On the basis that no publicity is bad publicity, last night’s Newsnight feature certainly raised the profile of coeliac disease and gluten free food and, in the ‘value for money’ area, the NHS came out a lot worse than the gluten-free food manufacturers. None the less, a very brief trawl through the first dozen or so comments on the Newsnight site brought up around eight complaints about the cost of gluten-free food in the shops and four queries as to why coeliacs should get food on prescription at all – and especially why they should get cakes and Bourbon biscuits…
Setting aside the lamentable genius of the NHS for wasting money (which reduced Mrs Crimbles’ Jeremy Woods’ fellow guest to speechlessness – tricky in an interviewee…), gluten-free food does still remain significantly more expensive than ‘normal’ food. Although, historically, there are very good reasons for this (unusual, expensive and hard to obtain ingredients, no economies of scale, more difficult – and therefore expensive – manufacturing techniques, extra testing for allergens, poor distribution) as gluten-free/freefrom food becomes more mainstream these reasons become less and less valid. While a small premium (to cover extra testing and allergen control) may be acceptable prices of £2.50 for a loaf which in ‘normal’ format might cost £1 does, even taking all of the above into account, seem excessive.
The arguments over whether coeliacs should be entitled to get their food on prescription has been raging for several months – since these figure first came out. I blogged about it back in January (see here) and it has been widely covered elsewhere on the blogosphere. A number of NHS trusts are currently reveiwing their policy, and Coeliac UK are trying to deflect the flak by advising that only staple foods (bread, pasta etc), not treat foods (cakes, Bourbon biscuits), should be available on prescription. But while Jeremy Woods, quite reasonably, stayed on coeliac message last night and supported prescription food for coeliacs, maybe a better way to go would be to focus on getting the price of gluten-free food down to within striking distance of non-gluten-free food.
In a discussion last night, prompted by a call to say that Jeremy would be on Newsnight, FoodsMatter’s webmaster suggested that, instead of spending the money on prescription food for coeliacs, the government should spend it on helping gluten-free manufacturers to get the price of gluten-free food down. Unlikely though it is that this would come to pass, it makes some sense. And it certainly makes some sense for the burgeoning number of manufacturers of gluten-free foods to focus their attention on reducing their prices so as to capture the custom of those coeliacs whose loaf of bread currently costs the NHS (us) £32!
i watched last night with interest as i read all the comments on the website with some disgust I am coeliac and i choose not to get my gluten free food on prescription because it takes so long and the bread choice I get i don’t like so i buy mine from the shop but i would be interested like he said on maybe a voucher scheme or a benefit to help out the cost which would be less cost on the NHS and the government. i also think that the handling cost are extortionate and should be regulated more
Entirely agree about the handling charges, Mandy. I do think that Jeremy’s voucher scheme is the way to go – and to get the price of gluten free food down!!
Clearly, to have the NHS pay £32.00 for a loaf of bread is the economics of the madhouse. That it has been going on for years unchecked makes one wonder what other financial lunacies are built into the NHS purchasing systems. The answer to NHS budgetary problems is almost certainly to examine – in forensic detail – the way it manages its existing budgets rather than another top down re-organisation which will almost certainly add to costs rather than lowering them.
I missed the Newsnight report & haven’t had time to look on iPlayer. Did they back up the £32 loaf claim? The reason I ask is that I remember this report from Fullfact.org last year
and this one from Tabloid Watch.
Both reports query the £32 per loaf claim on the basis that it resulted from a misinterpretation of statistics which were based on prescriptions issued (for multiple loaves) and not on the price of a single loaf, e.g. the Welsh Health Ministers’ statement:
“…Reports in the press this morning suggesting that a loaf of gluten free bread costs the NHS £32 are incorrect.
The £32 figure appears to have been arrived at following a misinterpretation of NHS prescribing statistics – which show the total number of prescriptions dispensed, rather than the total number of loaves prescribed. This data is available on the Welsh Government website …”
Was any of this discussed during the Newsnight piece?
HI Claire –
Thank you for raising this – and you are quite right- I too now remember the corrections to the claims. The answer to your question is no, Newsnight did not discuss this during the piece – whether because they did not know or because it somewhat dented the impact of the piece I do not know.
While the correction is not really relevant to the basic discussion as to whether to not coeliacs should get any food at all on prescription when this is not available to diabetics or those suffering from the many other conditions which require you to live on a special diet, it certainly takes the heat out of the accusation that the NHS is spending 12 times more than the cost of a loaf to provide it on prescription.
Here is the quote (on the tabloidwatch site) from the Welsh Health Minister covering the £32 loaf:
Welsh Health Minister Lesley Griffiths said:
“This claim is inaccurate. The actual cost for the single loaf of gluten-free bread in question is around £2.82, not the £ 32 claimed. The £32 cost quoted is for an average prescription on which several loaves are ordered at a time…
Loaf of bread
Over the last 12 months there were 27 prescriptions issued for the gluten free bread quoted as costing £32 per loaf. On the 27 prescriptions, the total amount of the bread prescribed was 123,600 grams. Each loaf is 400 grams. Therefore, 309 loaves were prescribed for £ 871.36 ie £2.82 per 400 gram loaf.
We just had the following email in from Helen and as it seemed very pertinent I am copying it in here:
I did not see the Newsnight programme but viewed it on line in the small hours of Saturday morning. The research NOT done for the article was awful. Factually incorrect, erroneous etc . And Mrs Crimbles, although perfectly nice gluten-free foods, are not even available on prescription so were they really the best people to have commenting?….
As a long term coeliac who does get food n prescription I have made it my business to find out as much as I can about what I am able to get. Gluten-free prescription foods are controlled by the ACBS (Advisory
Committee on Borderline Substances) – very strict as they deal primarily with medicines.
In the policy document dated May 2011 it advises that it ‘will only approve items that are considered to be dietary staples e.g.
Plain breakfast cereals containing no added sugar
Bread and rolls
Crackers and crisp breads
Flours and bread mixes
Pastry mixes
Pizza bases
Pastas
Xanthan gum
All these items may be based on white brown or wholemeal grains and should not contain any additional products such as fruit/fruit flavourings, chocolate/chocolate flavourings, (my italics) nuts, seeds or cheese.
Foods containing these additions will be considered luxury items and will not be approved by the ACBS.
End of quote.
Therefore the items so proudly on display on the Newsnight cannot be available on FP10 – although it is possible to prescribe any item that is not specifically on the black list, but very rarely done.
The big difference between the ranges available on FP10 and whats in the High street is that on the High Street you can choose what you buy.
What is frustrating for me as a coeliac getting foods on prescription is that PCTs openly favour the bigger manufacturers so that it is often impossible to get foods made by some of the smaller ones, if that is what you prefer. Even though they are theoretically available on prescription, your local PCT will quite likely not prescribe them.