A no-deal Brexit could spark a deficit of medications that may lead to mortality and patients with conditions such as cancer, epilepsy and killer infections may be hit as cross-Channel supplies face reductions of up to 60 per cent.
And investigations discovered that important medicines could run out if Boris Johnson allows Britain to crash out of the EU and from a medical point of view this is likely to be little short of a tragedy especially as we near winter with its overwhelming pressures on the NHS that could spark a deficit of drugs which would be disastrous.
And the drugs that we should be worrying about are antibiotics and acutely, the concern is around flu vaccines and any further setbacks moving us pretty close to the flu season and there’s a concern that transplant patients may be left without drugs that help them stop their bodies rejecting new organs.
Immunosuppression medications are important for these patients and for most people with epilepsy, their medicine management has to be finely tuned to maximise their seizure control and to reduce side effects.
One seizure and they quickly find they are no longer permitted to drive and their work or education may be affected because seizures can be deadly, plus all cancer treatments are essential and any suspension would be unacceptable.
There are further concerns supplies of radioisotopes, required to run scanners, could be hit which means that the diagnosis of cancers, heart problems and other fatal diseases could be missed and with the deficit of Hormone Replacement Therapy medications already gripping Britain, a rift in supplies from overseas could hit millions of women suffering the crippling effects of the menopause.
The menopause can be a particularly challenging time for women, so it’s crucial they have access to the medicine they require, especially as we head into winter. This is when pressure on the NHS is most intense and uncertainty grows around the fallout of a possible no-deal Brexit.
The antidepressant drug Prozac is also in short supply and people with mental health problems who use medication to help manage their symptoms often rely on a range of treatments and people living with haemophilia rely on a clotting agent.
Without it, some would face the threat of life-threatening bleeds.
Crohn’s and Colitis UK chief executive Sarah Sleet said that easy access to drugs and treatments was essential for sufferers.
Without them, patients could get really sick and may need surgery needlessly with supplies of medicines crossing the Channel diminished by between 40 per cent and 60 per cent of current levels on the first day of Brexit.
Around three million packs of drugs reach the United Kingdom through ports with pharmaceutical firms and the Government having a listing of at-risk medications which are being kept top-secret to circumvent scaring the people and there are worries that even a brief duration of stay could prove disastrous.
There are thousands of drugs in this category and the most challenging areas might be those where different medications are used and patients can’t simply be safely switched between them and epilepsy medication would be an illustration of this and chemotherapy.
Clive Smith has to inject himself with factor VIII clotting agent three times a week to stop internal bleeds and the 38-year-old barrister from Ilkley, West Yorks said that when it comes to the border he hopes that medications will come first because without medicines his joints would begin to swell after a few days and could cause permanent damage and he would struggle to go to work or live his life and there’s a risk to his life because if he slipped and banged his head he could suffer an internal bleed.
The message to the Government is that they should not be playing politics with people’s lives!
Nicola Davies’s daughter Emma is severely epileptic and has severe learning disabilities. Emma, 37, lives in a home in Chalfont Saint Peter, Bucks and she takes a mixture of drugs of different dosages to manage her seizures. Emma has uncontrolled epilepsy which is especially troubling for her mother and it’s absolutely necessary they have a constant accumulation of medicine because these seizures can be life-threatening if Emma is not brought out of them.
Nancy Greig, 42, has ulcerative colitis and has had her colon removed. She wears a bag and she couldn’t leave the bathroom if she ran out of supplies of this product and deficits would make people like Emma prisoners in their own homes.
The health service project manager from Ayre, South Ayreshire, added: “I’ve also heard that my antidepressants are in short supply. You can’t just stop these things.
“I’m worried I’ll have a relapse and I won’t be able to function and pick up my son from nursery.”
And hospitals are reserving hotel rooms for staff so they can get to work in the case of a no-deal Brexit causing travel chaos with Maidstone and Tunbridge Wells NHS Trust making bookings across its area and East Kent NHS Trust which has rooms in place for the fortnight following October 31.
Neither would verify how many rooms were booked or for how many staff but Maidstone and Tunbridge Wells NHS Trust said the move would guarantee that they can continue their services reliably and efficiently under all circumstances and that they’ve reserved a small number of hotel rooms near to their emergency hospitals as a precautionary measure.
Elsewhere, Kent Community Health Foundation Trust is making arrangements for their staff to sleep at work and the South East Coast Ambulance Service is looking into accommodation for drivers and paramedics.
So, those people who are still keen on Brexit following the Yellowhammer report, well, you’re simply cannon fodder for the wealthy Leave elite because do you honestly think that these billionaire Brexiters really care if these people get their medicine or not? Of course, they don’t, not one bit and their compassion will be in short supply because they only care about securing their offshore investments and they simply want us to be pawns in their foolish diversions.
The United Kingdom imports more than 37 million medicine packs from the EU every month. Sixty per cent of those are radiopharmaceuticals to tackle cancer which are shipped from the EU and have a short shelf life so they can’t withstand even a slight delay.
And even the Government are acknowledging that delays will be inevitable. People will die, but of course, not the billionaire Brexiters because they’ll have private helicopters for their own supplies but there are numerous commenters who are asserting that this is just fear-mongering, yet Operation Yellowhammer reports are coming directly from the Governments own advisers who are saying there will be drug deficits because consignments will be held up at customs for inspections at border ports, which by the way, are already overburdened and understaffed and without special arrangements the situation can’t be expected to continue as it is now, and common sense should tell people that setbacks are unavoidable but then common sense sadly appears to be in fairly short supply when it comes to the actualities of Brexit.
And if Britain does run out of life-saving medications that would be a major bonus for the degenerative Tories because thousands of more people will perish, therefore saving the Tories millions in benefits and pensions, hence paving the way for yet more tax evaders to settle here.
Before England entered the EU, we were dull, bigoted, pretentious, boring and still living in black and white. The banks shut at three, the shops closed at five and pubs shut at 10.30 pm. On Sundays and on Wednesday afternoons everything was shut and late-night television ended at midnight.
Food was bland, beer was warm, lager was trendy and wine was for the rich. Brandy and Babycham was a cocktail and everyone sipped tea, all the blasted time.
British cars looked terrible, were poorly constructed and you normally had to wait months for delivery because car makers were on strike.
Still, they were the good old days when women, children et cetera knew their place. There was seemingly no domestic violence, although a lot of women seemingly walked into doors.
There was no abuse or child molestation and if it did happen, it was their own fault for leading men on.
Everyone trusted bankers, businessmen, doctors, journalists, policemen, politicians, priests, and Rolf Harris and if you were wealthy, white, and a man in the United Kingdom it was a magnificent place to live in the late 1960s, early 1970s and Boris Johnson would have loved it!
The United Kingdom was way behind other bigger European nations in terms of economic development and the reasons for that were the damages of war and the immense political struggles within the United Kingdom, because the United Kingdom had a socialist administration following the war, which was opposed by the industry with big parts of the British economy sinking, for instance, the car industry which was one of the biggest in Europe.
On the other hand, the United Kingdom was relying on its dominant position in the commonwealth, importing inferior agricultural commodities from Australia and New Zealand and exporting industrial goods to these countries, however, many crown colonies became autonomous following World War II.
Shortly after the foundation of the EC in 1957, the United Kingdom recognised that they would be better off as an EC member, so they laboured laboriously to join the EC.
In fact it was French president Charles de Gaulle who used his political weight to block these attempts because he didn’t want to have the United Kingdom play an important role in the EC, and the German administrations in the 1960s didn’t want to disrupt their alliance with France because the entire EC idea was based on the Montan-Union, a plan that was put together by German and Franch coal and steel in order to overcome the German-French hatred of preceding centuries, so originally the EC was a French idea, and Charles de Gaulle wanted it to stay that way.
However, the situation changed at the end of the 1960s when Charles de Gaulle left office in France and Germany got a new social-democrat chancellor Willy Brandt.
And in England, you could be poor but live a perfectly okay life. You could get a 9-5 position at the council, not really good pay, but job security and a reliable pension.
You could live in a perfectly reasonable small flat or house, in a reasonable area, amongst a number of other people such as your family and friends who weren’t seeking to transform the world every day and at a job interview you could just say ‘because I have to pay the bills’ and you didn’t have to pretend to be genuinely passionate about improving the world of supermarket shelf filling, or council form filling – it was okay to be ordinary.
There was employment for all and life was much more predictable than today as well as astounding music and youth culture because the population was on average much younger than today.
Old people were more disadvantaged due to inflation while younger people enjoyed inflation-related pay increases. Housing was cheap, but it was difficult to borrow money and the United Kingdom was a much less congested place as people emigrated more than they came and on the whole, the United Kingdom was a much happier and independent country.
The United Kingdom made all of its own rules and had a reasonably healthy economy, was a world leader and had a somewhat different position on immigration, but of course, that was 40 years ago and the world today is a vastly diverse place, so the United Kingdom wouldn’t necessarily walk out in the same position.
And we will presumably struggle if we crash out and curtailments will happen but whether we crash or not Boris Johnson and his offensive Tories are finished.
But this is real and most of our drugs come from Europe and no deal will lead to drastic deficits but our Government don’t care who suffers as long as they get what they want.
Medicines form a vital part of the care administered by the NHS and more than one billion items are distributed yearly through community pharmacies, and the total bill for medicines is more than £17 billion.
For patients with long-term conditions such as diabetes, asthma or schizophrenia, everyday medicines play a vital role in managing their health and wellbeing and we all know that someone with a regular prescription, whether it’s for these illnesses, or for blood pressure, heart problems or cancer, or whether it’s creams used for rashes or skin problems, everyone takes it for granted that they will be able to get their medicine when they need them.
But everything we take for granted is at risk as a consequence of Brexit and if there isn’t a rooted plan for managing supply, there could be deficits. So, let’s take a look at how drugs get from the factory to our neighbourhood pharmacy because this is, by its nature, an international business.
The vital components required are usually manufactured in India and the far east. These are then transported to production factories that turn them into pills and liquids that come in a prescribed form and many of the plants that furnish the United Kingdom are elsewhere in Europe.
From there, they’re shipped to wholesalers here in the United Kingdom who then distribute them to pharmacies and hospitals to be given to patients but the whole method has to be meticulously maintained to ensure that everything happens in a timely way, particularly for medicines with a short shelf life, such as lifesaving EpiPens needed for those with severe allergies, or those with special requirements, such as insulin, which needs to be kept at between 2C and 8C at all times.
The goods that benefit from free movement across Europe include medications and the pharmaceutical supply industry has modified itself to these arrangements so any big unexpected change, whether it’s leaving the customs union and single market, or negotiations breaking down resulting in no deal, has the potential to generate significant problems with stays at ports, raised costs and legal or regulatory differences amongst other issues.
Even as things stand, the process is a finely balanced one and at each step, things can and sometimes do go awry. For instance, in preparing the active ingredient there can be contamination, which means the whole batch has to be discarded.
And at the manufacturing stage, there might be an issue that occurs in its failing quality control and then having to be discarded. Or during transport to the wholesaler, the container may become too hot and the contents exceed the maximum recommended temperature, following which it may have to be destroyed.
Any of these kinds of problems can lead to a stay in stock, and subsequent deficits of selective drugs but when this occurs, as it does occasionally with a small number of drugs, the pharmacist may have to issue a short prescription in order to guarantee the maximum number of patients have access to the ready stock.
If the stock problem continues, the pharmacist will either speak to the prescriber to find an alternative or ask the patient to go back to the prescriber and at the moment, we can deal with these issues but they pale into nothingness compared to the problems Brexit has the potential to create.
Therefore, what are the solutions? Well, there’s some manufacturing capacity in the United Kingdom but not nearly enough to meet the entire country’s need for medicine.
Attempting to increase capacity can be done but would take a considerable amount of time, as any new plant needs to be approved for delivering high-quality, safe medications, with some, such as those that produce insulin, have extremely particular specifications and as a consequence, simply making more drugs here in the United Kingdom can’t be the solution.
There has been some debate about stockpiling, but the immediate question is how could such large amounts of medications be stored in suitable environments, remembering that some need to be kept cold.
Then there’s the problem of paying for the medicines because stockpiling lasting three months equates to about £4.5 billion, which is an unbelievable amount of money and pharmacies don’t get paid until the medications are dispensed and how can they afford to buy the amounts needed? That’s before you even get to the issue of shelf lives, which for some medications are short.
And if the Government and the NHS are serious about planning, then they must include community pharmacists who are used to dealing with these logistics and can support any decisions made because they’re a crucial component of the supply chain and are the final link to the patient and they may additionally have some room for storage, but there needs to be some definitive understanding of what this capacity is, how it can be used and how medications can be transferred between pharmacies in a timely and non-bureaucratic way and not involving pharmacists could lead to poor decisions that will impact on patient safety and patient care.
Finally, we must remember that medications are vital for the health and wellbeing of the population, especially the most defenceless segments of society and without timely access, yet more weight will be put on our hospitals through patients having emergencies due to a shortage of medicine.