The Cardiff and Vale NHS Trust poster - pinned up in a local GP's surgery - amounts to an admission that the local NHS wastes at least £500,000 a year by paying way too much for basic over-the-counter pain-killers

The Cardiff and Vale NHS Trust poster – pinned up in a local GP’s surgery – amounts to an implicit admission that the local NHS wastes at least £500,000 a year  – by paying way too much for basic over-the-counter pain-killers

A notice displayed in a local doctors surgery has – perhaps inadvertently –  revealed that the Cardiff and Vale NHS Board is paying FOUR TIMES the price for basic pain-killers that is charged over the counter in chemist’s shops or supermarkets .

The admission is made in a poster pinned up in local doctors’ surgeries which says the Cardiff & Vale NHS spent a total of  £710,000  just on “prescribed paracetamol” last year.

What may surprise patients reading the poster is that the NHS appears to blame patients – rather than doctors or NHS managers  – for incurring that level of cost .

The notice is, in effect, a blunt message to local patients – even those with chronic pain – that they should think twice before asking their GP for painkillers – and that they should go and buy their own tablets, rather than ask doctors to issue prescriptions for them.

Tesco paracetamol is sold over-the-counter a quarter of the price which is paid by the NHS

Tesco paracetamol is sold over-the-counter for 25 pence for a pack of 16 tablets  – a quarter of the price which is paid by the NHS.

The notice goes on to point out that if patients bought their own drugs ‘over-the-counter’  – rather than asking their doctor for them –   then the £710,000 that the Cardiff and Vale Board currently spends on paracetamol prescriptions could instead pay for:-

  • 28 more Community Nurses
  • 182 Hip Replacement operations
  • 47 Breast Cancer treatments
  • 710 treatments for Alzheimer’s patients
  • 740 more cataract operations
The Cardiff and Vale poster as it appears in local doctor's surgeries

The Cardiff and Vale poster as it appears in local doctor’s surgeries

The notice bears the formal logo and imprimatur of the Cardiff and Vale NHS Trust Board ;  however a spokesman in the Board’s Communications Department  has told PDN that he was  “not aware” of poster and would need to “check with the pharmacy team for an official answer”.

The spokesman said the notice could be to do with the “nationally-negotiated community pharmacy contract”  which “means that the NHS pays per item, rather than by the cost.”

One patient however, said the message of the notice amounted to a sort of “moral blackmail” to cover up the Cardiff and Vale NHS Board’s own ineptitude in administering its drugs prescriptions and purchasing system and asked “how many other drugs is the NHS overpaying for?”.



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  1. plainjane says:

    Paracetamol is totally ineffective for chronic pain and yes yes people shouldnt be going in to ask for paracetamol to get it free rather than pay the pennies it costs to buy in boots! The additional cost is for the prescibing – not the drug – the administration cost – it doesnt appear in your hands out of thin air

  2. whatsoccurin says:

    I think it is just the tip of the iceberg-I once went to the surgery and overheard a patient arguing with the receptionist over her prescription for gluten free bread!-Doctors need to be supported when they say “no” to patients.

  3. Christopher David says:

    I’m not for privatising the NHS but I am for cutting out a hefty percentage of management and bringing in private business mangers including buyers. Civil servants and public sector wallah’s playing at being business people rarely works. They don’t have the experience, skills, training or basic nous- the wrong types! I happen to know internal systems are in areas very poor as well. What you saw with James Martin and the kitchens prevails throughout.

    • whatsoccurin says:

      I think you are right-having spent over 30 years in social work and listened to managers emphasising their “budget holding” responsibilities when a regrading was in the pipeline but stating “it is out of my hands” when they overspent. Last night BBC W ales did an item on social care for the elderly, and Older Persons Commissioner,Sarah Rochira (probably paid over £100000 per year) made simplistic points that a social work assistant could make more articulately.

  4. Dermott O'Logical says:

    The price that the NHS pays for a prescription is the Drug Tariff price + a professional fee for the pharmacy. The Drug Tariff price is the average cost price (not retail price) of the available brands. Tesco may well be selling paracetamol tablets as a “loss leader”.

    Pharmacies are paid 2.3p per tablet; Tesco is charging 1.6p per tablet for a pack of 16. 2.3p is not 300% of 1.6p; the correct figure is closer to 150%. But then add in the professional fee to the pharmacy, which is 90p per item, which is paid whether you have 32 tablets on the prescription or 200, and you can begin to understand where the 300% figure comes from.

    The point that the poster is making is that when you get a prescription for paracetamol, the NHS has to pay the GP surgery and the pharmacy for their services in addition to paying for the cost of the tablets. So patients would be doing the NHS a big favour if they simply bought their paracetamol tablets over-the-counter. Few if any prescriptions for paracetamol are dispensed in England to folks who have to pay £8.40 per item for their prescriptions … but then about 90% of prescriptions in England are dispensed to patients who claim an exemption from paying the prescription charge.

    Paracetamol is both overused and misused. It has been linked with the asthma / excema epidemic, with autism, with failures of vaccinations, and with feminisation of male babies if taken by the mother during early pregnancy.

    • Ivor Bagman says:

      That sounds
      Very logical
      Dermot !
      But –
      Will anyone
      Listen ?
      I hope they do .

    • Joe blow says:

      Quite. It’s not the paracetamol that costs the money, it’s the doctor’s and pharmacist’s time.

  5. jm says:

    This is all to do with the buying agreement, and nothing at all to do with patient care.
    I remember a lady in boots asking for sugar coated aspirins and being refused because of the additional cost …
    However, am not sure that a dose of private sector ‘expertise’ is what is needed – I remain very sceptical indeed that the public sector has anything to gain from further exposure to private sector practices!
    I remember the Thatcher government trying to get the university sector to ‘learn’ from british industry. Needless to say, our then world leading universities were puzzled by what they might learn from british industry, and then declined to do
    so! j

    • Christopher David says:

      JM I agree with your opening sentence,however having worked both in the private sector and public sector (albeit primarily business divisions) in my experience public sector workers are just not equipped to be run efficient business systems. The NS has to be separated medical from administration, the latter should be run on business like lines.One has to just take the example we have here to get a thin end of wedge flavour. In the spirit of the David Lodge novel nice works (with a bit of poetic licence and stretch) the universities and business can- and do learn and collaborate with/from each other. We all know the NHS administration is overlarge, inefficient and over costly detracting from its excellent front line. Politicians don’t help either.

  6. Dermott O'Logical says:

    The NHS drives a hard bargain for medicines dispensed against prescriptions in the community, and this determines how much profit each pharmacy is allowed to make. The relentless downward pressure on costs over the years has also kept my earnings as a locum pharmacist down. I am now being paid the hourly rate I was being paid in the year 2000, so a wry smile comes to my face when I hear how other folks complain that they have had only a 1 or 2% pay rise. All I have seen in the last 10 years is pay cuts. The cost of paracetamol tablets to the NHS is very reasonable; the problem is the demand by a population that is living longer (as the politicians are always very pleased to tell us), that expects to have its medicines “free”, but despite all this medication is sicker than ever before. We are “rattling on” for longer because the NHS is happy to dish out medicines to treat symptoms, and would like to see, but doesn’t require or otherwise actively encourage patients to take responsibility for their own health and thus prevent or delay the onset of those illnesses.

  7. Burt reynolds says:

    All of this just gives me a headache

  8. pompousfruit says:

    At one time painkillers in chemists shops cost much more when they were branded only. It’s only in the past few years that supermarkets have been able to sell their own label generic brands.

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