Doctors say prescribing gluten-free food is ‘ripping off the NHS’ – costing £25 MILLION a year
GPs are being forced to "behave as grocers" as the NHS wastes millions prescribing gluten-free food to coeliac suffers, a leading doctor has warned.
Doctor James Cave said it was a "scandal" that family doctors were prescribing the food like a drug and claimed the NHS was being "ripped off" by suppliers who charge more than five times the price to supply gluten-free food.
Currently, the NHS pays up to £6.73 for 500g of pasta, yet 500g of gluten free pasta will cost just £1.20 at a supermarket.
It is the price mark-up like this that saw the NHS spend £25.7 on gluten-free food prescriptions last year.
Meanwhile, around 40 per cent of clinical commissioning groups - which commission health care services for local areas - in England have made cuts to save cash.
In a BMJ article this week, Dr Cave said: "It's ludicrous for the NHS to be treating a food product as a drug and to require GPs and pharmacists to behave as grocers."
Dr Cave says the "complex rules" imposed by the NHS governing what can be prescribed and how often it can be prescribed are stressful for people with coeliac disease and their GPs.
He said: "It's a time-consuming rigmarole and, for the NHS, a very expensive one.
"The eight basic gluten-free staples advised for people with coeliac disease are all cheaper from a supermarket than the NHS price.
"This is a scandal.
"If we stopped prescribing gluten-free products tomorrow GPs would shout for joy and the NHS would stop being ripped off."
What is coeliac disease?
Coeliac disease is an autoimmune disease caused by the immune system reacting badly to gluten.
Gluten is a protein commonly found in wheat, barley, rye, oat - which means it is prevalent in bread and baked goods.
According to charity Coeliac UK it affects one in 100 people but only 24 per cent of people who have the condition have been diagnosed.
When someone with coeliac disease eats gluten, their immune system reacts by damaging the lining of the small intestine - which affects the absorption of nutrients - and can also lead to an inflamed bowel.
What are the symptoms?
Symptoms range from mild to severe, and can include bloating, diarrhoea, nausea, wind, constipation, tiredness, mouth ulcers, sudden or unexpected weight loss, hair loss and anaemia.
Some symptoms of coeliac disease may be mistaken as irritable bowel syndrome or wheat intolerance.
The symptoms can also be put down to stress or getting older.
How to manage it?
Once you have been diagnosed you will need to adopt a gluten-free diet.
All types of rice, potato, corn, plain meat, fish, eggs, cheese, milk, most yoghurts, fruits, vegetables and peas, beans and lentils are naturally gluten-free and are suitable for the diet.
But foods like bread, pasta and oats will either have to be cut out of your diet or you can buy gluten-free versions.
Instead, Dr Cave suggested introducing a national voucher scheme or a personalised health budget for patients, so they receive the difference between the cost of gluten free products and the prescription.
He added: "This could be funded from the money saved by no longer paying for overpriced NHS gluten-free food.
"The price of gluten-free food might fall further once proper market forces were in play.
"Most importantly, people with coeliac disease who currently struggle with the logistics of a lifelong gluten-free diet and a cumbersome and antiquated supply system, would have the convenience and choice we all enjoy."
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But gastroenterology experts and coeliac charities argued that removing the prescriptions unfairly discriminates against people with coeliac disease.
They argue that "a gluten-free diet is the only treatment for coeliac disease and adhering to this diet is challenging."
Currently, coeliacs can get a prescription for basic foods including pasta, oats and bread which are then collected at the pharmacist.
But around 40 per cent of CCGs in England have stopped, or are considering stopping, these prescriptions, while Scotland, Wales, and Northern Ireland are not following suit.
Experts argue that there is no other example in the NHS of a disease having its treatment costs cut by 50 - 100 per cent.
They warn that targeting gluten-free food prescriptions may reduce costs in the short term but there will be long term costs in terms of patient outcomes.
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