The Good Doctor’s Blog: “Willful waste brings woeful want”

Blogspot: By Dr Emil Shehadeh

How “Willful waste brings woeful want”

The Curse of Wasted Medications and Appointments

WE know from research that 30-50% of patients do not take their medications as they should. This results in vast amounts of waste. Only recently I was handed a bag of unwanted medications by a family, worth circa £3000.00. We are spending just over £13.00 billion on drugs every year in the NHS. This is a huge amount of money, much of which is simply money down the drain. It is sad to consider that such waste takes place when we are struggling to finance some new life-saving treatments.

A few days ago, the news headline ran something like this :“Health secretary announces measure aimed at encouraging patients to complete course of medication and minimise waste”. He intends to have the cost of medication printed on every medicine box. He further intends to label every box with ““funded by the UK taxpayer”. Although this will only apply to drugs costing more than £20.00, this is a refreshing approach by the NHS.

Whilst wasted medications burden the NHS with direct costs amounting to the price of the medication, the hidden cost of not taking prescribed medication are much more serious and exceed the direct cost of the medication. Failure to take prescribed medication translates into undertreated or even untreated diabetes and hypertension, to mention two common conditions. Non-concordance with anti-hypertensives and anti-diabetic mediation results in complications, which include strokes, heart attacks, renal failure, blindness etc. The cost of managing these complications in terms of hospital admissions, long term care, loss of employment, not to mention new additional medication, far exceeds the price of the wasted medication.

Perhaps Mr Hunt should also attach a label warning patients about the consequences of not taking prescribed medication. Fear of harm can be a positive motive force for people to do the right thing.

At the same time, the NHS has announced that they intend to tackle the public regarding wasted appointments, which are costing us £1 billion ( hospital) and £750,000.00 (GP appointments) every year . Whilst Mr Hunt does not have the courage to charge for missed appointments, he has said that patients will be sent letters to advise them of how much money wasted appointments cost.

At the risk of contradicting myself, some so called missed appointments have either never been sent out in the first place, or posted either a day before the appointment is due, often received after the appointment date. I have experienced this as a patient. This presents the NHS with a problem in charging for wasted appointments. The solution is to have a more honest and efficient appointment system, and just as dentist can charge for missed appointments, so should the NHS.

Interestingly, evidence exists that awareness of cost does affect the health behaviour of the older generation. Why not the young? Have we brought up a generation of dependent young people, who have everything served on a plate without awareness of cost? Is this just part of the societal trend towards a self-centred approach to life in general?

It is unusual for politicians to tackle the public. Are we at the cusp of a new era in politics, in which politicians challenge voters to stop impoverishing the NHS through woeful waste, and further hold the public to account? I most certainly hope so. The NHS cannot go on slowly bleeding hard earned cash for much longer. Does the government have the guts to go further and charge for wasted appointments? Watch that space.

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