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Prescribe Calpol? Do I look like your mother?

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When I was growing up, we had a medicine cupboard. Among the plasters, pills and potions, there was also a miniature bottle of whisky for medicinal purposes. The irony of this is that we were a strictly Muslim household. My parents obviously had a far more relaxed attitude to the rules than many of my patients who refuse to take gelatine-containing capsules.

As a child, the only medicine I recall us receiving from the GP was banana-flavoured amoxicillin. Anything else like paracetamol, cough mixture, Vicks or cod liver oil were stocked in the medicine cupboard.

But now, the entire population, rich and poor, young and old, has lost the ability to self-care. Common sense has been suspended in favour of a ‘you can’t be too careful, doc’ paranoia. Even when we have reassured a patient that their two-week cough is unlikely to be serious, they will insist on a range of over-the-counter medications because they are entitled to free prescriptions.

GPs are drowning in workload but the Government keeps opening more floodgates. Well here’s one lifejacket – over-the-counter prescriptions.

Just because a patient is not paying a prescription charge, that does not make their medication free. But a bottle of liquid paracetamol can be obtained from the pound shop for – you’ve guessed it – £1. Every time we prescribe a bottle of this, we reinforce GP attendance at a cost of £40 per consultation. If we add to this the cost of the medication and pharmacist involvement, the country is paying about £45 for a £1 bottle of medicine. The NHS is haemorrhaging this sort of money on a daily basis, spending more than £80m a year on paracetamol alone. This figure doesn’t even include the cost of seeing a GP for the script.

Every GP I know thinks is madness but we are unsupported in making a stand. The entitlement and complaints culture has stripped us of independent decision-making. We need to feel empowered to say ‘no’ to these requests, but no one will do this without a narrative supporting it. So patients with self-limiting illnesses will clog up the service because no one in power has the guts to suggest they should self-medicate, regardless of their income. We cannot rely on the RCGP or GPC to campaign for practical suggestions so we need to do it ourselves. We need collectively to refuse to prescribe this sort of nonsense. Maybe then we could provide a decent service for patients in genuine need.

In anticipation of the backlash of comments telling me how poor some patients are, let me share my family’s story of self-care. My parents had nine kids and always kept a supply of Calpol and vitamin drops, in spite of a very low income. They viewed it as no different from providing toothpaste, soap and other toiletries the NHS does not fund.

So you see, to quote from Disney’s Tangled, my mother really did know best. She knew to keep a medicine chest.

Dr Shaba Nabi is a GP trainer in Bristol.

 

 

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Readers' comments (59)

  • I totally agree with Dr Nabi's sentiment. You can't really blame people with little money if they take up a "free" offer - you can call it a sense of entitlement, or you can call it good economic sense. An NHS which is free at the point of use, is always going to be exploited, especially when times are tough for the poorer members of society.

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  • shame you are so unable to talk openly to people who consult you Shabi.....do it with respect for a change

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  • Kostana.thax for something useful to share

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  • Well yes.you do look like my mother.

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  • The problem is not with patients, but with the Governments policies. Please stop these type of articles which try to belittle patients concerns.

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  • Parents living on the breadline who have to visit food banks in order to feed their children really may have difficulty affording calpol.

    Articles like these just betray the high levels of privilege and ignorance prevalent in gp land.

    If you don't want to see these patients - get your CCGs to set up a Minor Ailments Service in your areas.

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  • It's pretty easy to say no really. And ethically you have a responsibility to do so. Just stick by your guns!! Gift wrap it with an explanation of the economy of prescribing and you're all good. I am a locum and work all across London, Hertfordshire and Derbyshire in very rich and very poor areas and with an explanation there is very rarely much resistance. The only time there is any is from those from outside the UK who are not familiar with how the NHS is funded and even then an explanation will usually suffice. If not, we don't have to please everyone. The customer is not always right!!

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  • Ivan Benett

    A bit Parent=Child Shaba, (TA) no wonder they keep coming back

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  • Wow! Some GPs working part-time and not bothering about providing adequate access to patients is not considered wrong, but vulnerable patients on low-income coming for some Calpol is wrong. Great Hypocrisy.

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  • Spot on again as usual Shaba. Good article and well written. Jeremy Hunt seems to have sneaked in on June 24th at 6.18 !! Lol.

    Anyway, I fully agree that calpol, ibuprofen, sticky plasters etc should be otc. We should be able to say a resounding NO to such demands without the fear of being reported to GMC. Until that day arrives we will be at the mercy of punters who are will to wait an hour to get paracetamol on the cheap. More than the GMC, its colleagues who will drone on about the vulnerable and insist that select patients need to be given all this free that will upset the applecart. Sorry but most can afford to buy calpol, so, it should be taken off the list. With a 1.5 TRILLION debt to repay, I cant see things getting better soon. Devoted GPs seem to be quitting in droves and soon the public and the Govt may need that extra bottle of paracetamol for a mighty big splitting headache heading their way

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