to think that I shouldn't have to swallow my principles to save the NHS money?

(252 Posts)
Tollund Wed 12-Dec-12 10:36:50

I was seen by a practice nurse this morning and prescribed antibiotics for my chest infection. When he wrote the prescription I said that if they were capsules with gelatine in them I couldn't take them and would need the medicine instead. He told me that he didn't know if they did or not and didn't have time to research it, and if I really couldn't bring myself to take them I'd have to ask the pharmacist what they would recommend. I've been here before so I said that they wouldn't prescribe anything and I'd end up having to come back to pick up yet another prescription. He said to go and see what they said but he wouldn't prescribe the medicine as it was more expensive. (I'm guessing he doesn't see a lot of Hindus and not sure how far he'd get suggesting that people should take things containing boiled up connective tissue and bones whether they've spent a lifetime avoiding them or not.)

So I went to the pharmacist and exactly what I had said would happen, happened and I've wasted over an hour trying to get them to liaise amongst themselves so I didn't physically need to run between the surgery and chemist to pick up prescriptions myself. (With a chest infection when it's -2!)

AIBU to think that the practice nurse was being a total arse and that I shouldn't be made to run around wasting time because he "was too busy" and clearly thought I was being stupid for not just taking the gelatine?

beingginger Wed 12-Dec-12 11:20:42

The capsules cost £1.06 the liquid is £1.32 assuming you were getting Amoxicillin, So about the same price.
In future you should ask for Penicillin Tablets (no gelatin).

I would say the same to anybody who wouldn't take something due to religion, as well. You CHOOSE to be vegetarian, or to follow a religion

So should the NHS just tell non meat eating inpatients to suck it up or order in takeaway if they can't/won't eat the standard hospital fare? Hospitals cater to patients dietary choices so why not their medication ones?

Kalisi Wed 12-Dec-12 11:25:36

They should have given you the choice to pay. So in that respect yanbu as they seemed to make no effort towards fixing the issue. It surely can't be the only time that a patient has refused a treatment for something other than medical reasons so the surgery should have a system in place.
On the other hand, the NHS should not have to pay more to respect your principals. I would absolutely say the same to any religious objection seeing that religion is also a choice

Kalisi Wed 12-Dec-12 11:32:13

As for hospital foods, I suppose it depends on the price. Hospitals can probably provide a Veg option for limited fuss and around the same price. If I decided off my own back that I would only eat Organic food for example I doubt they would be so accomodating.

PenelopePipPop Wed 12-Dec-12 11:32:13

On this occasion I'd be in the YANBU camp. Whether he gave you a private or NHS prescription if your stated position is you wouldn't take the gelatin capsules he needed to make a prescription for something you would take. To be fair to him he probably does not realise that pharmacists cannot just fill an NHS prescription with something else instead, i.e. if it says 2 x 250mg tablet but the patient says they are happy taking the 500mg tablets that is no good without a dr's signature. I have had to explain this to my GP umpteen times because one of the more obscure meds I take is actually now quite hard to get hold of in 250mgs. So he may have assumed the pharmacist could sort you out.

And more generally I am not sure the NHS should put it's staff in the position of having to choose between a validly help ethical position and a religious position they will support. Either way if you have a significant objection to consuming gelatin they should prescribe an alternative on an NHS prescription. I would have thought many antibiotics will still come out cheaper than the prescription charge anyway (though poss not liquid suspensions).

I am curious to know what you would do if the only med you could take was available only in gelatin capsule form. I take anti-epilepsy drugs which are only available in gelatin capsules - they have to be so that they are slowly released in the stomach. The only med which works for me is only available in this format. Would you endure seizures rather than consume gelatin?

PeazlyPops Wed 12-Dec-12 11:35:45

YABU. I'm a lifelong, very strict veggie, but even I suck it up and take antibiotics with gelatine.

* Hospitals can probably provide a Veg option for limited fuss and around the same price. If I decided off my own back that I would only eat Organic food for example I doubt they would be so accomodating.*

True, but the fact is they are willing, within reason, to accommodate different dietary requirements. It isn't a case of "one size fits all eat it or starve/buy your own" viz a viz food so its not immediately clear to me why the same policy doesn't extend to meds.

CheeringBell Wed 12-Dec-12 11:39:35

I can't believe your Practice Nurse acting in that way. Very unprofessional and not following the Nursing and Midwifery council code of conduct. It takes a few seconds to look up drugs in the BNF (a book that all prescribers should have) - even quicker on the net. Anyway being a prescriber your nurse should have known that most antibiotics are available as a suspension (i.e. in liquid form). The suspensions are not expensive - a bottle of Amoxicillin, a common antibiotic used for chest infections, costs £1.30!

If you feel like complaining and don't feel able to approach the Practice Manager then maybe the Patient Liaison Service (Pals) can help as they can advocate for you. http://www.pals.nhs.uk

Good luck with getting your medicine and I hope you feel better soon.

Ephiny Wed 12-Dec-12 11:47:08

I am vegetarian too, I wouldn't for example eat a dessert with gelatine in. But when it comes to essential medication like antibiotics, I would put my health before my distaste for animal products.

But for those saying the OP should pay the difference/pay for the medication -- as far as I know the NHS doesn't work like that, you can't 'top up' your care. She could of course go fully private if there's a private GP in the area, though the consultation would be quite expensive. Or can NHS GPs give private prescriptions? (this sounds like the ideal solution if so).

FredFredGeorge Wed 12-Dec-12 11:47:39

YANBU - the prescribing individual and pharmacist should have comfortably met your needs for gelatin free medicine in this case. As noted most common generic drugs are freely available in either non-gelatin capsule or suspension form at minimal or no extra cost.

YWBU if there was a significant cost difference that you would not meet, but in the case of a basic anti-biotic it's unreasonable for the practice nurse to force another appointment to resolve it.

trueblood1fan Wed 12-Dec-12 11:57:05

im vegan but as the nhs are funding mine/your drugs i also suck it & take what im given & am bloody grateful. yabvu, pay if you want special treatment.

CheeringBell Wed 12-Dec-12 12:02:31

I don't get the argument that it's the OP's choice so she has to pay or put up with it. What about those people who's choice it is to smoke, eat poor diets, drink to excess? Should the NHS not treat them too?

trueblood1fan Wed 12-Dec-12 12:06:19

alot of posters probably do think smokers shoud pay for treatment rather than the nhs BUT have you seen the amount of tax smokers pay in? op wants more expensive drugs for free on the nhs, suck it up & pay :-)

samandi Wed 12-Dec-12 12:12:06

I'm not sure why some people think different rules should apply because of "religious reasons". Personally I think if you're happy to take medicines which have been tested on animals then it's not much of a step further (if any) to take medicines containing animal products.

Does anyone else remember the case about 10 years ago where, if memory serves me, the NHS was doling out standard issue (ie, WHITE) prosthetic limbs to ethnic minorities?

Seem to recall those who protested getting told to suck it up or pay for "more ethnic" models themselves if they as a black person had some objection to wearing a white prosthetic.

CheeringBell Wed 12-Dec-12 12:17:33

trueblood1fan > But her prescription charge would most likely cover the cost of an antibiotic in liquid form..

My main concern is that the nurse didn't seem to know what to do and didn't check with someone who did. It's not like antibiotics are uncommon drugs to prescribe. What if that same nurse was prescribing to an child or someone who couldn't swallow solids safely? Should they go without too? Any delay in treatment is a cause of concern. If the infection were to get worse then the costs would be much more that an extra 30p or whatever...hospital stay, IV antibiotics......

samandi Wed 12-Dec-12 12:17:38

I don't get the argument that it's the OP's choice so she has to pay or put up with it. What about those people who's choice it is to smoke, eat poor diets, drink to excess? Should the NHS not treat them too?

It's two different scenarios. In this case the OP would be refusing treatment.

The practice nurse does sound a bit dim though, and I can't see why he couldn't prescribe a non gelatine alternative if it's readily available and not much more expensive.

TheCraicDealer Wed 12-Dec-12 12:18:11

The argument about obese people or smokers doesn't really apply. There's a difference between refusing to treat someone altogether and being reluctant to prescribe a more expensive drug (that works only as well as the more cost-effective version) because the patient fancies it.

Personally I think that if you're going to get all finger-wavy about it you should do your research and realise decanting the powder from the capsule isn't going to impact the effectiveness in this instance. But I suspect the OP is trying to limit not only her intake of animal products, but also her complicit support of their use by accepting products that include gelatine.

sashh Wed 12-Dec-12 12:20:06

OP

I would probably have phoned the pharmacy from the doctor's office but you are right, you should complain.

The nurse didn't know so should have checked. The same if you had an allergy.

All surgeries have a copy of the BNF and it is also available online so easy to check for interactions, but I don't think it lists ingredients, you would need the information sheet for that.

Casserole Wed 12-Dec-12 12:21:15

Do you pay for your prescriptions OP?
If so, she is already overpaying for either option. The meds, as has been said, are about 20p different in cost. And the prescription charge is about 4 times the cost of either!

I think you should have been given the choice.

samandi Wed 12-Dec-12 12:21:39

So, to people who are saying IABU - would you still be saying this to me if I was Hindu/Muslim/Jewish etc?

I would say exactly the same. Religious beliefs should not be some kind of magical reason for getting exemptions or special treatment, and it irritates me when they are. Actually I might be more disparaging of those wanting special treatment for "religious reasons", especially if they can't justify exactly why they feel they should have it.

Tollund Wed 12-Dec-12 12:22:48

Ok, sorry, I've been a bit distracted this morning as am still at work so haven't been quite as clear as I could have been! (But many thanks to PumpkinPositive for still getting where I was coming from anyway!) In my OP I wasn't clear and clearly my brain was working faster than my typing fingers - when I said about him not seeing many Hindus I meant that as an example - I now live somewhere very non-diverse where everyone is white CofE, so perhaps he's just not very clued up, as when I lived in a city where there was much more diversity I have never had this problem! But obviously I didn't explain that properly so apologies if that was misleading.

Why I posted this is because I have never in all my adult life come across this before - I've always been prescribed something suitable without being made to feel like an idiot for having the convictions that I do, and not once has anyone said to me that prescribing me alternative tablets/liquid costs more or is a pain in the arse.

I do find it genuinely interesting that some people think that it would be ok if I was, say Jewish, but not if I choose to be vegetarian. I think that we live in a society that accommodates diversity of belief - there are vegetarian alternatives which may or may not be more expensive, but at what point do we start getting out the calculators and saying what people are entitled to? I think CheeringBell makes a very good point:

"I don't get the argument that it's the OP's choice so she has to pay or put up with it. What about those people who's choice it is to smoke, eat poor diets, drink to excess? Should the NHS not treat them too?"

I'm otherwise healthy and don't make decisions that mean that I end up taking more out of the system than anyone else, arguably I have used much less of the NHS's resources than many - it just all feels a bit churlish.

And to people who say that they are strict vegetarians/vegans and yet still swallow animals' connective tissues without finding out whether there are alternatives available, well you're not really that strict, are you? wink

samandi Wed 12-Dec-12 12:29:10

Why I posted this is because I have never in all my adult life come across this before - I've always been prescribed something suitable without being made to feel like an idiot for having the convictions that I do

if I really couldn't bring myself to take them I'd have to ask the pharmacist what they would recommend. I've been here before so I said that they wouldn't prescribe anything and I'd end up having to come back to pick up yet another prescription.

Is this the first time it's happened then, or has it happened before?

I do find it genuinely interesting that some people think that it would be ok if I was, say Jewish,

Who said that? Have only skimmed but by far most people are saying it wouldn't make a difference.

You haven't answered the query about testing medicines on animals either.

trueblood1fan Wed 12-Dec-12 12:29:31

op you say you work so i presume you pay? then you should be given a choice.

samandi Wed 12-Dec-12 12:29:49

And to people who say that they are strict vegetarians/vegans and yet still swallow animals' connective tissues without finding out whether there are alternatives available, well you're not really that strict, are you

Perhaps not so precious.

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