The chair of the British Medical Association’s prescribing subcommittee has called for politicians to lead on changes to NHS prescriptions, which he claims could worsen health inequalities.
Andrew Green told HSJ proposals by NHS England to end the prescribing of 18 medicines could force GPs to “negotiate bureaucratic hurdles”, increase workloads and expose GPs to patient complaints.
Ahead of a formal response from the BMA to the consultation launched by NHS England on Friday, Dr Green called for politicians to lead on any changes to ensure accountability to the public.
He said: “This proposal to reduce the NHS provision of commonly used effective and safe medicines represents a fundamental change in the relationship between residents of England and their NHS.
“A change of this magnitude should not be instigated by CCGs but should only happen following regulatory change by politicians who can then bear the political and electoral responsibility for their actions.”
NHS England is consulting over limits to the prescription of “low value” products costing £141m a year including homeopathy and herbal medicines.
Products include those of low clinical effectiveness or those with significant safety concerns, as well as products that are clinically effective but where more cost effective alternatives are available.
Dr Green said the BMA’s GP committee recognised the need to prescribe cost effective medication but called for patients to be involved if prescribing is changed for any reason other than clinical benefit.
He said: “Any prescribing policy needs to include flexibility to allow GPs to continue to meet individual patients’ needs without having to negotiate bureaucratic hurdles.
“GPs have a contractual duty to prescribe drugs that their patients need and pressure must not be placed on them to act in a way that may contravene those regulations.”
He said a decision to stop the prescription of effective medication also available over the counter “cannot be supported” as it would be likely to increase health inequalities and expose GPs to the potential for complaints.
“We are particularly concerned about the harm this may cause for those already most disadvantaged in society and cannot have GPs applying arbitrary means tests or judgements as to the likelihood of patients not taking recommended medicines on the basis of cost,” Dr Green said.