Val: [00:00:00] Welcome to another episode of Stories, Labels, and Misconceptions with me, Val Barrett. 

Dr Jeremy: I'm Dr. Jeremy Anderson. 

Val: Here's a podcast where we like to share our stories, experiences, and explore solutions to the issues we face today within public services.

Val: How are you today, Jeremy? 

Dr Jeremy: I'm doing great. I'm smoking a brisket right now. 

Val: I don't know what brisket is. 

Dr Jeremy: Oh, a brisket is, 

Val: Yes. 

Dr Jeremy: A brisket is a cheap cut of meat, a large cut like pork belly, but for cows~ ~

Val: ~okay.~

Val: ~I ~thought it was beef. 

Dr Jeremy: It's beef. ~Yeah. It's ~

Val: ~beef. ~Okay. 

Dr Jeremy: Yeah. It's like the belly. It used to be cheap. And in Southern American barbecue, they would use big pieces of cheap meat because it's tough. So you cook it slow to make it tender and delicious, it's become very popular.

Dr Jeremy: So prices have gone up. When I'm on a recipe, it's a 30-hour cook. 

Val: Wow. 

Dr Jeremy: Wow. So you cook it super low. Super slow and [00:01:00] supposed to be delicious. So I've I started that this morning and will eat it tomorrow 

Val: Or next week. ~Yeah. ~

Dr Jeremy: ~So ~that's what I'm up to 

Val: This weekend. Okay. Let's get into today's episode.

Val: Okay. And today we're going to be talking about NHS prescriptions. 

Dr Jeremy: Yes. 

Val: The government announced brilliant news. For the first time in three years, NHS prescription charges just in England will be frozen. So that will keep the cost of a prescription below a tenner. So I automatically fought prescriptions to say you have a condition where you're taking, say, three medications.

Val: And it's all on one prescription. I thought all that, that, that prescription be under a tenner. No, each item is under a tenner. So that would be, I think it's 9 [00:02:00] pounds, 90 per medication. So God help you. If you take, like me, I'm on nine nine different forms of medication. So that is a lot of money, but the government says the decision means 80 million savings, which will help with cost of living for millions who regularly pay for prescriptions.

Val: As the government delivers security for working people through its plan for change. Have you noticed how it says for working people? 

Yes. 

Val: All people working. Everybody's suffering. 

Dr Jeremy: Yes. If you live in Scotland or Wales, everyone gets free prescriptions.

Val: I don't know how 

Dr Jeremy: I don't know, but it's only in England where not everybody gets a free prescription. And so the difference means it's a political [00:03:00] choice, right? You can do it if you want to do it. 

Val: Yeah. 

Dr Jeremy: In England, they choose not to do it. There's a number of criteria that give you access to free medication.

Dr Jeremy: If you don't have access to free medications on the NHS, there are support schemes and exemptions. It's fairly complicated in, in England. So I was looking up. This is, this is NHS bsa.nhs.uk. Is where I'm getting this from.

Dr Jeremy: And I was looking at just the, so there's multiple criteria for getting free NHS prescriptions. One of those is age, so under sixteen or 

Val: full-time education, 16, 18 if you're in 

Dr Jeremy: education, or if you're over 60. Certain benefits. Pregnant women or people on low income, there's there's what they call an HC2 certificate that people can use to get low-cost prescriptions.

Dr Jeremy: People with certain medical conditions can get an exemption from paying for [00:04:00] prescriptions, but it's only some conditions, ~not all. ~

Val: ~Yeah. Yeah, ~I know diabetes. 

Dr Jeremy: Yeah. I was looking at the list. Various kinds of diabetes epilepsy 

Val: cancer, 

Dr Jeremy: Obviously.

Val: Obviously. 

Dr Jeremy: I think 

Val: is so strange. I mentioned two others, and when I got to cancer, not dissing any illness, please. But when I said cancer, you said, obviously, 

Dr Jeremy: I was thinking some of them I've never even heard of. They're very rare. I don't know anyone who has myasthenia gravis.

Dr Jeremy: I couldn't 

Val: Even pronounce it. I don't know what it is. I'm 

Dr Jeremy: Not sure if I've pronounced it correctly. And if I've heard of it before, or myxoidema, which is hypothyroidism that needs thyroid hormone replacement. ~All I know ~

Val: ~is that I, I don't have, ~I don't have that. 

Dr Jeremy: These things, and when you look them up, they're described as being very rare.

Dr Jeremy: Cancer, not so rare. That's what I was thinking of. And 

Val: diabetes isn't rare. 

Dr Jeremy: 2 diabetes isn't rare, but the type of diabetes that they're describing, this diabetes insipidus, [00:05:00] is a kind of hypopituitarism. ~Okay. So that is it. What ~

Val: ~is that? ~Type one or type two? 

Dr Jeremy: It's neither. This is about people who urinate 20 litres a day.

Dr Jeremy: I'm not sure why it's called. I don't know the relationship to diabetes, but this diabetes mellitus, that's type one diabetes. That's people born with a condition where their body doesn't produce insulin. 

Val: Yeah. 

Dr Jeremy: What isn't included in this list is type two diabetes, which is the diabetes people acquire of insulin resistance.

Dr Jeremy: Their body they become resistant to the effects of insulin. 

Val: What happens if you've got diabetes type two and you're not working, you get free prescriptions. If you don't say you do work, we know that the cost of living has gone up, and you have to sacrifice one thing.

Val: You've got kids. You've got. Nine times out of 10, the 00:06:00 mother sacrifices her needs to feed her kids. What could be the downside of not taking medication for diabetes type 2, if they can't afford it? 

Dr Jeremy: Yeah, that's a good question. So for type two diabetes, really, they're, you're looking at trying to control people's blood sugar level.

Dr Jeremy: Yeah. So you don't want it to be too low. You don't want it to be too high. And it's one of those illnesses where there aren't a whole lot of symptoms, as far as I know. So if people have uncontrolled diabetes. They may not know it. But of course, I think it causes long-term damage. 

Val: Yeah. 

Dr Jeremy: What happens is, people don't live as long.

Dr Jeremy: Usually with diabetes, you have blood sugar levels that are too high. And so [00:07:00] I'm just looking up just online, just looking at long-term complications. You can have nerve damage. which is to neuropathy in the extremities, causing numbness, tingling, pain, loss of sensation.

Dr Jeremy: So sometimes people long term, they find they get limbs amputated. If you have a loss of sensation or pain in your limbs and you develop ulcers that, That get too big, then eventually all they can do is amputate the limbs, it can uncontrolled diabetes will damage the kidneys, kidney failure diabetic retinopathy is causes damage to blood vessels in the retina.

Dr Jeremy: So that leads to blindness. And uncontrolled diabetes is increases risk of heart disease and stroke, cardiovascular problems, which then 

Val: puts you on medications. 

Dr Jeremy: It puts you on a whole bunch of other medications. 

Val: Exactly. And more cost on the NHS. Yeah. Sometimes it makes sense for illnesses like this to be [00:08:00] exempt.

Val: From charges, because when I looked at the list, I was shocked asthma. 

Yeah. 

Val: I read, on the website, asthma UK, loved the heading. Paying to breathe or something like that, they have to pay to breathe 

Dr Jeremy: So asthma is not included in the exemptions.

Dr Jeremy: ~So I'm always ~

Val: ~wondering ~what is the barometer? What is the measurement tool NHS England uses? To measure all these conditions to say, okay, this condition is going to have free prescriptions, whether you work or not, but these won't, I don't know how they make it. ~I wouldn't want to, ~

~I ~don't know 

Val: Because I think, if you don't take your asthma pump now, I have a lung condition.

Val: I have bronchiastasis, so I have inhalers myself. 

Yes. 

Val: And I mainly suffer when it's really hot, cold or windy. I [00:09:00] cannot breathe. I am fighting for breath. I cannot walk far, people look at me and think, Oh, you look fine. But then I'll walk, and it's I am literally fighting for breath.

Yes, 

Val: London traffic, as we know, it isn't good. We've got the environmental fumes are making it worse for people with lung conditions. So it makes it weird that they don't have I,t considering the government is also going on about Oh environmental air pollution. 

Yes. 

Val: Air pollution makes your asthma worse.

Val: It doesn't make sense that they talk about air pollution in one hand, but people with asthma have to pay to breathe. 

Yes. 

Val: More people are being diagnosed with it. 

Dr Jeremy: And [00:10:00] it seems very random they pick a specific list of conditions.

Dr Jeremy: Yeah. Free prescriptions. 

Val (2): But 

Dr Jeremy: There's a lot more health conditions people do pay for their medications. 

Val (2): It's 

Dr Jeremy: obviously subsidised to a large extent. We're not paying retail prices like in the US. But they do have to pay, given that it is free for everybody in places like Scotland and Wales. 

Val: one 

Dr Jeremy: Why this seemingly arbitrary list in England?

Val: Yeah. 

Dr Jeremy: And it 

Val: Three in four people struggle to pay. For prescriptions. So they're probably using their inhaler less. Which can exacerbate their situation. To a person who doesn't work in the NHS, it's saying to me that this illness matters more than that illness.

Val: To somebody who suffers, it doesn't matter what it is; that matters to them. 

[00:11:00] Yes. 

Val: But then, NHS England said it doesn't matter as much because you are going to pay. Yeah, 'cause we don't think it does when it is a potential killer. 

Dr Jeremy: Absolutely. And it reminds me of, so when the no one's listening report came out a few years ago 

Dr Jeremy: Following the death of a young man with sickle cell disease, there were a number of hearings, and a report was created called No One's Listening. 

Val (2): Yeah. 

Dr Jeremy: This was presented at an all party parliamentary group hearing where this report was presented to the government and one of the things that came up in the report, as well as all the other things related to factors that were contributing to this young man's death and people's experience of treatment in the ward.

Dr Jeremy: One issue that should have been emphasised more was the lack of free prescriptions for people with sickle cell disease. And the people who made the report presented very clearly that this is a very onerous process. There are [00:12:00] schemes to help pay for prescriptions.

Dr Jeremy: But you have to be on certain benefits to get free prescriptions. 

Dr Jeremy: Or you have to be low-income, 

Val: to, 

Dr Jeremy: I don't know what the particular threshold is. But whatever the threshold is, it just it incentivises people to not be as productive because they don't want to lose access.

Dr Jeremy: To their prescriptions, or at least these price reduction schemes. It's a strange thing that kind of incentivises people to not be as productive, but also having to apply for various kinds of schemes, filling out forms. and continue to fill out forms.

Dr Jeremy: Is an onerous thing for people with disabilities. It's actually difficult to do that. And so there's an, I'm sure there's a number of people who would be eligible for these schemes, but can't jump, they need to access it. A more equitable solution would be to [00:13:00] say these conditions should get NHS free prescriptions across the board.

Dr Jeremy: You shouldn't have to keep proving that you're eligible for that that perk. And so they presented this to the government and the government. I was very disappointed with the government of the day and the way they responded by just saying, we've got these assistance schemes and they just parroted back pretty much what had just been said to them that, we offer this, we offer that, and they just didn't address what had been put to them.

Val: Yeah. 

Dr Jeremy: Nothing ever changed. I was very disappointed by that 

Val: But then even me, cause I, as I've got lung disease, heart disease. And heart disease, don't get free prescriptions.

No. 

Val: How do they say to themselves, Okay, if you've got an angina, you may get it or not 

Val (2): Yeah. 

Val: It'd be good to know the criteria, who sits on the board, [00:14:00] who makes decisions, 

Dr Jeremy: I don't know, 

Val: Who does?

Dr Jeremy: No, I don't know who does, who decides, what the criteria is. 

Val: When NHS England goes, who then makes that decision, who is responsible for the decisions made by NHS England 

Dr Jeremy: Yes. 

Val: Is it going to come from the Department of Health?

Dr Jeremy: Yes, the people from NHS England who remain will get rolled into the Department of Health and Social Care. The decision will come from the Department of Health. But it might even be a, like a ministerial decision or a or an issue for Parliament before they start making major changes.

Dr Jeremy: Because they have to get funding for it. 

Val: I just wish they would look at health in a more holistic way. Because, okay, they have this budget, that budget and say, okay, we're not going to spend money [00:15:00] on, let's say, for people with asthma to get their prescription for free. But let's say the person with asthma can't afford to pay because their children need nappies or whatever.

Val: So they go without their prescription, makes them worse. They end up in A&E. We know there's a big cost to go to A&E. 

Yes. 

Val: Then they're hospitalised. Let's say there's a big cost there. Why don't you just give them the bloody prescriptions? 

Dr Jeremy: That's a good point because being admitted to hospital is one of the criteria that people can get medication.

Dr Jeremy: So if you get prescription medication while you're an inpatient, you don't pay for that. 

Val: That's why 

Dr Jeremy: Go to your GP 

Val: leave, 

Dr Jeremy: You can't 

Val: Stay forever. 

Dr Jeremy: Exactly. There's a significant cost attached to staying in hospital. If you incentivise people. To come to hospital so they can [00:16:00] get their prescription for free.

Dr Jeremy: You're paying for the prescription anyway, plus you're paying for the cost of their admission. So if you just say you get the prescription for free as an outpatient, you pay the same for the prescription, but avoid the inpatient cost because you're not incentivising people to come to hospital when they don't need to.

Val: But then, wouldn't you say this is part of social care? Because if the government's aim. Is to keep people out of acute care, stay at home, stay well in the community. Part of that would be to make sure you get your medication. 

Dr Jeremy: You don't have to go to hospital to get it.

Dr Jeremy: ~Yeah. ~

Val: ~So ~they need 

Dr Jeremy: it. 

Val: Even if you're on a low wage, you need it. Just on that marker where it's not low enough. Do you see what I mean? 

Yeah. 

Val: It's like the [00:17:00], just about managing are not just about managing anymore. You're on that line where they say you can't get it free because you earn 50 pence more, stupid things like that.

Val: You earn a couple of pence more, and it's still hard. I don't know. Anyway, this is something else I found out. 

Okay. 

Val: Let's look at savings because the government is always on about savings, but they don't do what they say ~they're going to do. ~

Dr Jeremy: ~You mean they're ~not saving money? 

Val: ~They like to spend.~

Val: ~So ~I had to look at the NHS spend. 

Okay. 

Val: On medication. I'm going to quiz you. So we're going to go back to 2022. 

Dr Jeremy: Right during COVID. 

Val: Was it? I can't remember. So I'm going to say on prescription for paracetamol, aspirin, and ibuprofen. Is it? I say it for 

Dr Jeremy: ibuprofen. 

Val: Ibruprofen[00:18:00] I said it. 

Dr Jeremy: Yes. 

Val: So yeah, 2022, the NHS spent X amount on prescriptions for paracetamol. Ibuprofen and aspirin. Was it 10 million, 50 million or a hundred million? 

Dr Jeremy: Got it. 10 million, 

Val: No. 

Dr Jeremy: 50 million. 

Val: No. We have money. 

Dr Jeremy: Hundred million. Taxpayers money. 

Val: Million. Hundred 

Dr Jeremy: million. 

Val: We're spending taxpayers' money 

Dr Jeremy: on paracetamol. 

Val: 100 million aspirin. In 2022, considering in 2018 when Sajid Javid. Was the Secretary of State for Health, he told GPs to stop prescribing these things because you can get them in the shops for 39 P [00:19:00], and it was costing in some cases, £4.50 a pack, and you can get it for 37 P. So imagine that. So why were GPs still up to 2022 prescribing these drugs? 

Dr Jeremy: When these drugs get prescribed by a GP, 

Val: Not supposed to prescribe them. 

Dr Jeremy: The cost is higher than if you purchased it yourself. So they've got an arrangement where they pay a certain price, but that's much inflated.

Dr Jeremy: That's the 

Val: price that what are they called? When they're buying from pharma and sell to the NHS, that's the price. 4. 50 and it's 37p. In a high street shop, I think that says a lot. You can get the prescription for free, [00:20:00] but it's not really free 'cause taxpayers are paying.

Val: You just do it. I think that attitude has to change. I buy my own aspirin and paracetamol. It's not something I would think of asking the GP. To prescribe me 

Dr Jeremy: No 

Val: 100 million. Can you imagine you have a condition where the government says you're not going to get free prescriptions because your condition on our barometer isn't, whatever measurement it is, right?

Val: It's not that bad for us to say, okay, it's going to be free. Can you imagine then they have to hear that someone won't dig in their pocket the 37p 

Dr Jeremy: So medications are available without a prescription, so people are getting a prescription because it'll be paid for.

Val: Yes. 

Dr Jeremy: We spend a huge amount of money on that. 

Val: [00:21:00] That was just in 2022.

Dr Jeremy: If stopped, that would pay for a lot of 

Dr Jeremy: Pay for 

Dr Jeremy: This, that people need a prescription for and are much more expensive. 

Val: What we talked about a few episodes back is that the government are always looking for things to cut. Not looking for ways to save. 

Yeah, 

Val: This shouldn't be happening in 20. If this happened in 2022, I couldn't find it beyond four, but you can bet your bottom dollar they're still prescribing it. And it's around that price. That's awful. Considering other illnesses, pensioners losing whatever, hundred million, but that ain't the worst of it.

Val: I then found, paracetamol in that year was 73. 7 million aspirin, 25. 2 [00:22:00] million you can buy it. I don't know why GPs dishing it out like sweets. 

Dr Jeremy: They're thinking, okay, I can give this, if you have someone on low income or has conditions where they get it for free, then.

Dr Jeremy: I suppose the GP wants to help, but didn't realise 

Val: Come on, 

Dr Jeremy: These medications are at a much higher price than a person would pay if I 

Val: buy something for 37 P to let somebody with asthma, not pay nine pounds 90, but that inhaler that they need to help save their lives. I'm paying the 37 pence.

Dr Jeremy: Yeah. 

Val: That just makes sense. 

Dr Jeremy: Yes. 

Val: I don't know if they're still doing it, but the government told the GPs in [00:23:00] 2018 that has to stop. 

Val: Those figures were in 2022. In total, 9.6 billion. Was spent on prescription drugs in England alone in 2021 to 2022. That's a lot. 

Dr Jeremy: That's a lot 

Val: I was shocked when I found that. I really was. And then when I read the article, Asthma UK is doing a campaign. 

Dr Jeremy: Campaigning to have medications provided for free. 

Val: Cause they've done their research, other people can't afford it all the time.

Dr Jeremy: Yeah. 

Val: Awful. When you don't know what it's like to fight for breath. It's awful. It really is. wow. Let's take a [00:24:00] breather. 

Dr Jeremy: I was just reminded of this story a few years ago, where I can't remember the name of the guy. I'll have to look it up later, but. He became a CEO of this pharma company that makes EpiPens, like the epinephrine doses that people take if they have allergies, like if you eat a peanut or get stung by a bee and you have anaphylactic shock, you take this EpiPen and it saves your life.

Dr Jeremy: So, people who have severe allergies they need these things. And when this guy became CEO, he decided we're selling it at this price. It went from 20 bucks to 750 bucks for a an EpiPen.

Dr Jeremy: So it wasn't that the product was that expensive to make or the device was improved; he decided this is what people are willing to pay to save their lives. Yes, if you can pay that, you will, but not everybody can, right? Severe allergy people who have to carry these pens, that's also not on the medical exemption list.

Val: Especially when a child goes to school, they may have a spare [00:25:00] one at school, spare one at home. So you're not just going to have one. 

Dr Jeremy: Yeah, and you have to replace them every once in a while because they expire, and it's an ongoing cost to people, and they have to get multiple pens.

Dr Jeremy: Yeah. Even the decision to use it, right? If you think you might have eaten a peanut, 

Val: Right? 

Dr Jeremy: You're not sure how bad it's going to be, 

Val: But it's going to cost you 750. 750? Yeah. Yeah. I don't eat any nuts. So I'm fine. I'm good. Anyway, I found what the NHS England how it decides. So it says here, the NHS in England decides which medical conditions qualify for free prescriptions.

Val: These decisions are based on a combination of factors. Including the conditions severity, the need for long-term medication and the [00:26:00] impact on an individual's ability to work or engage in other activities. Specifically, the NHS utilises a system of medical exemption certificates, the MedEx, 

Dr Jeremy: eligibility? Who's eligible?

Dr Jeremy: Who can get it? 

right? 

Dr Jeremy: Do you want to hear a funny story? So when my wife moved to Vancouver from Quebec and she can speak English, but her mother tongue is French. She was doing her training.

Dr Jeremy: And preparing for an academic presentation where she was supposed to say the word simultaneously. Oh, 

Val: No. 

Dr Jeremy: And for a French, a native French speaker to say that word. Not only was she not pronouncing it correctly, but she couldn't recognise she was saying it wrong. She couldn't hear the difference between 00:27:00] the way her supervisor was saying it and the way she was saying it.

Dr Jeremy: So they decided they would just say together. 

Val: How did she say it? 

Dr Jeremy: She said simultaneously. 

Val: Okay, but with an accent. 

Dr Jeremy: She had an accident and missed a little E ously, simultaneously, and she just said simultaneously. 

Val: Okay. 

Dr Jeremy: Her supervisor was saying it simultaneously 

and 

Dr Jeremy: She was saying simultaneously, and he's no, simultaneously.

Dr Jeremy: And she's simultaneously. ~It's ~

Val: ~awful. ~When you cannot 

Dr Jeremy: She couldn't comprehend that to the French, it sounds the same. 

Val: Okay. 

Dr Jeremy: It's interesting. 

Val: But whereas I know I'm saying it wrong, the more I'm saying it, I'm just killing it.

Val: No excuse. I'm British. I just can't speak that well. So yeah, we've established that fact. So yeah, so that's how. The [00:28:00] NHS spends your tax money. 

Dr Jeremy: Part of the criteria you mentioned was your likelihood of being able to work.

Val: Please. 

Dr Jeremy: So it really is a health economic case. We'll pay for this because it will pay for itself. If we give you this medication and it makes you more likely to continue working. You'll continue paying taxes. 

Val: If you're asthmatic and can't afford your medication, you're not going to be able to work. In fact, you're going to be costing the NHS more money. There doesn't seem to be a lot of joined-up thinking. 

Dr Jeremy: No, 

Val: They don't have the bandwidth to look across the board and think, okay, this is the NHS. This is social care. We want people to stay at home. We don't want bed blockers. And the only way they're not going to get bed blockers is by keeping people.

Val: You keep people well, and you give them money where they can heat them, heat their home adequately. [00:29:00] 

Yeah. 

Val: They don't live in a home that has damp or mould. They have adequate money to buy decent food, and they have their medication. 

Dr Jeremy: Yeah. 

Val: It makes sense. When I was growing up, when I used to watch PMQS, I used to love it.

Val: This thing, oh, it's a wonderful show. And, I was always told that these people. The brightest of the bright, they were the best. They are the ones that are born to rule. They know best if they say, Hey, it's because it's right. And who is somebody like a mere mortal like myself to question that? Most went to top universities. In that top, 1%. 

Dr Jeremy: Yes. 

Val: Grades, always get the best jobs. 

Dr Jeremy: Most prime ministers went to Eden. 

Val: Yeah. 

Dr Jeremy: Yeah. 

Val: Go into [00:30:00] government, work themselves up, running their departments.

Val: It took me a long time to realise just because you're there. Doesn't mean you know everything; nobody knows everything. It doesn't mean you have emotional intelligence, that you have bare common sense. It just doesn't. You may be intellectually bright 

Dr Jeremy: Yeah, 

Val: But there's something missing. Do you know what I mean? There's something, another component that's actually missing. You're not that full-rounded person that looks at things like we've discussed. You're not giving free prescriptions to people with asthma, it's not a luxury. To breathe. It's not something you choose, it's something we all do because we want to live. So we need to breathe. Clean [00:31:00] water. Somewhere to live. These are the things all human beings need. 

Dr Jeremy: Yes, speaking on a higher level there. You've read the criteria that NHS England is using to determine.

Val: That makes no sense. 

Dr Jeremy: It makes sense. If you've made a choice to frame it as we're going to pay for these medications, if there's some utility, that is, if they if they help people stay in a job, for example. 

Val: Asthma fits in that box. You could say that. 

Dr Jeremy: Sure. ~Sure.~

Dr Jeremy: ~ ~It still doesn't make 

Val: full sense. 

Dr Jeremy: And maybe the asthma associations can make that case. If they get added to the list because they can show utility, that's fine for them, but it's actually, there's already a decision we've made that we're going to base it on these criteria. Another decision you could make is saying societies are judged by how well they treat the most vulnerable. 

Val: Yes. ~Yeah. ~

Dr Jeremy: We're going to provide these things the same way Scotland and Wales do, because we're 00:32:00] deciding that vulnerable people need these things and we're just going to provide them, whether it keeps them in the job or not. We've never talked about that. 

Val: Scotland is smaller, isn't it? 

Dr Jeremy: Yes. Scotland and Wales are smaller. So 

Val: they won't have, smaller. They won't have 

Dr Jeremy: the tax base 

Val: Hear that noise. 

Dr Jeremy: That would be the sound of a snoring dog. 

Val: Are you ever apart?

Dr Jeremy: No, never. These are total Velcro dogs. They just want to be with you all the time. 

Val: No. I don't believe that. You. Cannot be parted from your dog. ~It's ~

Dr Jeremy: ~ ~Both. 

Val: There's times he wants to run away. 

Dr Jeremy: He never wants to run away. 

Val: Scotland does it, but we've already found the government a hundred million.

Dr Jeremy: Yeah. 

Val: We've found a hundred million. 

Dr Jeremy: It's like we've saved the government a hundred million bucks. 

Val: Someone else saw it. Sajid Javid did. 

Dr Jeremy: Okay. 

Val: But if he has 00:33:00] given the GPs a directive, why aren't they following it? This way, that's the part I don't get. Or the pharmacies should say no. We're not dispensing that. 

Dr Jeremy: Wow. 

Val: The only people winning are the pharmas. 

Dr Jeremy: Yeah, 

Val: pharmaceuticals, £4.50 a pack, and it probably cost them less than 37p to make 

Dr Jeremy: I'm sure it cost a lot less.

Dr Jeremy: These are not expensive drugs. It'd be useful to get someone to talk, if we could find someone or someone contacted us who has knowledge of insider knowledge of how pharmaceutical companies and 

Val: How 

Dr Jeremy: They negotiate with governments and whatnot. I know someone at Pfizer, but I don't think someone like that could come on the podcast and speak publicly about these things.

Dr Jeremy: We need someone not controlled by an NDA I would be shocked if they [00:34:00] weren't 

Val: Really. 

Dr Jeremy: Yeah. It's a private company, right? So they don't want their boys on the air, but it would be interesting to find out maybe someone who's negotiated deals before, who's represented, associations like asthma, cystic fibrosis or sickle cell, to talk about how these drugs get added and what kinds of cases need to be made.

Val: But I'm sure the negotiation of price with the government is out there under the Freedom of Information Act, it's taxpayers' money. I'm surprised about how they choose the conditions and what we just read, what we just said. But the barometer, the level,

Dr Jeremy: Yeah. 

Val: So, guys, we have saved. I think I'll work here. He's done. Yeah. A hundred million. Yeah. Yeah, we should get nominated for the Nobel Peace Prize 

Dr Jeremy: [00:35:00] hmmm 

Val: ~something.~

Val: ~Probably not. ~We hope you enjoyed today's show. I can't start laughing. Oh, if you or anyone has a condition and you feel that they shouldn't be paying for their prescription. Let us know, send us a voicemail. The number will be in the description. 

Dr Jeremy: Excellent. 

Val: Have a great day. Leave us a review and follow us wherever you get your podcasts. 

Dr Jeremy: Thanks for listening. 

Val: Bye.