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 57.

    Situations like this just add more fuel to the privatisation of Public services. Private companies would work out the best deal, negotiate with suppliers and make sure they get the best possible deal, NHS buyers have no idea how to get the most for our money.

    We need to make public servants accountable, maybe give them bonuses if they cut costs, better that than paying prices like this.

  • rate this

    Comment number 56.

    44. TheWalrus999

    "Exactly the kind of cuts in public spending that can and should be made.
    How did it get to this?"

    Market forces, PFI and opening public services up to the greedy private sector through incompetent NuLab and Con governments looking after their mates with big fat contracts - THAT'S HOW!

  • rate this

    Comment number 55.

    Some 'ill' people are bloody nuisances....

  • rate this

    Comment number 54.

    We experienced a number of new Mum requestion prescriptions for all sorts of "Special" Baby Milk with no clinical proof. The Health Visitors were advised this was inappropriate use of funds and the process stopped.
    We often have patients requesting a shopping list of Gluten Free products, our PCT has issued guidance to limit to essentials only "luxury" items patients have to pay themselves.

  • rate this

    Comment number 53.

    Would it just not be more beneficial to use the money being spent on items such as this, and teach people to cook? It makes me a little sad in supermarkets where you can buy chopped mushrooms, chips and curry sauce frozen, even frozen chopped onions or omelette in a tin...not saying everyone should be a culinary genius, but a pizza base is yeast, water and flour.....

  • rate this

    Comment number 52.

    I'm recently diagnosed and it's cost me a fortune trying out the options to find something vaguely palatable. At £2.50 a small loaf that is stale within 24 hrs it's not cheap and being coeliac isn't a lifestyle choice it's essential. BUT it seems beyond the wit of man for our pharmacy to co-ordinate orders and deliveries to reduce the delivery costs - only in the public sector could this happen

  • rate this

    Comment number 51.

    Am I seeing things?
    Criticism of the saintly NHS on HYS attracting positive votes?

    I've said it before and I'll say it again. It is very easy to spend other people's money. With a £100bn + budget and massive public support to fall back on, how carefully do you actually think they are spending our money? Oh they'll go through the 'correct procedures' but will they have engaged brains?

  • rate this

    Comment number 50.

    The Supermarkets sell a good range of Wheat and Gluten Free products and the range gets better year on year, Ok the price is a little higher, but not that much. My wife has coeliac disease, and I am wheat intollerant. We do not get prescriptions for our food and I don't see why anyone should.

  • rate this

    Comment number 49.

    The NHS is a HUGE organisation with massive buying power. They should be paying pence for pizzas.

    You cant just blame suppliers! If i offered you a can if fizzy drink for £4, would you buy it? or would you shop elsewhere?

  • rate this

    Comment number 48.

    How difficult is it? You suffer from a disease, you read up on what you can and can't eat and you stick to it because otherwise you will suffer even more! It's not rocket science. And I cook for someone who is allergic to gluten. Yes, it's sometimes difficult, but it's not impossible. To get your food on the NHS is just wrong. What about people who are highly allergic to dairy? Where does it end?

  • rate this

    Comment number 47.

    @Colin: A little short sighted from you there. You obviously fail to understand how little food you can eat as a coeliac, and that it is much more expensive. Providing the food actually cuts the expense if people did get the complications that can occur. Why should the NHS pay for anything? Because that is why we have it!

  • rate this

    Comment number 46.

    This is merely the end-result of the free-market and capitalism's "caveat emptor" working itself out when we have two parties, both of which have different inds of failings or faults. The NHS is incompetent in not being able to stamp this out and blacklist any supplier trying this on. The private company is being greedy and immoral in screwing excessive money out of people. Capitalism fails here.

  • rate this

    Comment number 45.

    So the NHS can pay for Gluten free foods for sufferers but can't pay for inhalers for asthma sufferes. People with a gluten intolerance can quite easily pick up gluten free foods in their supermarkets but an asthmatic can't grab an inhaler off the shelf during their weekly shop. The NHS needs a serious shake up!!!!

  • rate this

    Comment number 44.

    Exactly the kind of cuts in public spending that can and should be made.
    How did it get to this?

  • rate this

    Comment number 43.

    Why not give coeliacs a budget for their extra food costs? I've tried a gluten free diet and it can be expensive and not much fun, but then again you can cook cheap gluten free meals. It's only the special ready made alternatives to bread, cakes and biscuits and processed foods on the whole that cost so much, and having a limited budget would encourage the finding of cheaper solutions.

  • rate this

    Comment number 42.

    "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"

    I'm confused, what exactly is the £8.95 for if it's not for manufacturing the pizza?

    Also the price the public sector agrees to pay for things is sickening, heads should roll for this sort of incompetence.

  • rate this

    Comment number 41.

    13. Yes, active people might be able to, others certainly not. It is very difficult to ensure a wholy gluten free diet.
    By doing this, the NHS pays a relatively small amount to stop people with coeliac disease developing more serious conditions costing many times more. Now it has saved the pounds, it gets hammered by penny pinchers to save pennies!
    Note diabetes costs the NHS £3.9bn pa.

  • rate this

    Comment number 40.

    It's funny, every time I vistit other countries they have never heard of half of these food alergies. These are the countries that actually eat freshly prepared, un-processed foods as a matter of course. So next time we are all sitting down watching a 'lifestyle' cookery programmes that suggest the same, perhaps we should put down our TV dinner and pay attention?

  • rate this

    Comment number 39.

    you'll be telling me diabetics get a prescription for diet coke next

  • rate this

    Comment number 38.

    I wish I could say this suprises me.

    ..I wish I could say that.


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