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BBC’s Panorama takes aim at ‘very dangerous’ online doctors

The CQC has called for a change in the law to crack down on service providers based abroad
The CQC has called for a change in the law to crack down on service providers based abroad

A BBC investigation has highlighted the ease with which vulnerable patients can obtain prescription-only medicines (POMs) from “very dangerous” websites.

The Panorama programme – which aired last night (August 6) – exposed a number of online prescribing sites which the BBC claimed are taking advantage of a regulatory loophole by using companies based outside of the UK to employ doctors.

Steve Field, chief inspector of general practice at healthcare regulator the Care Quality Commission (CQC), told the programme that websites not regulated by the CQC can be “very, very dangerous”.

However, the CQC currently has no jurisdiction over organisations registered outside England, and Mr Field called for a “change in the law” to crack down on “services that offer care into England but are based abroad – and the risks that this can pose”.

“It is never acceptable to put financial interests above patient safety, or to exploit legislation to avoid the scrutiny of regulation that exists to keep people safe,” he said.

“The Department of Health and Social Care is looking into this as a priority and we look forward to hearing their plan to strengthen the systems that offer better protection to people.”

Ordering co-codamol and orlistat

As part of the programme, two volunteers were tasked with obtaining POMs – co-codamol and slimming pill Xenical (orlistat) – which the BBC claimed their GPs would be “highly unlikely” to prescribe, from online doctor sites RXE Xpress and Express Doctor respectively.

The volunteers were both able to obtain the medicines and have them delivered to their homes by submitting false medical histories on the respective sites’ online forms.

One volunteer – who had formerly been addicted to painkillers – was able to obtain 200 tablets of 500mg co-codamol for €149 (£133.40) including delivery, while the other – a former anorexia sufferer – had three months’ worth of slimming pills sent to her home for the price of €315 (£281.95).

“Both women had to pay for the drugs via a company in Romania, before the online doctor had even checked their online questionnaires,” the BBC alleged. Neither company is registered with the CQC, it pointed out.

C+D has contacted both RXE Xpress and Express Doctor for comment.

UK Meds

Online pharmacy UK Meds came under fire in the programme after one former opiate addict was able to order 100 dihydrocodeine tablets for £49.95 plus delivery, while another ordered 56 capsules of 300mg pregabalin – a drug the BBC claimed is becoming “increasingly abused” – for £59.95.

Both volunteers gave false medical history and were allowed to select the medicines they wanted without any interaction with a healthcare professional, the BBC alleged.

“UK Meds cannot be regulated by the CQC because it hires doctors to do consultations and prescriptions through its sister company EU General Practitioners in Romania,” the broadcaster claimed.

In its response, UK Meds said it complies with all regulations from the Medicines and Healthcare products Regulatory Agency and General Pharmaceutical Council (GPhC), but “the company is not required to be registered by the CQC”.

“Patient care and safety is at the core of our business and we aim to maintain those values, review any elements that we feel need to be updated in accordance with industry guidelines and regulations and invest in areas that we feel can improve safety for the public,” it stressed.

The GPhC told C+D today (August 7) that it is considering “concerns” that have been raised with the regulator about the online pharmacy. Read the full story here.

Commenting ahead of the programme yesterday, GPhC chief executive Duncan Rudkin said the BBC had highlighted “some significant concerns that we share about potential risks for people obtaining medicines online”.

The GPhC is currently seeking views on its proposals to prevent online pharmacies from supplying certain medicine groups, such as opiates and asthma inhalers, unless safeguards are put in place.

The GPhC’s ‘discussion document’ can be viewed here, and you have until August 21 to share your thoughts on the proposals here.

In March, C+D spent a week exploring the world of online pharmacies. Read all the coverage here.

What did you make of the programme?

Locum Pharmacist, Locum pharmacist

UK Meds is owned by Mason Soiza, a 24-year-old alleged internet spammer who once registered an escort website, and his father, Joe.

Peter Sainsburys, Community pharmacist

Pharmacists are seen as an easy target. It makes it look like the regulator is working hard if many are sent to FtP.

Adam Hall, Community pharmacist

Patients lie all the time. If they lie to get hold of medicines (illegally?) should we then shed a tear if they suffer as a consequence of their deceit? Darwinism at work, if you ask me

Mark Boland, Pharmaceutical Adviser

Anorexia as a significant psychological component. The patient does not have a full sense of reality. To potentially supply Orlistat to such a patient is disgraceful. It is the manipulation of vunerable patient for profit and there is a significant risk of killing that patient. People with very severe mental illness are well known to seek out benzodiazpines and opiods in order to 'self-medicate'. They are often not in a position to 'take responsibilty'. I strongly support draconian prison sentences for people involved in this 'trade'.

I think the point they were trying to make is that the online doctors were prescribing for conditions you really need to see a patient face to face (especially if the patient is unknown to you). Would you prescribe 200 30/500 co-codamol tablets or pregabalin 300mg for the first time to a patient purely based on an online questionnaire?

You are right to an extent about patients taking responsibility for their actions, but the examples shown in the programme demonstrate dangerous prescribing in my view. 

Adam Hall, Community pharmacist

I agree - Prescribers need to be held accountable as well.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Very kind of Panorama to highlight this service for vulnerable patients who might not otherwise be able to access the medicines they so desperately need......

In all seriousness though, now EVERYONE is aware of how easy it is to get meds. Excellent publicity for these sites I'd say.

paul lisbon, GP

The guy at the pub was funny! but on a serious note, not sure I agree with making patients place false orders providing false information, the girl who suffered from anorexia admitted she lied on the questionnaire, so then what do we expect? however it is confusing how easy it is to get round CQC. 

A.S. Singh, Community pharmacist

And therein lies the problem. He probably knows very well that no one can touch him, not the MHRA, CQC, the police, the GMC especially being struck off. 

Hopefully these loopholes will be closed very soon but I highly doubt it. Funny how Pharmacists are so highly regulated some  can't take a bathroom break without notifying the GPhC but these guys bypass it so easily.

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