NHS cutting back on prescriptions?

[Murph7355]

jjlynn27 said:

Again, IVF is an irrelevance, whichever way you look at it. We have figures that we spend less money per capita than almost any other developed economy. With significantly better efficiencies. You say that you would rather that someone pays for their IVF treatment than that you'd pay through taxation. The amount you pay through taxation for IVF is pocket change. You wouldn't notice the difference. If you wanted kids, but couldn't get them any other way, I'm sure you'd notice paying for it. ...

Mr Will said:

For context; cutting the 10 types of prescription mentioned in the article will save us 14 pence each every month.

The gluten free food makes up 3 pence of that.

We have got to stop this way of thinking. Amortised over tens of millions of people you can boil everything down to a few pence each per month. It's bullst justification for overspend.

If it's unnecessary expenditure then it is unnecessary and should be stopped. Immediately. Do not pass go. Do not collect £200 (after all, you don't need it. It's only 0.00000000000000000000001p each ).

There is no single golden bullet to kill the 60bn deficit. Change is needed in everything. And the biggest pots need to take the biggest absolute hits. Pensions first and then yes, you guessed it. The NHS.

I also wish people would stop comparing what we spend on the NHS with other countries without fully considering the nature of their health systems and the other spending priorities their governments have. ALL of which are very relevant.

[IroningMan]

Are peanut substitutes available on prescription for those with an allergy to the real thing? How about lactose-free milk?

Does the Health Service not employ enough senior managers for one of them to find a few minutes to make decisions like this?

[Mr Will]

BoRED S2upid said:

Unbelievable we have 2 kids and always have a supply of calpol. I wouldn't dream of asking a doctor for it! This is why the NHS is screwed. And prescribing bread and pasta!? FFS I've heard it all now.

Well aren't you lucky.

My parents business failed when I was a young child and following their bankruptcy we had a few very hard years. Being able to get things the the hayfever medication for me and my sister from the GP rather than Boots made a difference. £3 per pack might not seem a lot to you but for some people £80 each summer is the choice between children whose eyes aren't swollen shut or food on the table.

[jjlynn27]

Murph7355 said:

jjlynn27 said:

Again, IVF is an irrelevance, whichever way you look at it. We have figures that we spend less money per capita than almost any other developed economy. With significantly better efficiencies. You say that you would rather that someone pays for their IVF treatment than that you'd pay through taxation. The amount you pay through taxation for IVF is pocket change. You wouldn't notice the difference. If you wanted kids, but couldn't get them any other way, I'm sure you'd notice paying for it. ...

Mr Will said:

For context; cutting the 10 types of prescription mentioned in the article will save us 14 pence each every month.

The gluten free food makes up 3 pence of that.

We have got to stop this way of thinking. Amortised over tens of millions of people you can boil everything down to a few pence each per month. It's bullst justification for overspend.

If it's unnecessary expenditure then it is unnecessary and should be stopped. Immediately. Do not pass go. Do not collect £200 (after all, you don't need it. It's only 0.00000000000000000000001p each ).

There is no single golden bullet to kill the 60bn deficit. Change is needed in everything. And the biggest pots need to take the biggest absolute hits. Pensions first and then yes, you guessed it. The NHS.

I also wish people would stop comparing what we spend on the NHS with other countries without fully considering the nature of their health systems and the other spending priorities their governments have. ALL of which are very relevant.

I'll try one more time. Saving money by stopping IVF is equivalent to trying to pump water out of Concordia with the garden bucket. It's a pointless exercise. Energies and efforts should be directed at meaningful actions. IVF/pasta/Calpol are distractions.

Why should we stop comparing ourselves with others regardless of what system they have in place? The figures discussed are total spend. Private and 'state', per capita.

Which system would you prefer to have in place of NHS?

[Evanivitch]

IroningMan said:

Are peanut substitutes available on prescription for those with an allergy to the real thing? How about lactose-free milk?

Does the Health Service not employ enough senior managers for one of them to find a few minutes to make decisions like this?

People with severe allergies are provided with EpiPens, which aren't cheap.

Lactose intolerance is not comparable to people with Coeliacs Disease. Lactose intolerance is a temporary discomfort in even the most severe cases. Coeliacs can be immobilised for days by mistakingly eating gluten.

[Evanivitch]

BoRED S2upid said:

Unbelievable we have 2 kids and always have a supply of calpol. I wouldn't dream of asking a doctor for it! This is why the NHS is screwed. And prescribing bread and pasta!? FFS I've heard it all now.

Okay, try this.

Buy one kid normal food. Buy the other quid the most expensive one. Not the more expensive, the most expensive. You can't freeze the bread either, because that's already full of all your other "special" stuff.

Also, you have to go to the supermarket every time, one of the big 4, not lidl or also.

If that's fine, good for you, you have a relatively easy life. Others don't.

[IroningMan]

Evanivitch said:

IroningMan said:

Are peanut substitutes available on prescription for those with an allergy to the real thing? How about lactose-free milk?

Does the Health Service not employ enough senior managers for one of them to find a few minutes to make decisions like this?

People with severe allergies are provided with EpiPens, which aren't cheap.

Lactose intolerance is not comparable to people with Coeliacs Disease. Lactose intolerance is a temporary discomfort in even the most severe cases. Coeliacs can be immobilised for days by mistakingly eating gluten.

EpiPens yes, but not alternatives to peanuts.

Coeliacs have plenty of alternatives to bread and pasta - for heaven's sake most people in the UK didn't eat pasta until the 1980s - and if you must have bread and cost is the challenge then make your own - come to that the same is true of pasta and pizza bases if you must have them.

[VolvoT5]

In general I think this is a good idea. When the NHS can't afford the latest cancer drugs and people are waiting 18 months to get a hip replacement we really can't justify prescribing paracetamol or cough syrups.

I also don't really understand why some illnesses are exempt from paying the fee and others are not... I suspect it is those that get free prescriptions (for whatever reason) that feel they are entitled to get everything on prescription.


Given that a prepayment certificate is only £104 per year perhaps we should just make everybody pay for the prescriptions apart from children.

[Sylvaforever]

Murph7355 said:

Countdown said:

Murph7355 said:

<snip> 4x the figure noted could be saved by simply not funding IVF on the NHS. So together, half a billion a year stripped from the cost base.<snip>

That's what i was alluding to. At what point do we say "Sorry, we don't think that's something that the State should provide. If you want it you're on your own..."

Indeed.

We're past the point where we should have. Someone should simply take the full list of treatments provided with the cost against each and work through it top to bottom.

Ah the old Scottish Nationalist paradigm...

[JagLover]

Murph7355 said:

We have got to stop this way of thinking. Amortised over tens of millions of people you can boil everything down to a few pence each per month. It's bullst justification for overspend.

If it's unnecessary expenditure then it is unnecessary and should be stopped. Immediately. Do not pass go. Do not collect £200 (after all, you don't need it. It's only 0.00000000000000000000001p each ).

Agreed

And as someone said a billion here and a billion here and pretty soon you are talking about real money.

Before the government starts asking me for more money I would like to see all such waste eliminated, which is what many posters are missing. It is hard to build a case the public can support on more NHS funding when there are people getting "prescription" groceries, when health tourists can wander off a plane and get free treatment and when people can get "lifestyle" treatments.

Build an efficient system, with no spending on frivolities, and if you are still short of funding you will find the public more sympathetic.

[jjlynn27]

sidicks said:

anonymous said:

[redacted]

I'm just asking you to justify your claims - an entirely reasonable request - that you seek to obfuscate and move the goalposts is telling.

Even jjlynn27, who I seem to disagree with on most things (!) has admitted that the current approach is unsustainable and that changes are required.

Edited by sidicks on Tuesday 28th March 17:06

Missed this post. Not sure what I admitted. We've been over this many times over many threads. Increase in spending didn't match increase in services provided. Midengined gave you the exact same options if differently worded. The current model is very much sustainable with increase in spending, either via general taxation or through insurance / cash. Or drastic reduction in services. People going on about ivf or travel vaccines or whatever other pet hate, are, imo, deluding themselves.

To make it clearer; unsustainable in terms of wanting the same level of service for effectively less money.

[sidicks]

jjlynn27 said:

Missed this post. Not sure what I admitted. We've been over this many times over many threads. Increase in spending didn't match increase in services provided. Midengined gave you the exact same options if differently worded. [b]The current model is very much sustainable with increase in spending['b], either via general taxation or through insurance / cash. Or drastic reduction in services. People going on about ivf or travel vaccines or whatever other pet hate, are, imo, deluding themselves.

To make it clearer; unsustainable in terms of wanting the same level of service for effectively less money.

And how is that going to be financed and what services are we going to cut instead (given a current deficit of £60bn)?

On that basis it's no more or less 'sustainable' than reducing the top rate of tax to 0%.

[Flip Martian]

Its bonkers. Until I saw this report I had no idea you could get GF food on prescription.

As an asthmatic I take 2 different inhalers and have to pay for them; they're not free on the NHS. Without them, ultimately I'd be dead. But some woman who can't tolerate gluten gets her bread and cake (etc) for free.

So not only am I paying for my own life saving drugs, I'm paying for her food.

Where on earth is that sensible?! FFS. I don't mind paying my prescription season ticket fee but I do actually think life saving meds or those for chronic conditions have a case to be made available free. GF food is just nonsensical. Go and buy it.

[Starfighter]

This should be easy to fix. If the required item NEEDS a prescription then it is provided. If not then the item is sourced by the patient.

[markymarkthree]

Why do you get free prescriptions and eye sight tests when you hit the big 60?

Surely that must be costing a few million that could all go back into the pot.

[Murph7355]

Mr Will said:

Well aren't you lucky.

My parents business failed when I was a young child and following their bankruptcy we had a few very hard years. Being able to get things the the hayfever medication for me and my sister from the GP rather than Boots made a difference. £3 per pack might not seem a lot to you but for some people £80 each summer is the choice between children whose eyes aren't swollen shut or food on the table.

Imagine if they'd not been paying the 14p a month (and all the other unnecessary 14p per months) while their business was still functioning and putting that to one side...and ignoring the basic mathematical premise, is "only 14p" really that different to "only a few quid"? (I guess for those not even paying the 14p the difference in principle is much bigger).

jjlynn27 said:

I'll try one more time. Saving money by stopping IVF is equivalent to trying to pump water out of Concordia with the garden bucket. It's a pointless exercise. Energies and efforts should be directed at meaningful actions. IVF/pasta/Calpol are distractions.

Why should we stop comparing ourselves with others regardless of what system they have in place? The figures discussed are total spend. Private and 'state', per capita.

Which system would you prefer to have in place of NHS?

I understood you the first time. We just have a fundamentally different view on how the government should save money. You think it should only hit the massive ticket items as everything else is pointless. I think that every single 14p per month of unnecessary expenditure should be saved. "I'll try one more time" - there is NO single ticket item that can instantly be lopped that will see this country with a surplus, let alone one that can start to materially pay off our debt. If you think there is, please let us know (and we can all email Mr Hammond).

Needing to consider the systems of other countries is important because the amount spent privately per capita is telling when in this country it's almost frowned upon and considered a sleight against Old Mother NHS to do this. If other nations whose outcomes we covet have a much higher proportion of private health care spend then maybe there are some answers in there for us. Granted outcomes are also seriously important, but the system is key too. Everything has to be considered in the round and not just cherry picked.

Same thing goes for what else other countries spend their money on. For example, if Germany were to channel its shortfall in its NATO expenditure from its public health expenditure pot, guess how its public expenditure would compare to our own (its private expenditure already makes up half as much again as a %age as ours, so they have that base covered). Maybe they have the balance right. But then people need to start campaigning their MPs along these lines if so and telling our government to spend less on defence (I'd say good luck with that right now).

I would prefer the NHS to operate within a finite budget that as a minimum would cover basic emergency care only (safety net) and work up from there. I would like to see other treatments covered by private healthcare, possibly with tax breaks for it that taper off on a means tested basis. I would like to see people and their families look after themselves/each other as the primary recourse for assistance before the govt is expected to step in. And I think unless we start doing this, quite possibly within my lifetime (assuming I live the average length) we will see an NHS that will collapse under the strain. If one believes the press (I tend not to), that is already happening.

Can people in this country afford to pay more tax? Quite probably. And definitely in some income brackets. But there are very few who will offer this (ie vote for it). Especially in the income brackets that would be ripe for a rise.

[Storer]

It is madness to have so many items, that are readily available (and in most cases quite cheaply), on NHS Prescription.

We have a health service we are struggling to afford with the increase in life expectancy and breakthroughs in the ability to cure more diseases.
When (not if) we are able to cure all forms of cancer we will see life expectancy extended further still. But at more cost to the NHS.

It has to be right to start cutting back on what is available free to many on Prescription.

This country still provides too much from the State's purse. Way too many people see things as 'their right'. The problem is that many do not put in anything like the amount they take out of the system.
I would like to see a system where what you get back relates, in some way, to what you have put in.

Nature does not work in this way so we are trying to 'beat' nature.

You may think nature is harsh and we are a more sentient being, but I think you are delusional.

[Paul Dishman]

There was a big cull in items allowed on NHS prescription in 1985. This is peanuts by comparison, but still worth doing. It's about time that all GF products were removed from NHS supply, they are freely available in supermarkets

[jjlynn27]

Murph7355 said:

I understood you the first time. We just have a fundamentally different view on how the government should save money. You think it should only hit the massive ticket items as everything else is pointless. I think that every single 14p per month of unnecessary expenditure should be saved. "I'll try one more time" - there is NO single ticket item that can instantly be lopped that will see this country with a surplus, let alone one that can start to materially pay off our debt. If you think there is, please let us know (and we can all email Mr Hammond).

Needing to consider the systems of other countries is important because the amount spent privately per capita is telling when in this country it's almost frowned upon and considered a sleight against Old Mother NHS to do this. If other nations whose outcomes we covet have a much higher proportion of private health care spend then maybe there are some answers in there for us. Granted outcomes are also seriously important, but the system is key too. Everything has to be considered in the round and not just cherry picked.

Same thing goes for what else other countries spend their money on. For example, if Germany were to channel its shortfall in its NATO expenditure from its public health expenditure pot, guess how its public expenditure would compare to our own (its private expenditure already makes up half as much again as a %age as ours, so they have that base covered). Maybe they have the balance right. But then people need to start campaigning their MPs along these lines if so and telling our government to spend less on defence (I'd say good luck with that right now).

I would prefer the NHS to operate within a finite budget that as a minimum would cover basic emergency care only (safety net) and work up from there. I would like to see other treatments covered by private healthcare, possibly with tax breaks for it that taper off on a means tested basis. I would like to see people and their families look after themselves/each other as the primary recourse for assistance before the govt is expected to step in. And I think unless we start doing this, quite possibly within my lifetime (assuming I live the average length) we will see an NHS that will collapse under the strain. If one believes the press (I tend not to), that is already happening.

Can people in this country afford to pay more tax? Quite probably. And definitely in some income brackets. But there are very few who will offer this (ie vote for it). Especially in the income brackets that would be ripe for a rise.

Good post.

I do think that addressing IVF and similar is avoiding having to deal with the bigger issue, the sustainability of service. There is empirical evidence that NHS is treating more people (pop growth), that people live longer and that cost of providing service to older people is significantly (many times) higher than to someone aged 50. We already have the sustainability plan that needs NHS to find 'efficiency savings' of 22b in next 5 years. After picking 'low hanging fruit', the next step will be (already is) cutting on expensive medicines.

You'd like to see something that, from what you are saying, looks like very much the system in the USA. Please correct me if I got that wrong.

I don't see USA system as an efficient system at all. Study after study is showing that the USA is spending 2x as much on healthcare as other developed economies with dire results.

Edited by jjlynn27 on Wednesday 29th March 09:50

[Evanivitch]

IroningMan said:

Evanivitch said:

IroningMan said:

Are peanut substitutes available on prescription for those with an allergy to the real thing? How about lactose-free milk?

Does the Health Service not employ enough senior managers for one of them to find a few minutes to make decisions like this?

People with severe allergies are provided with EpiPens, which aren't cheap.

Lactose intolerance is not comparable to people with Coeliacs Disease. Lactose intolerance is a temporary discomfort in even the most severe cases. Coeliacs can be immobilised for days by mistakingly eating gluten.

EpiPens yes, but not alternatives to peanuts.

Coeliacs have plenty of alternatives to bread and pasta - for heaven's sake most people in the UK didn't eat pasta until the 1980s - and if you must have bread and cost is the challenge then make your own - come to that the same is true of pasta and pizza bases if you must have them.

Brilliant answer, we should go back to the 1980s or people should make all their own gluten free products.

You realise these are people, in many cases children, trying to live a normal life?

It's not a case of must have them, it's a question of quality of life, and yes, telling a kid he can have pizza like all his friends or that you don't have to live off rice and potatoes is quite a big part of that.