What a novel concept! Fortunately, we have taken steps to shift the focus of attention, and bring forward the implementation of some controls, though there is a long way to go! All credit to the BBC for going the extra distance to pick up on this new focus that places responsibility for control measures in the hands of the prescriber. But it will not be welcome, and a tough battle is ahead for all the wrong reasons.
There is much about the subject on the Clinical Waste Discussion Forum, of agencies from health and environment, as well as financial regulators, demanding better control of medicines usage. The focus is almost invariably on waste, or drugs and of money, and on the pressures on the environment. However, we have been active over several years in identifying the root cause of this overprescribing, which has been difficult only in acceptance by the politically active and powerful medical lobby.
Doctors urged to cut medicine prescription waste
Most regulators and professional bodies, government agencies etc will supply an answer to this particular problem, usually demanding that patients stop expecting medication or requesting prescribed medicines for self-limiting and minor health problems. Repeat prescriptions are a frequent cause for concern, again placed at the feet of the patient who might have the temerity, like Oliver, to ask for more.
All of this ignores the fundamental issue that prescription of medicines is in the control of general medical practitioners, of family physicians, and not the patients who may ask but cannot expect to receive a prescription for every ailment.
Pressure to ensure that GPs control and improve standards of prescribing can reduce medicines wastage by up to 50%. This means fewer antibiotic courses encouraging development of resistance, fewer unwanted drugs in medicines cabinets available for intentional overdose and accidental child poisoning, and less waste going to the environment, as unwanted tablets and excreted pharmaceuticals entering the sewage systems.
Better prescribing – that is, prescribing that meets the standards taught to all trainees and demanded by existing rules and regulations – will come at a cost. GPs claim massively increased workloads and any ‘fault’ is someone else’s fault, every effort needed to improve must be someone else’s effort. And above all is money, with the expectation that fees will increase to complete the task to the standard that we already expect and demand.
UK environmental regulators puff and blow about this, at least occasionally, but are slow to act in the provision of take-back of community collection schemes, seeing that these will necessitate some expenditure and thus staying in the background in case it is they who are expected to pay. And even more so, they pretend that this is a problem for prescription medicines while ignoring the potential environmental impact of the massive excess of non-prescription medicines that go the same way.