NHS 'paid £17 for gluten-free pizza base'

Pizza Handling charges mean the NHS is paying four times the price for pizza bases

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Two prescription gluten-free pizza bases can cost the NHS as much as £34, BBC Newsnight has learned.

The NHS spent £27m on gluten-free prescriptions in 2011, but handling and delivery charges, which can quadruple the cost, are not recorded.

Coeliac disease sufferers can develop serious illnesses if they eat gluten.

Health Secretary Andrew Lansley said prescriptions encouraged sufferers to stick to gluten-free diets but that the area was "under ongoing review".

"The aim of providing gluten-free food products on NHS prescription is to encourage patients with coeliac disease to stick to a gluten-free, nutritious diet so they do not go on to develop more serious illnesses, which can affect their quality of life as well as being much more costly for the NHS," he said in a statement.

"However, we keep this area of prescribing under ongoing review and are currently considering how we might get better value from the prescribing of gluten-free products whilst ensuring patients continue to get the products they need."

Gluten-free bread, cake mixes and bourbon biscuits are also available to people with coeliac disease, an auto-immune disease, which is triggered by eating gluten, which is found in wheat, barley and rye.

In an example from Rotherham, it was discovered that the NHS had been paying four times the original price for pizza bases.

Start Quote

Geoff Martin

This is a lifetime complaint. When you've got it there is no cure for it”

End Quote Geoff Martin, who has coeliac disease

The two pizza bases originally cost £8.95. But by the time manufacturing, handling and delivery fees were added on, the bill for the NHS had been driven up to nearly £34.00.

Another example comes from 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.

Dr Choudri has coeliac disease himself and knows the importance of a gluten-free diet.

Without it, symptoms can range from digestive disorders to very serious illnesses including osteoporosis and bowel cancer.

Geoff Martin is one of a growing number of people in the UK diagnosed with the disease.

"This is a lifetime complaint. When you've got it there is no cure for it," he says.

The condition is triggered by an intolerance to gluten, a protein found in wheat, barley and rye - and therefore a common ingredient in many processed foods.

Gluten-free foods Gluten-free biscuits and cakes are currently available on NHS prescription

"The only solution to it," Geoff continues, "is eating food that is gluten free."

Living as he does in rural Oxfordshire, this is a problem. In order to guarantee a varied and balanced diet, Geoff relies on his prescriptions for gluten-free food.

Geoff's NHS trust is one of many now reviewing its policy on gluten-free food.

With an estimated one in 100 people affected by gluten intolerance, campaigners want the NHS to continue providing staple foods like bread and pasta.

These are increasingly available in shops, along with a wide range of gluten-free products. But they are often much more expensive than regular foods.

Coeliac UK, which represents sufferers, worries that the hidden costs of prescriptions (which patients pay for, unless they have other conditions which qualify them for free scripts) is giving the whole system a bad name.

Allergy advice label on food product Coeliac disease leads to tiredness, anaemia, weight loss, diarrhoea and constipation

Newsnight contacted one of the leading manufacturers of gluten-free food, Juvela. They blamed wholesalers for adding "extra charges, sometimes adding a £20 handling charge to a £3 loaf".

This is questioned by the British Association of Pharmaceutical Wholesalers, which represents some of the biggest companies.

They told us they would be "keen to investigate any relevant cases of alleged poor standards or distribution practice."

To try to safeguard prescriptions, Coeliac UK has drawn up guidelines for NHS trusts on what sort of items should be prescribed - recommending that biscuits and cake mixes should only be given in "exceptional circumstances."

But Newsnight has contacted five trusts which say they have not passed on the guidelines, and that cakes and biscuits are still available on prescription.

With NHS budgets under relentless pressure, these are increasingly being seen as rations the NHS cannot afford.

Watch Liz MacKean's full report on gluten-free prescriptions on Thursday 24 May at 22:30 BST on BBC Two, then afterwards on the BBC iPlayer and Newsnight website.


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  • rate this

    Comment number 17.

    The problem with sourcing items on prescription is that the NHS is locked into inflexible contracts, which it needs to renegotiate and stop being forced into a centralised sourcing strategy by MPs. It is easy to use this article to have a pop at the NHS but anyone thinking that this sort of practice is limited to the public sector obviously doesn`t follow the news very well.

  • rate this

    Comment number 16.

    In Italy they provide gluten free food on prescription also, but the person is required to pick the food up (in this case from chemists). The food is sold at the standard price that the chemist would normally charge - so this removes all the "handling" charges. It's a much better system.

  • rate this

    Comment number 15.

    I totally fail to understand why certain foods should be available on prescription. To me it is simple if someone can only eat a particular type of food then they should pay for it. After all if I can only eat Fillet Steak will the NHS pay for it - Nooooooo chance. Spend this money and the money spend on vanity driven cosmetic surgery on better uses for the benefit of the majority of patients.

  • rate this

    Comment number 14.

    Like any business the NHS has to negotiate the best price it can from suppliers. Given its purchasing power it should be able to drive a good deal.

    Nothing to do with Public/Private sector, just blindingly obvious business practice.

    Of course, in this case, given their catering capability they could make the gluten-free products themselves, maybe at significantly lower cost...

  • rate this

    Comment number 13.

    prescription for pizza? seriously? not trying to belittle the condition but the sufferers must be able to help themselves more surely? i found many gluten free recipes just by googling. shop wisely and it doesnt have to be expensive either....

  • rate this

    Comment number 12.

    I cannot believe the tax payers are paying for people's food like this. I always knew the NHS was overindulgent but this just takes it to a new level. If you have a food allergy that is your problem; there is a reason why Sainsbury's, Tesco, etc have gluten-free sections so take responsibility and buy your own food just like the rest of the population manages to do.

  • Comment number 11.

    All this user's posts have been removed.Why?

  • rate this

    Comment number 10.

    what they made out of gold? ho saw that price and thought ooo thats good i will buy 2.

  • rate this

    Comment number 9.

    Private companies viewing the NHS as a cash cow? Methinks this is a glimpse of the future

  • rate this

    Comment number 8.

    This is only the tip of a gigantic iceberg of waste in the public sector, from paying over the odds for goods to employing people to do jobs which have no purpose.

  • rate this

    Comment number 7.

    It's all well and good picking on a few specific instances, then making assumptions this is endemic across the entire NHS, but there are plenty of instances where this isn't the case.
    The problem is the bureaucracy associated with the NHS. Were funds used wisely, and a monopoly with private industry not entered into, then we would see less waste in these specific instances, eg better management.

  • rate this

    Comment number 6.

    Please supply boilertreat as per your quote numbered 2976/1

    I guess the general consciences in the public sector is

    'It’s not our money, and there’s always more coming soon.’

  • Comment number 5.

    All this user's posts have been removed.Why?

  • rate this

    Comment number 4.

    This is a disgusting waste of public money. Provide gluten free food of course, but not like this. This is abuse and ignorance and shows a complete lack of care and respect on BOTH parts - the NHS for lack of competence and the supplier for ripping Britain off. All involved should be ashamed and fired.

  • rate this

    Comment number 3.

    the government "pay" 20x as much for anything and always have

  • rate this

    Comment number 2.

    Why are we paying for non-essential food items (items that are normally classed as luxuries in the case of cakes and biscuits) on prescription. If you are intolerant to something, stop eating it! No-one died yet from NOT eating foods containing gluten!! By all means buy gluten-free, but as a prescription? No way!

  • rate this

    Comment number 1.

    Only in the public sector would this happen. But please, carry on with your general incompetence and then continue to wonder why no one supports you when you go on strike.


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