduced before binned, 95% Off” gluten free crumpets (made with rice flour), gave one pack to mum.

    MrsPcar & I: yuk.
    Mum & MrMum: yuk

  22. @Dongguan John, January 4, 2018 at 3:08 pm

    Was that the gluten free bread that the NHS was paying 35 quid a loaf for to give out for free that could be purchased at Tesco for £2?

    Yep, and the specially labelled expensive “Gluten Free Rice”

  23. And then there’s NIV’s non-essential ‘gender reassignment’ surgery, which I’m happy to do with a Swiss Army knife and a bottle of TCP… and my former colleague who maintained that Evening Primrose Oil was essential for relieving her PMT (even though her PMT seemed to last throughout the month, as she was always batshit crazy) because NHS and feminism…

    And the NHS is the Envy of the World…

  24. I still find it odd that I get free prescriptions for reaching the age of 60 when my retirement age is 67.

    Anyway, having listened to the Freaky guys’ episode on gluten and the history of Celiac disease ,which was very interesting, especially how many Americans didn’t know they had the disease I have even more sympathy for sufferers and less for those who go on a gluten free diet as a fashion statement..

    The guy who’d done all the research in Europe moved to the USA to get away from being a Celiac specialist and, long story short, he ended up doing some research to find out why the reported incidence was so low in the USA compared to Europe:

    Eventually they settled on $3 apiece. Fasano bought 2,000 samples and began testing them. If someone who has celiac disease eats gluten, their body produces abnormally high rates of certain kinds of antibodies. Gluten has been recognized as an intruder and their body is trying to fight it off — but instead the antibodies end up attacking healthy cells. This activity can be detected in a blood test. So, when Fasano screened the Red Cross blood samples, what did he find?

    FASANO: The prevalence was one in 250.

    A prevalence of 1 in 250! The previous estimate in the U.S. remember, was 1 in 10,000. This new finding would make celiac disease 40 times more common in the U.S than previously thought. Under the old estimate, only 27,000 Americans likely had celiac disease; the new estimate suggested it was more like a million.

    FASANO: That gave us the impetus to move to this large epidemiologic study on the national scale, in which we recruited more than 40,000 people.

    This new, national study, published in 2003, yielded an even higher estimate. It found that 1 of every 133 Americans had celiac disease. This was pretty much in line with the most recent European numbers. So America wasn’t so different from Italy after all! According to Fasano’s research, more than 2 million Americans had celiac disease. How was it possible that a disease so well-identified in some places had been practically invisible in the U.S.?

    But the real point is that those who go on glutne free diets as a fashion statement and aren;’t aware of the risks may be doing themselves more harm, and not just in the wallet:

    Part of that confusion is that “gluten-free” doesn’t really mean “healthy.”

    LEBWOHL: Adopting a strategy of going gluten-free can really backfire. First of all, because gluten is everywhere it’s so difficult to avoid. It can make eating out, grocery shopping, socializing or dating really fraught. There are also potential health concerns with going gluten-free. Gluten-free substitute foods often have more calories than a gluten-containing item. They often have higher fat content. A gluten-free diet is often a diet low in whole grains, low in fiber. We actually compared people who ate high-gluten diets to those who ate the lowest-gluten diets.

    We found, actually, that overall, when looking at the outcome of rates of heart attack, for example, there was no significant difference with regard to heart attack risk according to how much gluten you eat in your diet. But if you then take into account whole grains, those who ate more gluten in their diet, due to having a higher whole grain content in their diet, actually had a lower heart attack risk. In other words, a gluten-free or low-gluten diet, if deficient in whole grains, could actually increase the heart attack risk.

    FASANO: Let me clarify something. Not only gluten is not a villain, but without gluten you and I, we still jump from one tree and another. We [would] not have build the Coliseum or the Eiffel Tower because before the agriculture and, therefore, predictability — humankind spend 90, 95 percent of activity for food procurement and 5 percent for reproduction. No time to unleash ingenuity or doing anything about it.

    .

  25. I heard a claim that often it’s not gluten in bread that upsets people’s stomachs by the amount and type of yeast. Anyone know anything about that?

  26. I’ve just started some NHS treatment, so am keeping a log of how things go. So far:
    * went to GP surgery, asked for GP appointment, appointment 3 days later
    * went to GP, asked for referral to ENT, GP says OK and typed on computer.
    * three days later, letter saying: here is your appointment, or go online to self-book
    * go online, pick new appointment in one week’s time
    * today, go to appointment, see consultant, have wonderful things stuck up my nose. Sign paperwork, consultant says: wait three days for the swabs to be tested, then phone this number to book for surgery.

    So, so far, none of this NHS in crisis I keep reading about, and none of these month/year-long waiting lists, the waits have been just what I would consider reasonable for getting into a professional’s diary. Very slightly faster than my plumber and optician. 19 days from first contact to consultant including the Christmas/New Year shutdown. This is in a Labour-voting city of half a million peeps, 250 miles from the M25.

  27. Dearieme, I don’t know about the yeast theory, but lots of people have problems with the fructans found in wheat. They are part of a class of carbohydrates called FODMAPs. Low-FODMAP diets are becoming a standard treatment for people with irritable bowel syndrome.

    I’m not gluten-intolerant but I am intolerant to FODMAPs. My IBS improved massively after I moved to a low-FODMAP diet. I especially have to avoid onions and garlic, which are like kryptonite.

    The mechanism isn’t well understood but the leading theory is to do with shifts in gut bacteria. If you get too many of the wrong bacteria, they binge on the FODMAPs, giving off gas and other byproducts, leading to IBS and other symptoms.

  28. Having trouble believing this:
    Go to Tesco, get 6 paracetamol boxes,
    put first 2 through the self service, pay for them,
    put next 2 through, pay,
    rinse, repeat,
    what problem?

  29. Or just visit your local chemist, like I did the other day, for some Ibuprofen ; I actually asked about it and the lady said they were allowed to sell any quantity they liked, though they could refuse to do so if they thought they were for suicide reasons.

  30. Note to the suicidal: aspirin/ibuprofen/other NSAIDs drive the respiratory centre so you’re in for some prolonged hectically heavy and fast breathing and probably won’t expire. Paracetamol kills by causing the liver to selfdestruct but this takes time, several days, you may have changed your mind by the time your blood won’t coagulate and you’re bleeding through your gums, pores, into your lungs and there’s no liver transplant available. Tell histrionic teenagers this and sell them in generous size packs.

  31. jgh,

    I’ve said it before, but I don’t recognise the NHS I see reported on the BBC and to a lesser extent Sky.

    I’d always expect an organisation that is always under pressure to do more with the same budget to be under some pressure but not to the extent that is being reported.

    As Guido keeps pointng out, a lot of the doctors and nurses being quoted and interviewed have direct links to Jeremy Corbyn’s Labour so are politically motivated.

  32. @Spike

    “If you haven’t got enough money to feed your children or pay the rent” — Oh my, another person falls back to the unconscionable dilemma, of the form, “Which of our children must we starve?”

    The boy.

    Next question?

  33. @Ljh

    50 years ago, a second cousin decided to overdose on paracetamol while at uni. I suspect it was a ‘cry for help’ and she was discovered quite soon, but too late for much to be done (at the time, maybe there are better interventions available today). She died fairly unpleasantly a few days later.

  34. Chris Miller: Teenagers have no idea about the nasty physical ordeal of dying, nursing fantasies of floating off surrounded by regretful friends and relatives and continuing to look good. As the internet is awash with porn I think sex ed could be cut and a lesson on why od’ing is a bad idea to prevent such tragedies. Ironically the most successful at killing themselves are teenagers impressing their friends who do not anticipate death after downing ten shots.

  35. @jgh
    Compare with my experience: –

    Note that I am seeing lots of black spots in one eye.
    Get doctor appointment two weeks away.
    Doctor tells me I have to go to an optician.
    Wait another week to see my optician.
    Optician writes letter for me to take to doctor.
    Doctor arranges for me to see eye nurse at local health centre (another two weeks delay).
    Eye nurse confirms diagnosis of posterior vitreous detachment and refers me to consultant at hospital.
    After a further week, get letter asking me to go online to book appointment with consultant.
    Go online, get the response “no appointments available “.
    Repeat every day for a fortnight, with same response.
    Phone hospital to try to book appointment, get same answer.
    Give up, hoping that the retina won’t come adrift any time soon.

  36. Mr Womby: worry about light flashes which are from the retina. Black spots especially if it looks like a fly in your field of vision mean the vitreous humor has already detached itself from the retina and collapsed, the membrane forming the “ fly”. This is a normal consequence of aging, commonest in theshort sighted, annoying non progressive and untreatable. You will find reading a tablet or kindle easier than a book from now on. Your GP is useless btw.

  37. Yes I’ve been told to look out for the appearance of a curtain being drawn across my vision. “Get yourself straight to A&E and ask to be seen immediately.” To which my reply was “Hahaha!”

  38. Unless you are getting continuing flashes in the affected eye there is a very low probability of retinal detachment so pour yourself a drink and avoid the NHS. Ffs referring you to an optician rather than an ophthalmologist!!!

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