Yesterday there was a discussion piece on the radio about the recent changes to management of medicines, and the resulting costs and inconvenience for patients. Prescription charges are due to be increased in the Budget, to over £8 per item. If you have a variety of medicines on your prescription, then you are currently charged £7.85 per item – irrespective of the quantity of that item. The charge per medicine is the same, whether you are collecting a three-months’ supply, a one-month supply, or a single dose. Unsurprising, then, that patients with chronic conditions prefer to get three months’-worth for their money, if at all possible.
The Health Service, however, prefers to issue small quantities, so that medicines don’t go to waste when patients’ health changes. When my Froglet was small – and, therefore, exempt from prescription charges – there was one item on the repeat that wasn’t supplied through the normal High Street chemists. I could only get it from a specialist pharmacy, and its collection entailed an authorisation faxed through from a nurse-specialist, a twenty-mile round trip with an icebox to keep the medicine suitably cool en route, and a two-hour wait for the prescription to be filled. Grenouille’s doctor used to prescribe four months’ supply at a time, because, he said, the mothers of high-needs small children should not be obliged to make that sort of trek frequently. Then came the unfortunate day when the routine tests at the latest appointment showed that the medicine was having unwelcome side-effects. It had to be discontinued immediately.
Back home, to add to the worries about G’s health, I also had the the gut-wrenching job of discarding an unopened four-months’-worth of medicine, collected only two days before. Despite each little bottle still being double-sealed in its own twin layers of sterile plastic inner and cardboard outer, since it had left the pharmaceutical chain of control, it couldn’t be taken back for another patient. Even though (and I still wince, thinking about it) it had cost the NHS £1,000 per month. Four grand, binned in a handful of teeny-tiny vials. I quite understand why the Health Service prefers to restrict the quantity per prescription to a maximum of one month’s supply.
On the other hand, it is infuriating when I request extra quantities to cover G’s periods of illness or holiday, and get a ‘computer says no’ response. Especially when the pharmacy then supplies the wrong thing – by dispensing unswallowable tablets instead of liquid, perhaps, or substituting, for a named drug, a generic version that has the same potency – and also has an unexpected bonus in the form of a different preservative or some other extra ingredient that sets off Grenouille’s allergies. Either way, I then have to run around in headless-chicken mode to get everything sorted before we actually run out of items. We cannot, must not, run out of some things; their absence would be life-threatening for G. Even a two-mile round trip to the chemist’s gets wearing when you have to make it not once a month, but three times in a week because of underprescribing and pharmacy errors. That’s before you add in the anxiety because one of these medicines is, literally, vital.
So, I’ve exchanged the misdispensed item (which I didn’t find until I’d got it home, because it was a lone rogue pack added into a carton of correct ones). I’ve returned again to collect the stuff that was put on back-order and hadn’t come in when it was supposed to. Still remaining: supply of the item of which G needs extra quantities this month. Talking to the front desk at the surgery just gets a mulish repetition that quantities cannot be varied. The note that I added to the repeat request, explaining why the extra was needed, could not be taken into account, because it wasn’t on the computer. There is – it appears there can be – no explanation of why the prescription was not referred, as requested, to G’s named doctor. I will need to speak to the doctor myself. By appointment. And the first available, bookable appointment is exactly two weeks away.
I know we are lucky to have a (n almost) free-at-the-point-of-delivery Health Service. I know the health professionals have to try to keep costs down. I know it’s not personal, however much the repeated difficulties may get to feel like that. I know, I know, I know. Nevertheless. This month’s repeat prescription is working itself up to be a fine ordeal.