Three weeks of the limited list
Authors: J. A Grant, S. Hull, R. Sutcliffe, D. Rawlins, J Winship
Journal: BMJ (1985)

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.