i morning briefing: What’s behind the ‘critical’ medicine shortages?

Welcome to Friday’s Early Edition from i.

It’s a grim time for patients of the NHS. Painfully long waiting times, ongoing staff shortages, crumbling buildings … the problems go on. And now there’s another continuing crisis making life even worse – medicine shortages. Today experts are warning that problems with supplies are wreaking havoc on patients, as a survey reveals that shortages are becoming a “daily occurrence” in pharmacies across England. Those working in the sector have revealed how patients have been forced to “ration” their medicines in the face of it, while others are playing “pharmacy bingo” trying to find an outlet that holds their much-needed medication. Earlier this year, epilepsy patients revealed to i how they had been forced to stockpile drugs in preparation for shortages, to avoid life-threatening seizures. One said: “It’s strange to say the least that the Government are letting it get this far in the first place.” One expert, Mark Dayan, from the Nuffield Trust think tank, said: “Nearly every available indicator shows that since 2021 we have experienced a once unthinkable level of medicine shortages again and again”. So what is going on? We’ll take a look, after the headlines.

 Today’s news, and why it matters

 ‘Boris and I saved thousands from Covid – but we won’t talk again’. Dominic Cummings uses his first newspaper interview since leaving No 10 to talk about his split from Johnson and condemn Farage, Ukraine, and the Tory and Labour ‘sh*tshow’.

Keir Starmer will unveil Labour’s plans to stop small boats crossing the Channel as he attempts to persuade voters his party will tackle immigration and neutralise Rishi Sunak’s key pledge of sending flights to Rwanda. The Labour leader will make his announcement in Kent with the newly defected MP for Dover Natalie Elphicke.

Sir Keir is expected to resist demands for the immediate reinstatement of Diane Abbott into the Labour Party after he welcomed the former Tory MP Natalie Elphicke into the fold. Asked whether the Labour leader will relent, a shadow minister told i: “No. I don’t think he will go for it, I really don’t. He has to put the antisemitism thing to bed. That is the much bigger issue.”

Scientists are becoming increasingly worried about fast-spreading bird flu infections among dairy cows which are more likely to mutate into infections in humans. While a new human pandemic is seen among scientists as unlikely, it is a genuine concern and one that has been growing since the H5N1 bird flu virus was reported in cattle for the first time in the US just over a month ago.

The Bank of England has held interest rates at 5.25 per cent for a sixth consecutive meeting. The Monetary Policy Committee voted by a majority of 7-2 to keep rates unchanged as almost all economists had predicted.

Motorists have been warned to prepare for lengthy delays on the M25 this weekend, as a 10-mile stretch of the UK’s busiest motorway shuts over what is expected to be the warmest spell of the year so far. A section of the M25 will close in both directions between Junction 9 and Junction 10 from Friday evening until Monday morning to allow a new bridge to be installed.

What’s behind the drugs shortages, and what can be done?

Is it just Brexit? Experts have said leaving the EU has exacerbated problems, which could also get worse in the future as the UK is left out of EU measures. In April, Researchers at The Nuffield Trust urged the Government to carry out a review of the UK’s “broken” medicine supply chain after finding the impact of leaving the EU has worsened the issue in recent years. “In future it will pose the additional risk of being left out of EU measures to respond by shifting medicine between member states, buying products jointly, and trying to bring manufacturing back to Europe,” it said. (Read more on that here) Experts have also said that post-Brexit red tape is making it harder to get life-saving drugs into the UK when they are needed. Last year a report said there was “significant evidence” to indicate that Brexit is having a negative effect on medicine supply as well as staff shortages. The falling purchase of the pound since Brexit has also impacted the NHS’s ability to buy medicines from overseas. But Brexit isn’t the only factor. The war in Ukraine and manufacturing problems overseas have affected the drugs supply, including in other countries too. There are fears too that the Red Sea conflict has also impacted the supply chain. Responding to a report today showing the impact on pharmacies and patients, a Department of Health and Social Care spokesperson said: “Supply issues can arise for a wide range of reasons and are not specific to the UK.”

Which medicines are in short supply? Treatments for diabetes, ADHD and epilepsy are just some of the medicines that have been in short supply so far this year, according to Community Pharmacy England. Warnings late last year said those shortages could worsen even further this year due to supply issues and because of pharmacies closing. Diabetes patient Searleana Flesher told the PA News agency that because of the shortages, her once-a-day injection has been replaced with tablets, which leave her feeling sick. She accused celebrities taking similar medicines to treat people with diabetes, such as Ozempic, for misleading the public and causing shortages of vital medicine. Pharmacists have reported that more than a hundred medicines used in the UK are currently affected by shortages. Here, i takes a look at key medicines in short supply.

What can be done? Experts have called for a review of the medicine supply chain. One suggestion has been to allow pharmacists to make changes to medicines for patients without them needing a whole new prescription for a drug that is in short supply. William Pett, from Healthwatch England, said they are calling for a review “for pharmacy teams to be given flexibility, where it is safe to do so, to make changes to medicines they dispense in collaboration with patients.” Others have echoed this view. A London pharmacist, Reena Barai, recently told the Guardian: “I’m a pharmacist, I should be able to just swap a product that I know is equal in concentration and strength and drug. It’s just the formulation that’s slightly different. Why can’t I change it myself? Why do I have to go back to a doctor to get a prescription? It just seems silly.” She added a dedicated taskforce bringing together manufacturers, wholesalers, pharmacists and doctors could help address the problem.

The drugs shortages are happening despite the NHS spending hundreds of extra millions trying to mitigate the problem (Photo: Simon Dawson/Bloomberg via Getty Images)

Around the world

 Furious Israeli officials have accused Joe Biden of being on the side of Hamas in a widespread backlash after the president said the US would not supply arms for an invasion of Rafah in southern Gaza. Itamar Ben-Gvir, Israel’s national security minister from the far-right Jewish Power party, posted “Hamas loves Biden” using a heart emoji.

Israel has made it through to the Eurovision final after thousands of people in Malmo, Sweden, protested against singer Eden Golan’s participation in the song contest. At least 10,000 people, including Swedish climate activist Greta Thunberg, took part in the rally, which also called for a ceasefire in Gaza.

Florida police have publicly released body camera footage from a deputy sheriff who fatally shot a US Air Force member at his home. Senior Airman Roger Fortson, who was 23 years old, was taken to a hospital where he died, officials said.

Beach Boys founder Brian Wilson should be in a court conservatorship to manage his personal and medical decisions because of what his doctor calls a “major neurocognitive disorder”, a judge has decided.

Apple has apologised and admitted it “missed the mark” with its latest iPad Pro advertisement. The ad, posted on social media on Tuesday, was met with backlash from people who felt that the ad celebrated technology’s destruction of human creativity and art.

 Watch out for…

 Harry and Meghan, who begin a three-day visit to Nigeria, where they will take part in a range of engagements. 

 Thoughts for the day

 Labour has squandered its chance to become the party of ethical standards. The decision to welcome Natalie Elphicke on to the Labour benches drives a coach and horse through the party’s ethical strategy, argues Kate Maltby.

We’re all complicit in Piers Morgan’s Baby Reindeer interview. We’re calling for his head while surreptitiously reminding each other to tune in when the interview drops, says Emily Watkins.

I lost myself to motherhood – this is how I found my way back. I’d been a parent for more than six years by the time I realised that something of me was ebbing away, writes Hannah Fearn.

I’ve got some festival tickets for this summer – and the children are staying at home (Photo: zamrznutitonovi/ Getty Images)

Culture Break

 Loreen: ‘I’m against a Eurovision boycott – music is all we have in common’. 2023’s Eurovision winner is back – both at the contest and with a new single, writes Shaun Curran.

Loreen won the 2023 contest in Liverpool (Photo: Phil Noble/Reuters)

The Big Read

 The disturbing sex education that children are getting online. From pornographic Peppa Pig videos to a normalisation of sadomasochism – experts are increasingly concerned at the type of videos children are able to access, reports Emma Morgan.

There is concern about whether enough is being done to counter the misinformation children and teenagers are likely to see online about sex and relationships (Photo by Matt Cardy/Getty Images)

Sport

 Revealed: £30m of your tax money is spent on policing football matches. Tottenham’s games require higher levels of policing than any other club, with Champions League fixtures particularly resource-intensive, writes Sam Cunningham.

Football clubs are under pressure to contribute more to policing costs (Photo: Getty)

Something to brighten your day

 How to let go of a grudge and feel better. Letting go of a grudge can be tricky, but it is possible. Here, our experts explain how to move on and find peace.

It is possible to be free of a grudge (Photo: Klaus Vedfelt/Getty/ Digital Vision)