I have coeliac disease, the autoimmune condition which means that if I eat gluten – which is found in wheat, rye or barley, and many common foods – my body starts to attack itself. There is no cure for this lifelong condition, which affects one in every 100 people in the UK, and the only option is to eat a gluten-free diet.
Under current national prescribing guidelines I can receive up to 14 items – such as a loaf of bread, box of pasta, or packet of spaghetti – on prescription every month. I never claim everything I might be entitled to, but I do usually get a few items a month. In order to access this list, I pay £104 a year for a pre-payment prescription.
For many people, this is the only way they can afford to access gluten-free products. But under new plans announced on Tuesday by NHS England’s chief executive Simon Stevens, the NHS plans to stop this provision, as well as travel vaccinations and some drugs that are available over the counter. Stevens has said they need to tackle some of the waste in the system, with £114m being spent each year, “on medicine for upset tummies, haemorrhoids, travel sickness, indigestion, and that’s before you get to the £22m-plus on gluten-free that you can also now get at Morrisons, Lidl or Tescos.”
As Stevens says, gluten-free products have become much more widely available in recent years. But for many people, the cost of these products can be prohibitive.
Gluten-free spaghetti in my local Sainsbury’s is £1.35, whereas basic spaghetti is just 40p. Nestlé gluten-free cornflakes are £2.20 while own-brand cornflakes are £1 for 500g. A gluten-free loaf of bread can be as much as £3 – and is often much smaller than a normal one. To me the idea that bread should be considered a luxury is pretty ridiculous. Stevens notes that gluten-free digestive biscuits are also available, but the NHS’s own prescription guidelines state that these are only available in exceptional circumstances anyway – why not just tighten up the list of products instead of throwing it away altogether?
I am lucky; I will be able to absorb this extra cost into my household budget, but for others this will be impossible. Without the prescriptions, many won’t be able to follow their GP’s nutritional advice – and that could have serious consequences for their health. People with coeliac disease who don’t go on a gluten-free diet are at increased risk of conditions including anaemia, osteoporosis and bowel cancer. Obviously, this is especially serious for people who are elderly, vulnerable or suffer from other illnesses.
In recent years giving up gluten has become associated, generally, with being a faddy eater. This is absolutely not the case for those with coeliac disease; if I eat gluten by accident it has a serious and immediate impact on my health. But I think the association of gluten-free foods with celebrity diets may actually be keeping the prices high, and is leading to perceptions that this is a lifestyle choice, rather than the debilitating condition that it can be if not managed properly. Being a coeliac or gluten intolerant isn’t just something that happens to wealthier people who can live off avocados and courgetti spaghetti, whatever some might suggest.
People are more aware of the condition today, but that does not mean they necessarily take it seriously or understand it fully. In restaurants, for example, there are more gluten-free choices these days, but people also often assume this is a preference, not a necessity. I always check what I eat with the staff, but have been “gluten poisoned” many times because people think: “Oh, a bit of gluten doesn’t matter.”
People need appropriate and affordable options or they just won’t be able to take care of themselves. This shortsighted move, which is only making minimal savings, could lead to further stress on NHS budgets when people develop complications and related diseases. I recognise the need to make savings but, like many current policies, this will hit the people who can least afford it the hardest.
Why coeliacs like me need gluten-free food on prescription | Lyndsey Jenkins
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