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 1117.

    Paying over the odds is sadly typical of the NHS. I used to be a qualified nurse and our ward was charged £5 for a sealed sandwich and £14 for an ethnic meal. We once payed £400 for a filing cabinet that broke after 2 weeks - the same filing cabinet would have cost you or me £180! The NHS is one big cash cow and I'm amazed that sucessive governments haven't addressed it's procurement methods

  • rate this

    Comment number 1116.

    1107. Rinali
    I have a job to keep, house chores to do and other people to look after. If I'm not allowed convenience food and have to cook on top of that, I'd have to work less hours.
    I do all of the above and work 66+ hours a week, the extra hours I do allows me to buy ''convenience'' food, I wouldn't dream of asking other tax payers to pay for it.

    Cooking is fun by the way.

  • rate this

    Comment number 1115.


    I find fruit and meat to be extremely expensive. I can't afford to buy fresh meat more than once every 2 weeks. It's so much money. I can't believe you think they're cheap. What planet are you on? :/

  • rate this

    Comment number 1114.

    I work full time, have three children, a disabled husband, three dogs, a cat and lots of commitments. I do not claim benefits, my husband has a small pension and I am not superwoman. I get on with it and cook healthy meals and go out and enjoy healthy food. Surely I am not the only person in the world who cannot eat gluten or dairy and do this, if I am I may be about to become rich!

  • rate this

    Comment number 1113.

    Bread on prescription?!? There are lots of gluten free recipes for bread on the internet. Gluten free bread flour is about twice the price of normal bread flour. Why should other people have to pay for some one elses lazziness or lack of imagination. If you have special dietry needs best to make your own anyway? Maybe supply a breadmaker at a discount. Easy way to make bread.

  • rate this

    Comment number 1112.

    Exactly the same products at a subsidised price but from a different place and with a saving, some of which can be ploughed back in, of £60m or so. What could possibly be wrong with that?

  • rate this

    Comment number 1111.


    "It IS too expensive and it isn't widely available enough. Pretty sure I already mentioned that several times. You may want to work on your reading comprehension."

    So you think naturally gluten free foods like fruits, meats etc are too expensive and not widely available? My comprihension skills are fine. It's you I'm worried about.

  • rate this

    Comment number 1110.

    Suzanne from Cumbria says: "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"
    How dare she? This woman clearly has NO idea that pharmacies must source these products from different places, & with several patients it is impossible to 'co-ordinate' deliveries.
    How ungrateful is she???

  • rate this

    Comment number 1109.

    How very sad that we have posters piously slating those with coeliac disease.
    I'm lucky, I don't suffer. I have a good friend who does. They are in hospital for the second time this year having a section of their colon removed. Shame on you doubters.
    That said, this article is all about NHS procurement. Not coeliac.
    Your money is wasted for private gain!
    What will it take to get you angry?

  • rate this

    Comment number 1108.

    Bobi - if you have coeliac disease you are not allergic to gluten/wheat/barley/oats. People who have this disease eat any of the above cause their small intestine to become diseased, it is not a life style choice. It is not a case of moaning about not being able to have bread, but wanting to be well.. Do people really think it is ok to have to pay £3.00 for a 400g loaf from a supermarket

  • rate this

    Comment number 1107.


    It IS too expensive and it isn't widely available enough. Pretty sure I already mentioned that several times. You may want to work on your reading comprehension.

    I have a job to keep, house chores to do and other people to look after. If I'm not allowed convenience food and have to cook on top of that, I'd have to work less hours. Want to pay my benefit money? Didn't think so.

  • rate this

    Comment number 1106.

    Being unable to eat dairy and gluten and having to have regular health checks and colonoscopies, I still fail to understand why bread and cakes are an essential dietary item? I have been very ill, in a lot of pain and hospitalised but am so thankful with a healthy diet I live a normal life, restaurants are really helpful, I have even taken some of my own food, take aways are full of junk anyway!

  • rate this

    Comment number 1105.

    My dog has to eat gluten free products and I have to pay the full ;price for them. Just thought I would mention it. When we have revolutionary socialism, it will be free: ' to each according to his needs' as the Socialist Worker newspaper seller outside the BBC in Salford told me.

  • rate this

    Comment number 1104.

    Firstly as someone involved in the glutenfree scheme in Cumbria I find it distressing that (as usual) the facts have been greatly distorted. Most of the scheme is run by professional concientious pharmacists that do not pay any carriage or handling charges. In fact from personal experience I will say that the main of these charges referred to in this programme are added by large pharmacy chains.

  • rate this

    Comment number 1103.

    I am stunned by some of the selfish comments made by those who have no idea what it is like to have an intolerance to foods. It can be very debilitating, if not painful.
    I am wheat, gluten AND dairy intolerant. I have learned to shop for things that I can eat, but going out for meals is a nightmare, where most things on offer are full of wheat, gluten, cream, cheese, milk .....

  • rate this

    Comment number 1102.

    People don't seem to understand coeliac disease. It is not a life style choice, it can be quite serious. My son was ill for three years with it. The prescription food helps as this type of food is expensive. Even if we make bread ourselves with floor that is specially made it costs £3.00 a 2lbs. You have to be so careful with every type of food. Sad that so many people seem to unsympathetic

  • rate this

    Comment number 1101.

    Most of these comments are missing a vital bit of information. These prescriptions are NOT free.

    Despite having being diagnosed, which confirms your eligibility to receive prescriptions, you still have to pay for a food prescription, as you would for other types of medication!

    The majority of people do not get any benefit from this scheme, its just a matter of conveniance for some!

  • rate this

    Comment number 1100.

    Two of my family have had stomach cancer due to coeliac disease. One died a horrible death and the other has had their stomach removed & is now having chemotherapy. Both were late diagnosed Coeliacs. It has cost the NHS much more in medical bills than prescribing gluten free food. Gluten free prescriptions are essential to coeliacs as the food is very expensive it is not widely available.

  • rate this

    Comment number 1099.

    1089.Name Number 6

    The only fibre bar I know which is gluten free is available in 2 shops I know of and costs £1.40 a pop. The vast majority do have gluten in. I can't justify spending that on a few mouthfuls.

  • rate this

    Comment number 1098.

    Hey guys, I am one of the people out there with similar nutrition problems and I am working on a project that will hopefully make life easier for people with allergies! The idea is that a mobile app can tell you whether smth. is ok or not - http://www.youtube.com/watch?v=bD764k3eLAY&feature=player_embedded - what do you think? :)


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