BBC: "NHS 'paid 17 for gluten-free pizza base'"

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DarthVector

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From the BBC website:

http://www.bbc.co.uk/news/health-17755552

I have to wonder whether this is an attempt to stir up indignation so that prescription food can become an easy target for cuts, thereby avoiding the hard work of actually building an efficient distribution system. Note the distinct emphasis on pizzas, cakes and biscuits.

Although the article only refers to gluten-free food for coeliacs, it wouldn't surprise me to learn that there are other conditions that require specialist foods on prescription as well.

Sofie

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Oh, this again... My nearest shop that does gluten free food is a good hours' walk away. I can't (unlike if I just needed milk) pop to the shop and buy it.

Hurtyback

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Gluten-free items are costing the NHS a lot of money. This is not the fault of the people who need it but of the people who inflate the prices!

Sunny Clouds

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I followed a wheat and gluten free diet for some time as part of an exclusion diet.  By some time, I mean some years, since I just stuck with it.

I think that gluten free foods for adults should be time-limited for adults to allow them to adjust to a different diet except two times of year at their choice, for example a holy day and a birthday.

The vast majority of people around the world do not eat gluten-bearing grains.  A gluten-free diet may not be how most people in the uk are brought up but it's not impossible.

What do gluten-bearing grains do?  They provide fibre, starch, carbohydrate.  Most of that can be provided by other substances including other grains, potato and pulses.

Sophie - have you actually asked your local corner shop if they'll get in some gluten-free food for you?  Our local shops are happy to add specialist food to their stock.  You may have to pay up front and order more than one of stuff, but it seems to me that most food sold for the specialist gluten-free lookalike/tastealike market is long-life, so there's no reason why you couldn't buy half a dozen loaves or whatever.

Alternatively, again looking at shelf-life, a bulk order from a supermarket would, I think, cater for people in most parts of the UK (although I would accept that those in the Highlands and Islands would have a problem).

As for biscuits and cakes, they aren't actually a necessary part of anyone's diet.  Suppose that someone said 'we'll cut ESA and give part of it as a biscuit and cake voucher' there'd be screams from all those that don't eat biscuits and cake.

For the money it costs the NHS, I'd be inclined to give people money for a breadmaker and a pasta maker and an annual allowance towards supermarket delivery.

It's that or look seriously again at why people with coeliac disease should get free prescriptions for substitutes whilst people with other food allergies don't, no matter how severe their reaction to the food concerned.
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

Sunny Clouds

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I just looked on Amazon. Five kilos of gluten-free bread flour for 7.50 inclusive of postage. 
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

DarthVector

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As I understand it - I'm not a coeliac myself - the way coeliac food prescriptions work is that you get a given number of units to spend, where a loaf of bread would constitute one unit, for example. What you spend your prescription units on is up to you, in much the same way that what you spend your DLA on is up to you. The number of prescription units you get varies according to age and sex.

It is certainly true that many societies follow a gluten free diet as a matter of course, but there will always be people who are unable to tolerate a given staple foodstuff, regardless of what it is. Those people will always incur a cost in avoiding that foodstuff in a society which relies on it, whether in money or in time, and I see no reason why a civilised society should make them bear that burden all by themselves.

Of course, if someone chose to spend all their prescription units on biscuits, the costs of buying overpriced gluten-free bread and breakfast cereal would be theirs to bear, and rightly so.

On a related note, I do have a bone to pick with the food manufacturers who add things like wheat flour to products like ready-made sauces and microwavable meals. A bit more forethought from those manufacturers would drastically reduce the numbers of people who have to avoid their products. In many cases, cornflour would do just as well, for example.

Does anyone have a link to an article comparing the relative incidences of different food allergies / intolerances? I can't seem to find one, and I'm curious to know, because it would seem sensible to encourage food manufacturers to move to the ingredients that cause problems for the smallest number of people, so that fewer people would need to receive prescription food in the first place.

oldtone27

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"...it would seem sensible to encourage food manufacturers to move to the ingredients that cause problems for the smallest number of people..."

Sensible yes, but not necessarily in the manufacturers interests.

They will tend to buy the cheapest ingredients suitable for the products positioning in the market. Gluten free may not be the cheapest.

Also, they can market gluten free as a specialist product and charge a premium. Not fair perhaps, but its all about profit.

Sunny Clouds

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Some people have either a milk (protein) allergy or a severe lactose intolerance (mild ones are common) meaning they cannot tolerate any milk in the former case, or most milk-based products in the latter case, and milk is a normal, everyday part of our diet in the UK, but so far as I'm aware, people don't get stuff like cheese-substitutes on prescription.  So if two people can't eat pizza, why should one get their base on the NHS but another not get their topping on the NHS?

I don't see why coeliac disease should be treated differently from other conditions that exclude traditional foodstuffs in the UK.

As for how much gluten-free stuff is prescribed and on what basis, although there are guidelines, they are not binding.

If the government is going to cut back what people can get on the NHS, there will be all sorts of nasties like this to consider.

Already people can't get all sorts of things that make the difference between an independent lifestyle and sickness/pain/impairment/being confined to their home/dying earlier.

If you asked me whether I thought my local PCT should put money into, say, more electric wheelchairs or alzheimer's drugs or adequate pain relief for all who need it, or whether they should put money into pizza bases, I'd find it difficult to justify the pizza bases.  This is exactly what the government wants, of course, instead of saying it will fully fund the NHS, it leaves us all with nasty choices.

(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

Sunny Clouds

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Incidentally, I do think gluten free foods are important for children, or at least until they get to about 13-ish, because sandwiches can be important socially and a bit of cake to take to someone else's birthday party can make the difference between being socially included or excluded but there comes a point at which this can be managed unless someone has learning difficulties.

I don't know where the balance lies on this, but I do strongly feel that it should be either all people with serious reactions/allergies that can get substitutes on prescription or none.
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

RedAndBlue

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I never knew you could get specialised food on prescription, so that's news to me.

Obviously the price is an outrage, but I don't see the problem of making a variety of food available to people who otherwise couldn't eat it, even if it is unhealthy. Average Joe or Jane can go to a shop and buy a decent pizza for 2. Just because someone can't eat the normal ingredients it doesn't mean we should force them to forego them, especially if it's a one off treat.

Being Gluten intolerant really limits what foods you can eat, and the flavours of things food comes in. They might not "need" anything fun and unhealty, and can make do on lots of other cheaper forms of Gluten free food, but that's taking away someone's choice.

Admittedly it's not to the same degree, but that's the sort of thing we get thrown at us when we spend our benefits on things that aren't the bare minimum and necessity. It's the intention, to cause outrage, but swap NHS with DLA and Gluten Free Pizza with a, I don't know, "A top of the range smart phone" and it causes the same sort of outrage. Especially when we can make do with a cheap basic one.

People should be outraged at those at the very top impacting the end price of the food stuffs, rather than those who would want the food stuffs. I've no doubt this is a case of "supply and demand".
A man got sick because of officiate.

DarthVector

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I don't see why coeliac disease should be treated differently from other conditions that exclude traditional foodstuffs in the UK.

I agree entirely, but my position is that if someone's medical condition requires them to pay more for food, then they should get something to help redress the balance. It shouldn't be a case of cutting support for coeliacs, it should be a case of extending fair treatment to people with other food-restricting conditions.

It occurs to me that if the Government had done a real DLA reform, instead of a marketing smokescreen for cuts via PIP, then things like food allergies could have been folded into the reforms. I suspect that many coeliacs would be just as happy to receive cash to cover the extra cost of gluten-free food, and I'm fairly sure that it could be covered for something on the order of 10 per week.

That's only half of a low-rate DLA payment, and at 17 for a pizza base (my mind is still boggling), transferring the budget from the prescription system to a cash-in-hand arrangement would make it go a lot further.

Sofie

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but so far as I'm aware, people don't get stuff like cheese-substitutes on prescription.  So if two people can't eat pizza, why should one get their base on the NHS but another not get their topping on the NHS?

Last time I checked, milk substitutes (which I've had) aren't 5x the price. And people with gluten intolerance are far more restricted in what they can eat. No pasta, most biscuits, crisps, certain meat produce, no bread-based products, etc.

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I don't see why coeliac disease should be treated differently from other conditions that exclude traditional foodstuffs in the UK.

Most other conditions which exclude traditional foodstuffs, don't exclude around 90% of foods.

Quote
If you asked me whether I thought my local PCT should put money into, say, more electric wheelchairs or alzheimer's drugs or adequate pain relief for all who need it, or whether they should put money into pizza bases, I'd find it difficult to justify the pizza bases.  This is exactly what the government wants, of course, instead of saying it will fully fund the NHS, it leaves us all with nasty choices.

Should the person with gluten intolerance be forced to live on such a restricted diet?

Sunny Clouds

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I don't think it is terribly restricted.  You can have a full day's meals of normal British food starting with cornflakes for breakfast, meat/fish/eggs and salad for lunch and a meat and two veg evening meal followed by fruit and cheese.

Take pizzas.  You may consider it restrictive not to be able to eat them.  Would it surprise you to know that my father has never eaten a pizza in his whole life and he is over eighty? 

I rarely buy biscuits or cake and wouldn't miss either. 

And bread rolls in fancy packaging may be five times the price, but gluten-free flour, which as I've pointed out can be  bought on the internet or ordered via your corner shop, compares for price with well-known brands of wheat bread flour. 

And a gluten-free diet doesn't exclude 90% of food.  It may exclude a high percentage of junk food/processed food, but it doesn't exclude fresh/frozen/tinned fruit, veg, pulses, tree nuts, ground nuts, seeds, meat, fish, eggs, milk.  You can eat a balanced, nutritious and tasty diet without gluten. 

As I say, I did live on a wheat and gluten free diet for years so I'm not speaking simply from observation of others.  All you need is a cookbook and imagination.  If you absolutely must have 'substitutes' then don't get ripped off, do your homework and buy at a reasonable price.  Most little local grocers/corner shops/general stores are desperate enough for customers to order stuff in for you. 

(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

boccius

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It's the MIDDLE-MEN as per usual who are spivving their way through disability foodstuffs.

As one doctor said in that BBC report:

Dr Fayyaz Choudri, a GP who was responsible for overhauling gluten-free prescriptions in Allerdale, Cumbria.

"We saw there were occasions where there was a bread loaf costing 2.50 and there was a handling fee of 32.00," he says.


So the loaf was a reasonable charge, as were the pizza bases!

A.

Sofie

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Meat, fruit, veg, etc. may not be processed; but why must someone who is gluten intolerant be forced to live on such a restrictive diet? Not everyone has the time or energy to stand there and cook.