Coeliac Disease and Prescriptions

Rebecca Pow Excerpts

Tuesday 1st November 2016 Westminster Hall

[Mr Jones]

It can. There is some anecdotal evidence about the connection between coeliac disease and mental health. The hon. Gentleman raises an interesting point.

This situation is creating considerable uncertainty for those who rely on access to gluten-free staples on prescription, and it is the vulnerable who are most adversely affected. Individuals with the disease are not eating gluten-free food out of choice or because it is some type of fad or Hollywood diet. They do so because they have to. It is people on fixed incomes or on benefits who receive free prescriptions and those whose households rely on deliveries from community pharmacies who will suffer most if prescriptions are withdrawn.

A number of people have written to me ahead of this debate, and I would like to draw Members’ attention to their cases. Patricia said:

“The diet I and many others follow is not a fad. It is necessary as it will affect my health and wellbeing if not followed, and might actually result in my admission to hospital—an extra strain on the NHS.”

[Rebecca Pow (Taunton Deane) (Con)]

Will the hon. Gentleman consider students in this category? Many of them are on low budgets. They might be tempted not to buy the right food and then end up being sick and in the NHS, costing the state more money.

[Mr Jones]

That is the main point. What some CCGs are doing is a false economy, because one hospital admission will cost more than the annual cost of prescriptions for an individual who adheres to a gluten-free diet.

Another person living with coeliac disease, Janice, who is a constituent of mine, wrote to me saying:

“I strongly believe that these plans will cause more expense to the government when coeliac patients can’t afford shop priced gluten-free foods and don’t stick to their diet and end up with cancer of the bowels”,

as well as other conditions. She went on:

“I am a pensioner and find it increasingly hard to afford luxuries like biscuits and cakes. If I have to add gluten free bread, pasta and cereals to my shopping list this will cause more stress. I cannot have any form of gluten, even in small doses, as I am violently ill.”

As well as a failure to consider the evidence before making decisions to withdraw gluten-free prescriptions, there is also evidence of a lack of public consultation by CCGs. Coeliac UK has been doing a good job of holding CCGs to account. One example it provided is of Trevor, who told Coeliac UK that he has never received confirmation in writing that the policy had changed; he was informed only when Coeliac UK told him. He was diagnosed 10 years ago and has only ever had bread on prescription. He is unable to work and has ongoing medical problems. His nearest shop is a Co-op, which does not stock gluten-free products, and the nearest shop that does is some six miles away. That creates problems for people such as him.

The CCGs that have already removed access to prescriptions for gluten-free products have not outlined or implemented policies that offer alternatives to safeguard patients, such as access to specialist dietary or nutritional advice. When a coeliac patient is taken out of a CCG’s responsibility because their gluten-free food prescription has been withdrawn, that CCG can no longer monitor them or determine the changed policy’s impact on that patient’s health. This is an important factor, and I am concerned that it has not been taken into account by a number of CCGs.

In areas where gluten-free products are not prescribed, there is now no opportunity to encourage dietary adherence nor a prevention strategy for long-term management of people with coeliac disease. Effectively, patients who suffer the condition in these areas will be offered no support by the NHS. Although CCGs are engaged with local authorities and wellbeing boards to explore alternatives, none has yet been put in place.

The NHS has a good track record of involving the public in consultation, but the lack of consultation on the decision to withdraw prescriptions for gluten-free products is a disgrace, added to the fact that charities such as Coeliac UK are not consulted before such decisions are made.

--- Later in debate ---

[David Mowat]

That is an interesting idea, which I will consider, but I am not briefed to talk about it. The position of most Members on this issue is very clear from the tone of this debate and the points being made, and we will respond to that.

[Rebecca Pow]

Will the Minister give way?

[Liz McInnes (Heywood and Middleton) (Lab)]

Will the Minister give way?

[David Mowat]

First to my hon. Friend, and then to the hon. Lady.

[Rebecca Pow]

This is highly relevant. I, too, have been contacted by constituents who have suggested this voucher idea—that the bona fide coeliacs get the staples and so many vouchers a month, not for all their products, but for the bread, pasta and absolute staples.

[Liz McInnes]

Is the Minister aware that the annual cost per diagnosed patient of prescribing gluten-free food is £180 per year? Weigh that up against the cost of avoiding infertility, bowel cancer and osteoporosis. What is the obvious conclusion for any NHS professional?