“Doughnuts and Pizzas on the NHS” – the latest attack on the NHS from the Mail. The story originally claimed £116m of gluten-free junk food was being made available on prescription, as the cover page below shows, but this has later been changed, as you can see from the web version, to ‘£116m of food for special diets including junk food’.
I expect we have Coeliac UK’s strident response to thank for that correction. They pointed out that in fact only £27m was spent annually on gluten-free prescriptions, most of it on staples.
From what I can tell, that figure has been drawn from the total of the eight gluten-free food categories given in this document from the HSCIC published last month, by adding the eight numbers in the fifth column (see Section 8, Table 9.4). You’ll note that the junk food spend (biscuits) was £1.3m.
The coeliac community were rightly pissed off. Coeliac UK’s Sarah Sleet was interviewed throughout the day on various radio stations. The Independent journalist Siobhan Norton gave a good response. Blogger Kevin Gollop found the funny side.
Despite the events of yesterday, the Mail has continued with its attacks by today publishing a piece which I consider to be a lot worse, because it’s by a doctor – Dr Max Pemberton. You can read it here.
In the third paragraph he claims: “… the number of people claiming to be intolerant to foods – especially gluten … – is rising at an astonishing rate and, with it, the cost of providing ‘free-from’ foods on prescription”
To imply such a causal link is reckless and careless. Gluten-free food should not be prescribed to the self-diagnosed. Prescription food is not routinely available to those properly diagnosed with other food hypersensitivities, let alone those who have self-diagnosed or taken an IgG test.
Elsewhere, he recycles tired old figures; he perpetuates the myth that diabetics necessarily need special foods (he’s a doctor, remember); he attacks people who think they are ill, because that’s what the Mail does, repeatedly, as I have blogged before. Some of these patients may well have psychologically-mediated issues with food – and you’d expect a mental health specialist, as he is, to have more sympathy with them.
We have been here before with Dr Max Pemberton, of course. Click here for my thoughts on a very similar article he published five years ago (whole stretches of text are identical), in which he criticised the attention-seeking ‘mass delusion’ of people who believe themselves to be unwell, and dismissed a friend with lactose intolerance for avoiding milk, but eating chocolate biscuits, a story he churns out again in today’s Mail piece.
The Mail may quietly correct, and they may even issue a more formal correction – as they did previously on the prescription story they ran in 2011 which claimed that a loaf of bread cost the NHS £32, which you can still read here (although the original story itself is no longer online) – but I doubt they will ever apologise for the damage they have caused the coeliac community, or the resources Coeliac UK have had to spend on defending their position.
As I wrote in yesterday’s blog, gluten-free diets and foods are on average nutritionally inferior to gluten-containing diets. Some coeliacs – especially vulnerable ones in remote areas or with limited accessibility – need the support prescriptions provide. We have to keep defending this while it’s needed.
For me, the biggest worry about this whole thing is that it results in a negative perception of people with CD, and that it could cause a knee-jerk reaction in the form of further immediate cuts to prescription provision without full consideration of the best alternative.
I agree the provision is vital for some, but I don't like the sense of entitlement others seem to feel, nor the way coeliac uk focus on this as a priority rather than pushing for other alternatives.
I think there is an important conversation to had about the prescription system (including on the cost of products to NHS, the nutritional value of many of them, whether there are better and more affordable ways to get staple foods to those who need them etc.) this horrible sensationalist article puts us in danger of not being able to have that conversation. (E.g. My local CCG have cut list of prescribable items to white bread and flour only- why not higher fibre more nutritionally complete foods?)
I also find it frustrating that the talk of 'junk food' lacks all context. I think it highly unlikely that most GPs would be prescribing these items without need (in some cases this is perhaps precident from prior list of prescribable items), and in some cases it could be very important for someone to receive high calorie or sugar-containing products. Consider my friend on low income who's young son has coeliac & T1D, 1 packet of plain sweet biscuits a month is considered to be an important 'back up' for them. Someone who is underweight or malnourished or suffering some other complication might also need something we would consider 'junk'. Just because the population is getting obese and shouldnt eat sugar, doesn't mean everyone needs the same. That's why doctors can use their discretion when it comes to the guidelines. Just a thought.
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