Mark Drakeford asked to intervene after abrupt withdrawal of skin complaint medication

Martin Shipton

Health Secretary Mark Drakeford has been asked to intervene after a patient who suffers with a serious skin complaint was told he would no longer be prescribed the emollient he has used for many years.

In a letter to Mr Drakeford, who has temporarily returned to government at the invitation of First Minister Eluned Morgan, Ethan Jones, of Gwaun Cae Gurwen, Neath Port Talbot, wrote: “It has come to my attention after my brother visited Singleton Hospital [in Swansea] that the medication for his skin condition, Palmoplantar Keratoderma, will no longer be provided by the NHS.

“Upon questioning why, my brother was told that it was due to a letter that was sent by the Welsh Government. The doctor then proceeded to show the letter to my brother as proof. Within this letter, it was explained that this decision was made to cut costs. There has been no alternative medication provided or offered by the NHS. The letter stated that all emollients, including Oilatum (my brother’s medication) would no longer be offered by the NHS. My brother cannot use conventional soap or body wash as they are corrosive to his skin.

“My brother has severe mental health issues which have stemmed from bullying when he was a child. The majority of the bullying was as a result of his skin condition. So much so that around 10 years ago, at the young age of 17, he suffered a mental breakdown and is still receiving treatment for the trauma he suffered as a child. “Palmoplantar Keratoderma has been the focal point in which my brother bases his life around.

“He does not go anywhere away from the house without wearing gloves which cover his palms. My brother even wore gloves to his own wedding because of the anxiety he faces. This skin condition has ruled over his life for nearly three decades and to find out that the government – those who are supposed to act in the best interests of the people who elected them – have placed cutting costs above my brother’s health, is appalling. To put it mildly, I find it absolutely disgusting that the government of my country can brazenly disregard the health needs of its people without so much as a warning.

“I am not only speaking on behalf of my brother, but for the hundreds of people who suffer from this condition, and the thousands more that this government has let down in its ruthless pursuit of ‘cutting costs’. It is absolutely shameful that this is what my country has resorted to despite the unbelievable waste such as the 20mph speed limit signs. It is these decisions that make me question the viability of life not only in Wales, but in the UK as a whole.

“This decision to discontinue emollients will be devastating for so many people who rely on their medicinal benefits, yet it seems the government is more interested in money than the people they serve.”

Limiting

A Welsh Government spokesperson responded: “Health boards may be limiting the prescribing of bath and shower emollients where there is no evidence of clinical benefit as supported by recommendations from organisations such as National Institute for Health and Care Excellence (NICE).

“Clinicians should discuss any changes to their management plan with patients.”

Advice from NICE issued in July 2024 does not rule out prescribing Oilatum, but states: “There are a large number of emollients available in the UK, including creams, ointments, gels, lotions, sprays, washes, and bath and shower additives, available as non-proprietary and/or proprietary products.

“Most emollient products are plain (containing no active ingredients).”

NICE goes on to list emollients that include active ingredients, including Oilatum Plus bath additive, which is classified as an antiseptic.

Skin reactions

The advice states: “Emollients containing active ingredients are not generally recommended because they increase the risk of skin reactions. However, they may be useful in some people … Antiseptics (for example benzalkonium chloride) have a limited role in protecting skin which is prone to infection.

“ … Emollients are typically under-prescribed and under-used. This results in suboptimal treatment of dry skin and eczema, and may increase the occurrence of flares.

“Once the preferred choice of emollient is known, encourage appropriate usage by prescribing generous amounts (for example 500 g) to be used regularly (often four times daily).

“Where possible, pump-dispensers should be prescribed when large quantities of cream or lotion are required. This is because they are more convenient than other containers and are less likely to become contaminated by potential pathogens.

“The amount of emollient used should far exceed other topical treatments (for example corticosteroids) by a factor of at least 10.”