Prescriptions- a few more thoughts
Posted by Froggy on 27/2/2011
1) Pensioners and people of a grand age- these came up as the most in need of the system. Can anyone tell me is this fact or fiction? Yes the most vulnerable in society deserve our attention and help particularly where matters of health are concerned. But, how exactly is this system helping older people?
Answer 1
I am a pensioner diagnosed with CD & I rely on my prescription GF items to remain healthy.
Both my surgery and pharmacy are only short distance from my home so this means I can fairly easily walk to them (short walks are a good way to exercise my osteoarthritic knees ) .
I put in scrip at surgery, then collect it after 48 hours, walk to pharmacy with it & give it in.
Certain GF items arrive at pharmacy the next day & I collect those.
Others (eg fresh GF bread) take longer so my pharmacist telephones me to let me know when they arrive.
If I am unable to collect the prescription items a relative or neighbour does this but the pharmacy will , if needed, collect my scrip & arrange everything from then on , delivering my GF items to my door.
As a pensioner I am in the exempt group of NHS patients & I do not pay for prescription items.
My prescription items are not available off prescription I couldn’t obtain them from a supermarket, so the supermarket in my case does not offer me choice.
If I didn’t have the prescription GF things and I wanted to have supermarket GF items , because I don’t have access to a car, I would have to walk to bus stop (further than to pharmacy) , wait for bus, catch a bus, spend twenty minutes to half an hour on bus , go to supermarket and buy GF items & vice versa journey home.
The bus journey is free between certain hours as I have a bus pass (because I am a pensioner).
So, if I have prescription GF items:
1. I get my choice of food
2 I do not pay prescription charges
3 The journey to obtain them is fairly easy & quick.
4 I have safe exercise by walking to surgery and pharmacy
5 I get to chat to the staff I know at pharmacy
If I were to go to the supermarket to obtain my GF food
1. The food is not of my choice
2 I would have to pay for it out of my pension
3 The journey would be more difficult (especially if I have to wait at bus stop in cold/rainy conditions) & it would also take a longer time than going to surgery/pharmacy
4 Supermarket check-out people are different every time, they are not the friendly & familiar people I know in pharmacy.
2) Youngsters and people on low incomes- again the most vulnerable deserve our support- I completely agree- but it is those on low incomes and most vulnerable who most often have least access to wholesome healthy food. The poorest in our society are generally the worst off in terms of living a healthy lifestyle and this is a documented fact. So are we not perpetuating this by making gf prescription food available?
Nutritionally I think few would argue that for the most part gf food on prescription is high in salt, sugar, fat and other chemicals. I'm not saying that what is available on supermarket shelves is that much better either, but it strikes me as odd that we should be defending the rights of those on low income to continue eating gf food that can in fact be contributing to other health issues such as diabetes, heart problems etc etc.
Answer 2
Just because I am a pensioner on a small income does not mean I am completely ga-ga and it doesn’t mean I don’t understand what is and isn’t a good healthy diet.
My eyesight is not as sharp as it was but I am still able to read the small print on food labels and I thankfully I can still comprehend the meaning of what I read so I know how much salt, sugar, fat etc an item contains & I can decide how much of that item is a suitable amount for me to eat.
I think you will find that as pensioners ( having lived through a time of rationing when the nation had a very healthy diet, where food was never wasted and people had good information about eating well - both from government & eg at school from ‘domestic science’ lessons) we are not badly off as far as a healthy lifestyle is concerned & we are very likely to be eating a good (inexpensive) varied diet.
Pensioners are usually interested in preserving their health & are very likely to have access to the internet (some of us going to the library to do this, for free). Thus we can educate ourselves & gain information about diet & the importance of healthy foods, we are not, on the whole, I think, ignorant about how to avoid diet-related illnesses.
GF prescriptions are only a part of a coeliac’s food intake & pensioners recognise this.
Pensioners are quite likely to cook from scratch as we are time-rich and on a smaller income than those in paid employment.
We don’t need ‘protecting’ by having our GF prescriptions cut.
3) Abolishing gf prescriptions will lead to less compliance and in turn to more costs to the NHS. -Fact or Fiction? I think there is no way to prove this either way, but compliance and denial in many with CD is definitely a big problem. I don't think that gf products on prescription will stop anyone from cheating on their diet. What will stop them cheating is having more gf products available on the high street and being able to get a gf meal/snack at a fair price on the high street. Education and accessibility are really the key to ensuring people stick to their diet.
Answer 3
Yes, CUK & others have done research which shows coeliacs are more likely to stick to a strict GFD if they have a choice if prescription items.
Research shows if a coeliac doesn’t stay GF for life s/he is likely to develop health complications /illnesses which not only mean suffering for the patient but also are much more costly /time consuming to treat than the cost of GF prescription foods.
Taking osteoporosis, this condition is very expensive indeed if eg a patient has a fall & breaks a hip due to CD-related osteoporosis:
********************
The cost of hip fracture in the UK
...a typical hip fracture (will) cost approximately £25,424.
This excludes possible costs incurred by the family in caring for the patient or
associated travel costs of the patient travelling to a health care provider...
www.viewcare.co.uk/Publications/hipfracture.pdf **********************
The only person to suffer if a coeliac ‘cheats’ is the coeliac, seems pretty unlikely (and potty) to me to deliberately hurt yourself by eating gluten if you have access to prescription GF foods which you have chosen .
Whilst I agree it would be great to have more tasty GF items (especially, in my case vegetarian savoury ones) and affordable safe GF meals widely available I can’t see these are reasons to stop GF prescriptions.
If coeliacs are determined to eat gluten I don’t think cutting GF prescriptions will change their attitude, if they are sane adults there is not much anybody can do to make them GF ( given that those coeliacs are aware of the risks they run ).
Some people still smoke, even though they know perfectly well the chances are very high that they are going to live a short & unhealthy life but cutting prescription nicotine patches/other aids to help smokers to stop smoking to all smokers is not a great idea.
Yes, I agree education and accessibility are really the key to ensuring people stick to their diet but cutting GF foods on scrip is not ensuring accessibility.
4) Cost- there is a perceived notion that keeping to a GF diet means added cost to the weekly shopping bill. I think this may be true-but my guess is it is probably not as much as we might think. Has anyone done any research on this? I would love to do an experiment to see how much we are actually talking about. Would any of you out there be willing to get involved in this? If so can you email me at adriana@glutenfree4kids.com.
Just so that we are clear, I am not suggesting that we should abolish the system but my personal wish would be to reform the system so that it reflects all of our requirements beit young, old, middle aged, rich, poor, single, married, widowed, student, housewife, business person etc.
Answer 4
Yes, CUK and others have done research on the cost of GFD compared to ordinary standard diet & GF items are about 2 to 4 times more expensive.
Some producers eg M&S have certain items (such as GF rich fruit cake bar) which compares very well with their similar gluten version but most GF items I have checked are about double or more compared to the gluten versions.
If coeliacs are working full-time they will not have time to cook/ bake as much as, for example, pensioners can - I guess those in work may have to pay even more for their GF diet (compared to people like them who do not have CD) than , say, coeliac pensioners
Coeliacs outside the exempt groups pay for their prescription items so I see no justification for cutting GF prescriptions on grounds of cost.
I think it works OK for all coeliacs as it is, & there is no need to change a coeliac patient ‘s access to ACBS-approved GF items.
