HC Deb 05 November 1956 vol 558 cc1936-9
29. Mr. Shurmer

asked the Minister of Health by what means people who cannot afford to pay 1s. for each prescription but are not in receipt of National Assistance will be able to apply for reimbursement.

The Parliamentary Secretary to the Ministry of Health (Miss Patricia Hornsby-Smith)

I would refer the hon. Member to the reply given to the hon. Members for Tynemouth (Dame Irene Ward) and Attercliffe (Mr. J. Hynd) on 1st November.

Mr. Shurmer

Does the hon. Lady realise that there are many thousands of people whose income is just a little above the scale of the National Assistance Board and that today 1s. is quite a lot to them, and when they have to pay 3s. or 4s. more some of them will not be able to afford these prescriptions and it will be a difficult job for those visiting these people to find out what their income is? Therefore, the whole scheme is utterly impossible, and is not the best course to ask her to ask her right hon. Friend to abolish this and go back to the old 1s. charge for the whole of the prescription?

Miss Hornsby-Smith

The National Assistance Board has already, under the present system, dealt with cases like this, and if an applicant for assistance to the National Assistance Board satisfies the Board's test of hardship in respect of any portion of the payment which he will be required to make, he will be reimbursed the whole payment; so that the person faced with a charge of 5s. for prescriptions who, in the normal case, could establish a case for 2s. reimbursement, will be met on the whole 5s.

Dr. Summerskill

In spite of the hon. Lady's explanation, can she reconcile it with the answer which the Chancellor of the Exchequer gave to me on the subject on the day when he made his statement. He then said : … all persons in receipt of National Assistance and all old-age pensioners and others who cannot meet the charges without hardship … will be entitled to be reimbursed. What my hon. Friend wants to know and what I want to know is, will she define hardship in this context?

Miss Hornsby-Smith

Hardship is the standard that has been accepted by this House and is that carried out and laid down by the National Assistance Board.

Dame Irene Ward

Can my hon. Friend make it quite clear, because this is of the very greatest importance, whether people living on small fixed incomes who are slightly above the qualifications for National Assistance as laid down today will be reimbursed in accordance with the Chancellor's statement? We must know the answer.

Miss Hornsby-Smith

If the payment for prescriptions brings a case which hitherto has not come within the National Assistance hardship scale above that scale, the person concerned has a perfect right to apply and will be reimbursed by the National Assistance Board.

Dr. Siunmerskill

I apologise for pressing this point, but it is of great importance to the whole country. Will the hon. Lady read the answer of the Chancellor of the Exchequer, in which he makes it clear that he is not only referring to people who qualify under National Assistance, but he said to me— and others who cannot meet the charges without hardship."—[OFFICIAL REPORT, 25th October, 1956; Vol. 558, c. 834.] These "others" are such as those referred to by the hon. Lady for Tyne-mouth (Dame Irene Ward) who will not qualify within the terms of the National Assistance Board.

Miss Hornsby-Smith

The right hon. Lady is aware that there has been always one basis of hardship scale, and it may be that people who are just on the border while they are well and have not hitherto been allowable for a grant from the National Assistance Board will find it an additional hardship to pay the prescription charge, and in that event they will come within the National Assistance scale.

38. Mr. Swinger

asked the Minister of Health if he will exempt diabetic persons from the proposed increase in charges for prescriptions.

Miss Hornsby-Smith

No, Sir. But any person who, on application to the National Assistance Board, shows that he will suffer financial hardship in accordance with the Board's standards will be able to obtain a refund.

Mr. Swingler

Was not the National Health Service introduced to relieve the hardship of the worst sufferers, and is not it a fact that diabetic persons frequently have to get several items on prescriptions? Is the hon. Lady really saying that every time they must trail down to the National Assistance Board in order to have their incomes examined?

Miss Hornsby-Smith

In most cases, diabetics have comparatively long-term prescriptions which cover, from our knowledge of prescriptions, at least a month. In stable cases where the doctor is satisfied that those concerned are responsible persons, they may even get as much as two or three months' supply on one prescription.

Dr. Summerskill

Could not the hon. Lady ask her right hon. Friend whether he would make a statement which would relieve the anxiety of those chronic patients whose expectation of life is limited to the effect that they at least will be exempt from these extra charges?

Miss Hornsby-Smith

I cannot give the right hon. Lady any such undertaking, but I will pass her views to my right hon. Friend.

43. Mr. H. A. Price

asked the Minister of Health what is the normal period covered by a prescription for a diabetic patient.

Miss Hornsby-Smith

This is a matter which depends upon the doctor's decision in the circumstances of a particular case.

Mr. Price

Will the hon. Lady have special regard to the difficulties of diabetics and other chronic sick? Do their prescriptions normally cover long periods? What is the period? Is there a limit to the period and who sets that limit?

Miss Hornsby-Smith

The length of the prescription is entirely a matter for the medical practitioner, but the Ministry is advised that there would be no practical obstacle in the way of prescribing up to three months' supply of insulin to a co-operative patient whose treatment was stabilised.

44. Mr. H. A. Price

asked the Minister of Health what arrangements exist for the issue of composite packs to the chronic sick.

Miss Hornsby-Smith

Certain composite packs are already listed in the Drug Tariff and my right hon. Friend has informed the British Medical Association that, if the medical profession consider that further composite packs for any particular condition are desirable and would be generally prescribed, he will consider, with the manufacturers, whether appropriate dispensing packs could be produced.

Mr. Price

Is the hon. Lady aware that her Answer will cause comfort to many people, and does not that reply and the Answer to Question No. 43 answer most of those who are anxious about hardship cases?

Mrs. L. Jeger

While the chronic sick are waiting for these arrangements to be made with the manufacturers, could not the hon. Lady arrange with her right hon. Friend that certain items which form a composite treatment could be treated as one prescription even under the new arrangements?

Miss Hornsby-Smith

This is not a new idea. For certain ailments it is already the practice. For example, the vaporiser set covers several items for bronchitics. Another group of items covers diabetics, and there is a dressing set of five items which are in one pack and which has been in use for a long time.

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