The more I read about the NHS's troubles, the more I wonder whether dramatic headlines about bed shortages, waiting lists and superbugs serve to obscure a problem that is far less attention grabbing but potentially more damaging to UK healthcare.
I am talking of drugs wastage. Hundreds of millions of pounds a year of taxpayers' money go almost literally down the drain.
Some of this wastage is down to deliberate non-compliance, where patients refuse to take medicine in accordance with instructions. This has an enormous impact on drug costs to the NHS, as well as using up hospital time and resources.Efforts are being made to tackle the problem, including pharmacist-led initiatives such as monitored dosage systems.
Of course, not all drugs wastage is down to non-compliance. Side effects may lead to treatment being interrupted or changed, and community pharmacists regularly receive unused medicines, many of them highly expensive, from the relatives of people who have died.
But whatever the reason, the outcome is the same - the drugs are disposed of. Millions of pounds that could have been beneficially spent elsewhere might as well have been stuffed into blue bags and incinerated.
It is a problem that will not go away and, unless ways are found of tackling it, has the potential to become ruinous.
In 2005, medicines cost the NHS in England more than£10bn. Their use per head of population grows by five per cent every year.With four out of five hospital inpatients on four or more medications, hospital prescribing accounts for a fifth of the total NHS drugs bill.
The escalating need to cut wastage is burned into the psyche of hospital managers and commissioners alike. But the fact remains that the Royal Pharmaceutical Society of Great Britain code of ethics states that all medication returned to pharmacies, hospital or otherwise, must be destroyed because the quality of the medicine can no longer be guaranteed.
That would appear pretty final. However, research carried out by my company at several hospitals across the UK shows they would put returned drugs back on the shelf if - as with the unique monitored dosage system we have developed - the doses were microbially sealed against MRSA and other contamination, the seals remained intact, and the drugs were still within date.
Thus, one route to cutting waste has to be to take advantage of increasingly sophisticated technology to devise means that, without cutting across properly rigorous protections, allow unused medicines to be redispensed.
Another surely has to be a concerted, ongoing programme of patient education at both secondary and primary level to tackle the poor compliance that is at the root of the NHS's wastage woes.
As a result of their revised contract, high street pharmacists have been placing greater emphasis on enlightening customers on medicines management. But I am not sure how much educating goes on when patients are discharged from hospital clutching their medications.
To tackle this, discharge and admission planning needs to be more effectively co-ordinated so patients understand more clearly which medicines to take and when, without the extra complications heaped on them by poor communication between hospital prescribers and GPs.
With the economic crisis likely to have an impact on the NHS soon, everyone involved in prescribing and dispensing drugs and in dealing directly with patients needs to stress how desperately important compliance is.