Three weeks of the limited list

Three weeks into one of the most important changes in the National Health Service since its inception it is of course much too early to assess the lasting effects, but there is much doctor apprehension that things will never be the same again.

Abstract

We were only 20 minutes into first day of limited list when Mr McLeod phoned to ask about his Maalox tablets (aluminium hydroxide and magnesium hydroxide). It wasn't because he was upset about restrictions or because he had run out of his tablets; he just thought he would check with Grant what he would be doing about it when he did run out?in two weeks time. So it has continued throughout first three weeks of this era for NHS. If thought that might have escaped worst effects of Mr Fowler's black list here in rural Perthshire were sadly mistaken. We even considered ourselves well prepared with practice meetings, letters for patients explaining changes, and even labels for pill bottles pointing out that new pills still had same effect. At a special meeting with our local rival practice had inevitable rumbles: government by imposition not discussion; we must fight to ensure that this is not thin edge of wedge; and the list is totally unacceptable. I'm sure same clich?s have reverberated from Perth to Penzance?yet to what avail? Our local chemist was quick to point out at yet another meeting effect that restrictions would have on his stock (and profits)?he being only source of prescribable drugs, potions, and medicaments for 15 miles. Could possibly keep prescribing Rinurel linctus (paracetamol, phenylpropanolamine, and phenyl toloxamine) as he had just ordered 6 1. (What no Cab drivers' linctus?) Likewise, he was still flush with Actifed expectorant (triprolidine and pseudoephedrine) and Aludrox gel (aluminium hydroxide), but could forget about Actifed compound linctus and Aludrox SA suspension?or was it other way around? No matter, our chemist has faithfully for two weeks sent us small notes informing us as t? demise of yet another winchester of Dr D E Jough's cod liver oil with malt extract and vitamins?fortified syrup and many other potions which he wishes never to gather dust on his shelves again. But what of our patients. Mr McLeod has finally settled for Maalox suspension night and morning with aluminium hydroxide tablets during day. We have engaged in heated debate with Scottish Home and Health Department over whether can prescribe paracetamol, codeine phosphate, and caffeine efferverscent instead of Solpadeine for a patient whose chronic pain responds only to this combination. With some sense of triumph have been informed, after being told opposite, that can. Thus problems continue as have to deal with many frustrating phone calls and prescription difficulties every day. Three weeks into one of most important changes in National Health Service since its inception it is of course much too early to assess lasting effects. One gets feelings of patient anxiety and concern yet little sign of hardship or alteration in consulting pattern. A great deal of time and effort has been required to effect changes needed in repeat prescribing sheets and case notes and to deal with patients' anxieties. Reassurance has been over? riding need of past three weeks. We are trying to reassure patients that nothing really has changed, but there is much doctor apprehension that things will never be same again.