Monthly Archives: August 2015

The gluten-free prescriptions row: so where are my doughnuts?

I’ve been a little busy the last few months with other projects, so haven’t been posting here so much. However, with the recent spate of sensationalist articles courtesy of our dear, well-informed friends over at the Daily Mail, I feel compelled to respond.

First we had the article that claimed that gluten free foods on prescription are costing the NHS £116m a year. The correct figure is actually £28m according to Coeliac UK, who wrote this letter to refute the Mail’s claims and demand a correction (which they did). Turns out the GP quoted in the article was mis-quoted as well.

That wasn’t enough to make the Mail shut up about coeliacs bankrupting the NHS. Far from withdrawing with good grace, they trotted out Dr Max Pemberton (who is not, by the way, an expert on coeliac disease) who wrote  another diatribe today. I don’t know where Pemberton is getting his information from here about all these NHS-funded gluten free cake sprees, but what I want to know is where the hell are my doughnuts? I never saw those on any prescription lists. Is doctors’ pay so bad these days that Pembers is stashing bulk supplies of gluten-free contraband to sell on the black market to coeliacs desperate for a sugar fix?

The usual “food intolerances are bunkum” stuff appears, citing the obligatory anecdote about a “friend” who claims an intolerance to something but then will go right ahead and eat something they like containing the supposed offending ingredient, in this case chocolate biscuits when claiming a lactose intolerance.

OK Max, I kind of agree with you on that one – it annoying. But your chocolate biscuit-munching friend wouldn’t be able to get anything on prescription, so why the hell does your anecdote about her stupidity appear here?

Just to make it crystal bloody clear to Mail readers and anyone else suffering from chronic ignoramusitis, you can’t get prescriptions for gluten free food if you have not been medically diagnosed with coeliac disease. People with gluten intolerances (leaving out the debate about whether intolerances are real, imagined or otherwise) DO NOT GET THEM. I repeat, DO NOT GET THEM. You cannot go to a kinesiologist or have skin/hair/toenail clipping analysis and then demand gluten free food from the NHS.

If you’re coeliac, it’s a postcode lottery as to what you get or whether you get anything at all. Some of it is just so damned awful that those of us with the money to choose won’t bother with it and we’ll go and buy the brands we do like. But given the increased cost and lower availability of gluten free foods, it’s vital to be able to get some staples if you are on a low income or live in a remote area, as Alex Gazzola’s response to the Mail farce points out. And it isn’t our fault that the companies supplying this stuff charge the NHS an arm and a leg. Maybe all the NHS Procurement departments need to join up and negotiate some better deals.

Not to let the Mail off the hook, but there is misinformation coming from Coeliacsville as well. Some coeliacs talk about gluten-free bread and substitute products being “medicine” – well they sure as hell aren’t, but unfortunately giving them on prescription gives this impression. Most of these subsitute products, even if they are fortified, are still full of added sugar and additives to make the shelf life longer. They are often higher in calories than their wheat counterparts. Really, we would be better off getting those nutrients from naturally gluten-free foods and having gluten-free subs as more of an occasional treat. I’m just as partial to the odd gluten-free Genius croissant as anyone, but it sure doesn’t take a genius to work out that they’re not something you should be eating every morning for breakfast.

I saw one coeliac Mail commenter claim that coeliacs don’t absorb nutrients properly and that’s why we need the prescription stuff. While that’s true of undiagnosed coeliacs, most will regain this after a period of time on a GF diet, unless you’re one of the unlucky refractory coeliacs. GF substitute products are not magic foods that can overcome malabsorption – if you are not absorbing nutrients, you won’t absorb them no matter which way you take them in and you will need further treatment.

It’s a bugbear of mine that there isn’t sufficient support and nutrition education for coeliacs post-diagnosis, which leads to some of the above misconceptions. It’s a shame that a diagnosis of CD isn’t seen as an opportunity to help people lead healthier lives, educating about proper nutrition, even gluten-free cooking classes, rather than just shoving a prescription for some nasty white “bread” at us and waving us off, thankful that’s another patient off the gastroenterology list.

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