This week, NHS England chief executive Simon Stevens declared that the NHS will no longer fund some common treatments available over the counter. At face value, this will save the NHS £128 million.

Some will applaud this as a common-sense approach towards NHS cost containment, but my belief is that this is a piece of Trump-style populism which characterises people on low incomes as “spongers” – to quote Piers Morgan on Good Morning Britain on Tuesday.

Most pharmacists would agree that the list of items available on an NHS prescription should be rationalised, but it is derogatory to degrade this argument to digestive biscuits. There are single-parent families who cannot afford to pay £2 every few days for a loaf of bread, and it is these people we need to be concerned for.

Where is the safety net?

To put this in perspective, the NHS spend on management consultants for its latest reorganisation alone – sustainability and transformation plans – is now at more than £17m; nearly enough to pay for the gluten-free bill for a whole year. Most NHS policy-makers are from a hospital background, and they simply fail to understand the way that primary care, or patients, work.

As a frontline pharmacist, I have seen patient behaviour replicated thousands of times over a 14-year career. Telling people on low incomes (and I include many wealthy retired people in this category) that they must buy their medicines, will not lead to the change in behaviours which the bean counters expect.

Although paracetamol seems to escape the official list, the newspapers suggest that it is absolutely in scope, and nobody would be surprised if it were. I fear that this policy could push people into using stronger (free) painkillers than are necessary, leading to a generation of poorer people hooked on opiates. The poorest in society will face the choice of living in pain, or being forced to choose between eating and painkillers. This will only increase health inequalities.

All levels of the NHS have a legal duty to reduce inequalities – it is the basis for the National Pharmacy Association’s (NPA) legal challenge of the pharmacy funding cuts. But unfortunately the prescription proposals would not be the first effort from NHS managers to breach their legal powers.

The decision to scrap certain medications and services on prescription is only the latest example of ivory-tower thinking from Simon Stevens and co.

Mike Hewitson is a Dorset contractor, and a board member of both the NPA and Pharmaceutical Services Negotiating Committee