Yesterday’s Telegraph front page gave a brilliant insight into the reality of life in the NHS at a pivotal point in its history. The NHS in St Helens in Merseyside has announced that it is spending too much and will have to cut back. It is proposing to save £1.1 million per year by stopping free prescriptions for paracetamol, cold remedies and gluten free foods except where absolutely medically necessary. More seriously, it aims to save £2.5 million by stopping sending non-urgent patients to hospital for four months later this year.

The St Helens NHS deserves a great deal of praise for being honest with the public. Healthcare costs money and tough decisions will always have to be made. It is brave and right to limit free prescriptions for medicines such as paracetamol which are also available over the counter. GPs are already expected to ask people to pay for these medicines where they can. The St Helens proposal will strengthen the hand of GPs when they need to have what can be difficult conversations. Even this simple measure could save £300 million a year if applied across the whole NHS.