Monday 13 May 2013

The best medicine? Prescribing for Coeliac disease.

The NHS is an amazing British institution. Free healthcare, both primary and secondary, and very cheap or free prescriptions-what could be better than that! (Ok, I can think of a few things....but it's still pretty great.)

Food on prescription:
One of the things I didn't realise for quite a while after Alex was diagnosed with Coeliac's was that not only can you get medication on prescription on the NHS, you can also get FOOD on prescription. Seriously! Food that you can eat!! And it's not like finding greens hidden under your lovely mashed potato when you were a kid, there's no medicine hiding in the prescribable food, it's just standard gluten-free staples.
None of our health professionals highlighted that this was possible, it was only through reading some of the bumph that we got from the food companies suggesting that we request their product from our GP that it began to dawn on us that, yes, your GP can prescribe gluten-free products.

Do I? Don't I? Do I? Don't I?
This has given me a big dilemma. I find it strange that I can get a prescription for pasta, flour and pizza bases filled at the local chemist. I have felt uncomfortable in asking for a prescription for gluten-free food and in getting it filled, although it is something I have done a few times now.

This is my thought process (and I'm not saying my thoughts are right or wrong, or judging anyone for any decisions they have made in relation to this, I'm still not sure where I stand!!)

Reasons against me getting GF food on prescription:

  • It's not medicine.
  • It feels uncomfortable asking for the NHS to pay for food for my child that I would have to buy anyway.
  • Surely there are greater priorities for healthcare budgets, when so many services are being cut?
  • It's a bit of a pain going to the GP to get repeat prescriptions (yes, exceptionally lazy, I know), and I would feel stupid booking a GP appointment to change the prescription (I've only ever requested a prescription at the end of an appointment for a 'real' health issue.)


Reasons for me getting GF food on prescription:

  • There is no medicine for Coeliac's, you have no choice but to eat gluten-free.
  • Gluten-free food is stupidly expensive. (Fresh bread works out at about 30p a slice- and they're small slices! GF food is 3-4 times more expensive than 'normal' food.)
  • If Alex didn't eat gluten-free food, she would cost the NHS a lot more money in terms of medical needs.
  • Why look a gift-horse in the mouth?!
The technical bit:
The way the prescription works is that a person with a diagnosis of Coeliac's is allocated a certain number of units, based on their age and gender. They can then choose how to use these units on a mix of breads, crackers, pasta, flours, cereals etc. Once you have agreed the prescription with your doctor you bring it to your pharmacy, who will order the food in. You have should have a choice on which brands you get, which is why many of the gluten-free food companies offer free samples to newly diagnosed patients to win their business. (For more info, look here:http://www.coeliac.org.uk/gluten-free-diet-lifestyle/food-on-prescription)

I completely understand the importance of ensuring that everyone who is diagnosed with the illness has got access to food, and is not becoming unwell because they can't afford to eat gluten-free. On the other hand, food on prescription was introduced in the 1960's when gluten-free food was a lot less widely available, with few supermarkets stocking it and very little choice in the ones that did (so I hear- I'm not that old!!!).  On the other hand- 30p a slice!!

I have a repeat prescription for Alex that I get filled every now and then when the 'for' arguments are stronger in my head. Over the past few months there have been more calls in the media to change the way gluten-free products are prescribed, and NICE is due to review the guidelines for treating Coeliac's later in the year, so in the future, I may not have the option anyway. 

As I said, I am sitting so firmly on the fence with this one that I have splinters in my behind- I'd be interested to hear anyone else's thoughts about food on prescription. 

Jen


PS: I had no suitable photo for this post, so here's a completely gratuitous photo of my girlies!!




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