So this week’s rant is about overspending. Not my penchant for going online when insomnia kicks in but more about Primary Care overspend.  We often get letters requesting that we, i.e. Primary Care, reduce our spend on such things as prescribing, cut back on referrals, try to stop our patients accessing A&E because they can’t get an appointment at the surgery – you know the sort of thing.

Well, I’d like to focus on one particular area and that is prescribing – because it strikes me that actually, the Government could help us to help our CCGs by sorting out some of the anomalies. By this I mean making sure that GPs don’t prescribe things like Calpol, Paracetamol, Gaviscon, Ibuprofen, nit shampoo etc.   According to the BBC (who never lie, unlike some newspapers…..) the NHS spent £80 million on Paracetamol alone last year- £80 million pounds!  So when I hear of CCGs sending out letters saying they’re overspent and if we don’t sort it, they will go under, it rather makes me spit.   Patients who are on a low income will often demand such items are prescribed as they get them free, because they’re on benefits – and I do understand why you would want something free if you could get it for free. However, this is a massive problem and I think that Joe Public ought to know that if we don’t change what we’re doing now, we won’t have an NHS for them to abuse!

The other area of prescribing that irritates me immensely is that of the ‘free because you have a life limiting illness’ prescription. Now I have nothing against a diabetic patient getting their diabetic meds free of charge (after all, without them, they’d be up a creek…) but why should they get other medication (that has nothing to do with their diabetes) free of charge?   If you’re on Thyroxine, you get free medication, but again antibiotics for a chest infection are not necessarily to do with your thyroid replacement therapy and so why should this be funded?   Pregnant women may be pre-disposed to needing Gaviscon more readily than if they weren’t pregnant, but do they require free medication for a year after they’ve delivered? Personally, I think not.

Now, if we stopped the random prescribing of easy-to-get-over-the-counter-and-very-cheap-at-that medication, that would be one thing.  If we also reduced the amount of free-for-life medications, we could solve a massive expenditure crisis – and if the Government decreed that this was the rule, we wouldn’t have patients demanding drugs the way they often do.

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