Coeliac disease, though not really a disease at all (you can't catch it, don't worry!), is an autoimmune disease which causes the body to have an immune reaction to gluten. This is a protein found in wheat, barley and rye, so sufferers aren't able to eat your everyday, shop bought breads, cakes and pastas, among other things. As a result, many foods are available on prescription as, though supermarkets do sell a small selection of gluten free products, they are, on the whole, very expensive. In addition, it must be said that those with Coeliac disease do not receive this food free, unless they qualify for free prescriptions.
As you can imagine, having staple foods such as bread, pasta and flour mixes on prescription is a vital lifeline for the majority of those who have to follow a gluten free diet, especially those where such carbohydrate rich food sources are important in their nutritional regime, such as diabetics. So it is of great concern that the NHS is slowly reducing the amount of these products available for prescription.
The NHS has already removed luxury items such as sweet biscuits and cake mixes from prescriptions, and rightfully so; we shouldn't expect our health service to fund less than healthy foods. However, they are now limiting what Coeliacs can get on prescription by implementing a points system, which limits the range of products on your prescription. You may feel that this is a fair system, however, when you take into account the amount of points people are being allocated, and how much each prescription item is worth, it really isn't much.
Coeliac UK, Britain's main charity for the disease, have made their position on the matter clear; having gluten free products on prescription is a necessary service, and they have been in touch with many PCTs and health boards in order to support the case for this. They have also assisted in the writing of guidelines, based on age and gender, as well as other factors such as whether you are pregnant or breast feeding, which suggest the number of points a patient can receive for their prescription per month. Before taking into account the 'cost' of individual items, these allowances seem generous enough. But a closer look will reveal that, according to these guidelines, a female, aged 19-74, has an appetite equal to that of a child aged 7-14, or a male over the age of 75. As a twenty something year old female, I can safely say that my appetite is considerably bigger than both!
This then raises the issue of whether this kind of system is fair. For example, the 14 points given to someone of my age and gender would only equate to:
• 4 x 425g pack of bread rolls (5 points in total)
• 2 x 500g box of pasta (4 points)
• 1 x pack of 2 pizza bases (1 point)
• 2 x 500g box flour mix (4 points)
This is then your allowance every month for, essentially, a lifetime. More likely than not, you would be able to change these, but not regularly enough to get a range of products. I've heard stories of people requesting their entire allowance of points in flour mixes, in order to make everything from scratch, purely to avoid the hassle and stress of this new way of prescribing.
Furthermore, returning to the fact that Coeliac disease is linked with other conditions, such as diabetes, employing this 'one size fits all' attitude to prescription food is going to be damaging on another level as well. Diabetics require carbohydrates with most, if not all, meals, as they effectively stabilise blood sugar levels. The example above of a month's worth of carbohydrate, as well as rice and potatoes, which are gluten free naturally, is not enough for some people with the condition. In line with these concerns, Coeliac UK have also stated that it believes PCTs should allow their GPs and dieticians to decide what individuals need, depending on any other medical conditions they have, or their lifestyle. This would certainly be welcomed.
As it currently stands, many PCTs are working within the guidelines, and those that aren't are reviewing their policies to bring them more into line. Perhaps one answer would be to allow more range for Coeliacs on their prescriptions, but ensure that they only order their allocated points worth each month. This would satisfy those who hold the NHS purse strings, and prevent Coeliacs from feeling as if they've been backed into a corner, with little to no choice over what gluten free products they can consume. Alas, though, the debate continues, and if your interest is suitably piqued, I highly recommend heading to the Coeliac UK website, which is full of useful information on the subject.