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 37.

    As a coeliac disease sufferer, and a regular user of my yearly subscription to prescription food through the NHS (which isn't free, I might add), I'd just like to point out that you cannot get bourbon biscuits or cake through the NHS because they are sweet and therefore deemed unhealthy. I really only get bread flour and pasta via my prescription. Everything else is easier via the supermarket.

  • rate this

    Comment number 36.

    Just contacting 5 doesn't give an overall picture, here in the North East we can only get bread, 1 pckt flour and 1 pckt pasta a month. We can not order cakes, biscuits or other luxury items. Even on the bread it caused a slight problem when I wanted Juvela and not another make that costs less. I just wish companies wouldn't take the rise out of other peoples illness. Ceoliac UK well done!!

  • rate this

    Comment number 35.

    Supermarkets provide a range of gluten free products fresh & frozen! Its a recognised dietary need & more affordable. Perhaps people who pay into prescriptions or are exempt take the NHS prescription option otherwise why somebody choose to pay £7.65 (price/prescription item) for a loaf of bread! Maybe its time to stop prescribing for this group of people (excluding complex cases, eg. babies etc).

  • rate this

    Comment number 34.

    No surprise!. The NHS, Police, Fire and local authorities across the UK are professionals in wasting public money.

    Government established procurement authorities but by failing to make their use mandatory these organisations cover less that 30% of total procurement. As a result Governments, of all colours, have accepted such waste on a grand scale for years.

  • rate this

    Comment number 33.

    If they had decent kitchens and cooks they could make them themselves for a fraction of that!

  • rate this

    Comment number 32.

    Mismanagment at it's very best. Bring back Hospital Kitchins where everything was made fresh. The cost of making is less than buying & reheating like some hospitals have done for many years. More food is wasted than consumed in our hospitals, that say's it all to be honest.
    Allowing companies to charge crazy prices should be stopped by government.

  • rate this

    Comment number 31.

    Imagine being on a Gluten-Free diet. No bread, no biscuits, no fish and chips, no yorkshire pudding, eating out is a disaster waiting to happen. Gluten-free bread costs £3 a loaf and is stale as anything AND if you're as bad as my mum, one crumb will land you in hospital. If she didn't have this prescription, she'd be in a larger mountain of debt than she is already.

  • rate this

    Comment number 30.

    It's a bigger problem the huge spending on pharmaceutical drugs when there are cheaper alternative treatments that are not offered by the NHS. The prescription charge is now sufficiently high that for many drugs, if it weren't for the "not available without a prescription" law, you could buy them cheaper direct.

  • rate this

    Comment number 29.

    Irrespective of the actual cost, the issue is - should these foods be on prescription at all? However, all public sector procurement seems to be a licence for suppliers to print money - not just in the NHS!

  • rate this

    Comment number 28.

    I'm intolerant of Brussels sprouts. Can I have a prescription for steak please - delivered to my house.

  • rate this

    Comment number 27.

    Having undertaken some procurement whilst working in the NHS I was staggered by the way in which only certain suppliers can be used. Why not free up their supply chain? If something is cheaper elsewhere then buy it there and simply ensure invoices are correctly processed. It would take some adapting to but would surely be cheaper in the long-run.
    So much money is wasted by the public sector

  • rate this

    Comment number 26.

    Why is food being prescribed? Everyone needs to buy food and most supermarkets these days have a range of gluten free products. Why can those with gluten intolerance not simply buy gluten free products instead of ordinary ones in the same way as someone allergic to strawberries avoids products containing strawberries? And who "needs" biscuits anyway? This should be stopped.

  • rate this

    Comment number 25.

    Sometimes think that there are those in the public sector who just think, "It's not my money," when they procure things

    Well, no it's not... It's ours. So spend it more wisely !!!

  • rate this

    Comment number 24.

    Bauer wrote:
    "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."

    Rubbish, there are plenty of examples of private scector rip-off charges: Ryan Air, bank overdrafts & hospital car parks to name but three. Rather than taking cheap shots at the NHS, aim it at the suppliers.

  • rate this

    Comment number 23.

    I cant believe they have to do prescription Pizza. If the dr told me that eating something would make me seriously ill, but there are alternatives, I would just say thank you, and buy the alternative. I cant believe people expect that to be free on the NHS!! I say free, but because I pay tax, I need to pay £7.60 for my pre-scriptions, so to me its like having to pay £15 for a pizza.

  • Comment number 22.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 21.

    There are so many problems in the NHS at the moment in the way it will affect the future for all of us (privisation/GP comissioning), yet all we can discuss is gluten free pizza bases/bread which affects a very small amount % of the population! please BBC/ HYS - better topics for discussion!
    27 million is a tiny amount compared to the billions wasted/ lost elsewhere by the NHS!

  • rate this

    Comment number 20.

    A pizza base shouldnt make the headlines but what it does is it signifies the poor procurement in the public sector and suppliers charging what they can get away with , the problem is we cannot put this in perspective ie how much is wasted each year in the public sector just through bad buying . I believe in a simple , thorough , tough but fair buying system

  • rate this

    Comment number 19.

    Take this with a pinch of salt. The £32 loaf of bread story has been comprehensively debunked and media outlets that printed the story had to issue a correction. The calculations to get £32 loaves of bread, and I suspect also these £17 pizza bases too, are based on a misunderstanding of how NHS prescription statistics work. The 'price' for the £32 loaf of bread turned out to be £2.82.

  • rate this

    Comment number 18.

    It does not surprise me sadly with these modern day managers that work within government. The NHS should stop worrying how expensive pain and cancer drugs and check their less important accounts if they want to save money. The person that allowed this to happen should be sacked or at least demoted. Start making these people accountable.


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