The NHS is being “ripped off” by drug manufacturers and pharmaceutical firms who are charging as much as £1,000 a bottle for pain-relieving mouthwash while the government demands efficiency savings on staff and hospitals, ministers have been warned.

More than £230m a year is wasted because of hundred-fold price increases on out-of-patent medications and custom mixtures made with much cheaper ingredients, Scottish National Party MP Dr Philippa Whitford said in questions to the government’s health ministers.

The former NHS breast cancer surgeon asked what it was doing about cases like mouthwash used for relieving mouth ulcer pain in chemotherapy patients being sold at ridiculous mark-ups.

After nearly a decade of austerity and pay restraint has been officially declared over, ministers are still demanding trusts meet increasingly unachievable spending and performance targets.

The Central Ayrshire MP said: “NHS England is being ripped off to the tune of £230 million a year as the price of some off-patent drugs and non-standard preparations, or specials, have been hiked up hundreds of times, for example to over £1,000 for a bottle of pain-relieving mouthwash.

“In Scotland, specials remain in-house to keep the price down, but a year and a half on from the Health Service Medical Supplies (Costs) Act 2017, why have the Government not used its powers to stop this drug racketeering?”

Specials are typically special ointments or creams made up by big manufacturers for a particular trust or patient group.

The decentralised way that hospitals and NHS groups in England buy these medicines adds an “estimated £5bn to £10bn to NHS costs”, Dr Whitford said.

She added that it also accounted for 2.5 million nursing hours a week “being wasted on non-clinical paperwork,” making it the biggest inefficiency in the English NHS.

NHS at 70: demonstration and celebration march to mark anniversary Show all 18 1 /18 NHS at 70: demonstration and celebration march to mark anniversary NHS at 70: demonstration and celebration march to mark anniversary People holding placards attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary Labour Party leader, Jeremy Corbyn, addresses demonstrators following the march AFP/Getty NHS at 70: demonstration and celebration march to mark anniversary A man stands with a coffin, used as a prop at a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary epa06851663 Thousands of people march, to mark 70 years of the British National Health Service (NHS), in central London, Britain, 30 June 2018. Reports state that the gathering is calling on the government for increased funding and staffing for the NHS, as well as a protest against privatisation of an organisation which turns 70 years old on 05 July 2018. EPA/ANDY RAIN ANDY RAIN EPA NHS at 70: demonstration and celebration march to mark anniversary People holding placards attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary A man wears an NHS themed hat during a march in support of the National Health Service, in central London, Britain, June 30, 2018. REUTERS/Simon Dawson SIMON DAWSON Reuters NHS at 70: demonstration and celebration march to mark anniversary Demonstrators hold placards during a march in support of the National Health Service, in central London, Britain, June 30, 2018. REUTERS/Simon Dawson SIMON DAWSON REUTERS NHS at 70: demonstration and celebration march to mark anniversary epa06851662 A man with a birthday placard as thousands of people march, to mark 70 years of the British National Health Service (NHS), in central London, Britain, 30 June 2018. Reports state that the gathering is calling on the government for increased funding and staffing for the NHS, as well as a protest against privatisation of an organisation which turns 70 years old on 05 July 2018. EPA/ANDY RAIN ANDY RAIN EPA NHS at 70: demonstration and celebration march to mark anniversary Demonstrators stand in Whitehall during a march in support of the National Health Service, in central London, Britain, June 30, 2018. REUTERS/Simon Dawson SIMON DAWSON REUTERS NHS at 70: demonstration and celebration march to mark anniversary People march in central London to mark the 70th anniversary of the NHS. PRESS ASSOCIATION Photo. Picture date: Saturday June 30, 2018. See PA story INDUSTRY Demonstration. Photo credit should read: John Stillwell/PA Wire John Stillwell PA NHS at 70: demonstration and celebration march to mark anniversary Demonstrators hold placards during of a march in support of the National Health Service, in central London, Britain, June 30, 2018. REUTERS/Simon Dawson SIMON DAWSON REUTERS NHS at 70: demonstration and celebration march to mark anniversary People holding placards attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary Demonstrators hold placards during a march in support of the National Health Service, in central London, Britain, June 30, 2018. REUTERS/Simon Dawson SIMON DAWSON REUTERS NHS at 70: demonstration and celebration march to mark anniversary Jeremy Corbyn and Jon Ashworth speak during a march in central London, marking the 70th anniversary of the NHS. PRESS ASSOCIATION Photo. Picture date: Saturday June 30, 2018. See PA story INDUSTRY Demonstration. Photo credit should read: John Stillwell/PA Wire John Stillwell PA NHS at 70: demonstration and celebration march to mark anniversary People holding placards attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary People holding placards attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary People gather with placards to attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary People gather with placards to attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images

Her comments came after a report earlier this year by the National Audit Office, found that the government's failure to act on unreasonable price increases for generic medicines had cost the NHS more than £300m last year.

In response to calls to reverse this market, Stephen Barclay, the health minister in charge of NHS efficiency said: “We are looking at this area. As we commit an extra £20 billion in funding to the NHS, our commitment is to ensure that we derive value for money from that investment. That applies to specials, too."