Will antibiotics be in the candy bucked this Halloween? If only I could say I find it hard to believe. But with this government I have come to realise any statement from a cabinet minister is possible, however controversial it sounds. Our health secretary Thérèse Coffey, a Billinge-born lass, is quoted as saying she wants to give pharmacists the right to prescribe antibiotics, and, more significantly, admits that she has herself in the past handed her supplies of antibiotics to friends and family.
Health secretary’s statements on antibiotics
What is so bad about Coffey’s statement? The first part may or may not be bad. Pharmacists can do six months extra training after their study to get a pharmacist independent prescriber qualification, which gives them the right to prescribe a range of medications and give vaccinations. However, they are NOT trained in diagnostics, in examining patients, or ordering and interpreting medical tests. So, caution is needed here. But in principle, if the pharmacists have the time for this and work within their expertise, and if they get the additional training needed, it might work.
I want to concentrate on the second part of Coffey’s statement, where she admits that she has handed out her own antibiotics supply to friends and family in the past. Where did this supply come from? Was it medication that was prescribed for her by a medical practitioner, that she then decided not to take? Or did she get hold of antibiotics some other way? We need to clarify: Coffey is NOT a medically trained person who would be entitled to prescribe drugs of any kind. She has a PhD in Chemistry. Clever, but a different field.
If she has really said this – and it has been widely reported that she did – and if she really handed out her prescription medication to others, then in a normal government, that would be a sacking offence. Passing prescription medication onto third parties, individuals for whom it has not been prescribed, is against the law in this country.
Misuse of antibiotics
Sharing antibiotics with friends and family is a problem, because many illnesses are not caused by bacteria, or are so mild the body can fight the bacteria itself and build up natural immunity (such as bacterial sinusitis after a cold). Antibiotics do not work for virus infections (such as colds, flu, Covid), and definitely not for strains and sprains, cancer, allergic diseases.
But even if a patient is ill with an infection caused by bacteria, and antibiotics are needed, you can’t just take any antibiotics. Bacteria have different sensitivities and you need different antibiotics for different type infections. In addition, different antibiotics have different actions in the body – some work better in one organ, others concentrate more and therefore work better in another.
To know which antibiotics are the best for which case, you need thorough knowledge of how antibiotics work, both in the body and when attacking bacteria. And preferably also knowledge of that particular patient and any allergic or adverse reactions to medication they may have had in the past.
Every time antibiotics are prescribed, the chance of creating resistant bacteria increases. Bacteria live in and on our body, good and bad ones. Antibiotics kill bacteria, but some of these bacteria find a way of becoming resistant to antibiotics. Worse, they have found a way to transfer that and other resistance to other bacteria, by exchanging a little bit of genetic material called a plasmid.
Taking antibiotics means you kill bacteria in and on your body. The sensitive ones will die, the resistant ones survive and can become a big problem (leading to things like clostridium difficile diarrhoea in hospitals, or MRSA infection in wounds). You can spread these drug-resistant bacteria and infect others, and people can become carriers sometimes without even knowing it.
The more people take antibiotics, the bigger the risk of those resistant bacteria finding their way into the environment and sharing their plasmids with other bacteria, transferring their antibiotic resistance to bacteria that have never even been in touch with antibiotics.
Antibiotic resistance is a big problem already. A study in the medical journal Lancet (2022) calculates that in 2019, worldwide at least 1.2 million people died due to having antibiotic-resistant infections. This number is only going to get higher, and there will come a time when a simple chest or dental infection starts killing people in large numbers again, like happened a few centuries ago.
What does the law say?
The main law on the subject is the Human Medicines Regulations Act, 2012. This act became law in 2012, under a Conservative government with David Cameron as prime minister.
And this law is very clear that passing medications on to others is NOT permitted:
- Section 46.1 A person may not sell or supply, or offer to sell or supply, an unauthorised medicinal product.
- Section 47.1 A person who breaches regulation 46 is guilty of an offence.
- Section 47.2 A person guilty of an offence under this regulation is liable –
(a) on summary conviction to a fine not exceeding the statutory maximum; or
(b) on conviction on indictment to a fine, to imprisonment not exceeding two years or to both.
- Section 214.1 A person may not sell or supply a prescription only medicine except in accordance with a prescription given by an appropriate practitioner.
- Section 255.(4) A person (‘P’) is guilty of an offence if –
(a) P has in P’s possession a medicinal product to which regulation 214(1) applies; and
(b) P intends to supply it otherwise than in accordance with a prescription of an appropriate practitioner.
So, there are a few places where the law states it is unlawful to dispense prescription medication to people who do not have a valid prescription for that product. The penalty for this can be either a fine, or up to two years in prison.
Our health secretary has allegedly boasted that she has done just that, passed her own prescription medication on to others. This is an offence for which pharmacists would get struck off by their governing body, and for which medical and non-medical people alike could be fined or imprisoned.
Knowing our present government, all she will get is an ‘atta girl’. She can say things like this without fear of reprisal. After all, breaking the law seems almost a requirement for holding office these days.
The health secretary should resign
So what next? What will the health secretary suggest this week? Shall we fill a bucket with our left-over medication and leave it out for the adults at Halloween?
A health secretary should know better. I call for Coffey to resign, on the grounds of her admitting to breaking laws that she as health secretary should uphold and enforce.
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