Dear Dr Brian Mawhinney: The Minister for Health is right to worry about wasted NHS medicines, says a Barnet GP. Making people pay for everyday remedies could save lives

Dr Gerald Michael
Tuesday 22 February 1994 00:02 GMT
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I understand you are poised to dive into the nation's bathroom cabinets, which you believe to be stuffed full of unused drugs. You are right to do so. The purpose of your detective work is to find out which medicines are being handed out on prescription but not swallowed. Thus you hope to cut back on unnecessary spending.

The announcement last week of a 50p increase in prescription charges caused a storm of protest, but in fact the charges are levied on only a minority of prescriptions. This is because children, expectant and nursing mothers, pensioners and people on Income Support and Family Credit are not affected by the increase - their prescriptions are free.

Some people are too poor to buy medicines, protesters howl. But not, perhaps, everyone in these categories. For example, when people retire they have less money, but I'm not sure it is as little as that. In my 30 years as a GP, I have noticed that many older people have nice cars and holidays, drink and smoke and are generous to their grandchildren. And they exercise their right to free medicines at every opportunity. On their demise, many bequeath cupboards and drawers full of unopened bottles to the dustbins. This is what you'll be investigating.

When faced with patients who want pills for aches and pains, remedies for colds and constipation and medicine for indigestion, I often find that their sole motive in coming to me was to obtain them gratis.

So here's an idea: ask all these people to buy their everyday medications over the counter. Surely they would be well compensated by an improved health service?

Perhaps money is none of my business, but lately I have noticed it seems in short supply. Barnet Family Health Service Authority, for example, can no longer afford to pay for a replacement if any of my receptionists are ill. Patients face a lengthy wait for operations at the local hospital, and those needing a skin specialist often are left waiting until long after the illness has passed.

But in free prescriptions there is plenty of money sloshing around. The Government took laxative pills off National Health prescriptions, but agreed to pay for lactulose medicine, which now passes through chemist's shops daily in bucketfuls, and at enormous expense. I bet if lactulose alone were removed from National Health prescribing, Barnet would be able to afford substantially quicker heart-bypass operations and thus save lives.

If all over-the-counter remedies were removed, can you imagine the care we could give? Waiting lists would be reduced, GPs would have time to treat patients decently, sufficient nurses could be recruited for both primary care and hospitals, and new surgeries could be built to a high standard. Now that would be value for money - something your government is always striving for.

(Photograph omitted)

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