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Coroner calls for greater safeguards around online prescribing

Woman died after obtaining opiates after a consultation with doctors in Romania

Mark Gould

Thursday, 12 December 2019

A coroner has warned of the dangers of obtaining medications online following the death of a Suffolk woman who obtained opiate painkillers via an online consultation with doctors in Romania.

The coroner, Nigel Parsley, has written to Health Secretary Matt Hancock highlighting the case of Debbie Headspeath, 41, from Ipswich, who died from lung problems triggered by damage to her pancreas which had been caused by the large amounts of codeine she had been taking.

Mr Parsley has  also written to the Department of Health asking for urgent action to be taken to fix the “regulatory gaps” that allowed the tragic events to happen.

His report highlighted particular areas of concern:

  • There is no single database that allows a prescribing clinician to identify what has already been prescribed to a patient. For opiate drugs, such as codeine, there is no analysis of how many drugs are being prescribed outside of the NHS
  • Some online companies change their business model to avoid regulation by the health watchdog the Care Quality Commission (CQC) such as moving their headquarters outside of England, so the doctor's services could not be regulated
  • The General Pharmaceutical Council issued new guidance in April 2019 about online pharmacies, saying for high-risk medication such as opiates, a check had to be done by the pharmacies with the patient's family doctor, prior to medication being prescribed and dispensed. The coroner heard evidence which questioned if this was only advisory rather than compulsory.

Ms Headspeath got the medication, dispensed by UK pharmacies, after website consultations. But her own GP was unaware of what she had requested from doctors on the internet. The inquest heard how her GP originally started prescribing opiate painkillers for back pain in 2008 but over time wanted to wean her off. However Ms Headspeath was able to buy more medication, prescribed by doctors she accessed on UK online pharmacy websites, as well as getting some of the medication from her GP.

Ms Headspeath’s mother, Elaine Gardiner, said she had found bank statements showing that her daughter had spent more than £10,000 on online pharmacies and had taken out pay day loans to cover the costs. Mrs Gardiner said she decided to investigate her daughter's death, and wrote to the online providers.

"I was horrified such a thing could happen. I never thought for a minute that you could go online and just order an opiate drug and be given it just like that, without the doctor knowing anything about you, anything about your medical history or having met you," she told the BBC's Today Programme.

The General Pharmaceutical Council - the independent regulator for pharmacies - said it was responding to the coroner's report and would continue to take necessary action to make sure medicines are always supplied safely online.

Tim Ballard, from the CQC, told the inquest that since they started their round of inspection of providers of online doctors' services in 2017, many companies had moved abroad, typically to Romania, which meant their care could not be regulated.

The inquest heard that the Coroner's Office had written to several doctors employed by Romanian companies who had prescribed to Ms Headspeath via the UK online pharmacy websites. All the letters came back as 'return to sender'.

The Department of Health said they could not comment during an election period and it would be for the next Government to respond.

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