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Caught in the middle (again)

Dr david turner duo 3x2

Over the years we GPs have got used to doing the Department of Health’s dirty work.

Whether it is explaining to patients why the wait for their treatment is being measured in seasons rather than weeks, or sitting calmly and absorbing their angry rants when their referral has been rejected by the Orwellian ‘referral facilitation service’, we carry on uncomplainingly and deal with the fall-out.

The latest squeeze on prescribing budgets is about to give us all a few more ear bashings from patients. Don’t get me wrong, I think there should be some restriction of prescribing of over-the-counter medications on FP10 prescriptions, but what I take exception to is the Government once again making us the bad guys in patients’ eyes.

A recent example is nutrient feeds. We have been told we can no longer prescribe brand A and must instead prescribe cheaper brand B. This may be all well and good for new patients, but we have a number of bed bound, skeletally thin, dentally-challenged nonagenarians whose only source of nutrition is brand A and who refuse any other because they don’t like the taste.

I refuse to play a part in this cowardly rationing by stealth

So what am I supposed to do, refuse to prescribe brand A and tell them if they want that they’ll have to buy it? Of course, they can’t because they are bed bound, so their families will have to buy it for them. And their families will of course realise that legally we CAN still prescribe brand A and view us as penny pinching, money grabbing doctors trying to save from our prescribing budgets to line our own pockets.

Emollients and gluten free food are amongst some of the others we are being ‘encouraged’ to stop prescribing. I agree these can and should be bought over the counter by most patients, and for those who genuinely are too poor to pay a system to claim back prescribing costs could be put in place.

But if you want to cut back on prescribing costs, Mr Hunt, you need to have the courage to ‘black list’ the above so they are no longer available on FP10.

I will happily defend this course of action, but what I refuse to do is play a part in this cowardly rationing by stealth which will not only anger patients but chip away further at the goodwill between doctors and patients. Unless of course, that is all part of your plan.

Dr David Turner is a GP in West London