HC Deb 19 November 1956 vol 560 cc1349-54
1. Mr. Lewis

asked the Minister of Health if he will make a further statement on his proposal to increase the charges for National Health prescriptions in view of the Government's policy of keeping prices and the cost of living steady.

The Minister of Health (Mr. R. H. Turton)

At present each person on a doctor's list pays on an average about 3¼d. per month for prescriptions; under the proposed alteration the figure will be about 5½d. per month.

Mr. Lewis

Is it not immoral of the Government to give tax reliefs to the Surtax-payer and the wealthy and to introduce a graduated tax upon the sick? Is it not a fact that the person who is sick the most and the longest will pay the biggest tax? Is that the way the Government are going to do business in the future?

Mr. Turton

That is not a fair deduction. The system will be very similar to that of the prescription charge as first announced in 1949. There is no great difference between them.

Sir F. Messer

It was limited to two years.

Mr. Fort

Will my right hon. Friend say whether there is any difference in principle between his proposal and that of the Labour Government?

Mr. Turton

There is no difference at all. We are doing it per item, and they did it per form.

14. Captain Pilkington

asked the Minister of Health whether, when the new method of charging for prescriptions is introduced, exceptions can be made for certain illnesses which necessitate continued prescribing for several items over a long period.

Mr. Turton

No, Sir, but doctors will no doubt use their discretion about prescribing larger quantities in suitable cases; moreover, 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.

Captain Pilkington

Is my right hon. Friend satisfied that the first part of his Answer will mean that those who are likely to suffer more than others under this arrangement will be safeguarded?

Mr. Turton

Yes, that is the purpose of it.

Mr. J. Griffiths

Is the Minister aware that there is growing evidence which all hon. Members on both sides of the House are having brought home to them—I had it in my constituency this week—that not only will these new regulations cause hardship, but that most people I have spoken to about them say they will be completely impracticable and will, in many ways, retard their good work? Is he aware that there is a universal desire that he should reconsider the regulations?

Mr. Turton

There is no evidence that the new regulations will be difficult to work. What will not be possible will be to make what are called "shopping lists", which, though comparatively rare, are a material factor.

Dr. Summerskill

Has the Minister estimated what the cost of administration will be for these new regulations and how that will be related to the extra revenue which will accrue?

Mr. Turton

If the right hon. Lady puts down a Question on that, I will do my best to answer it.

Mr. J. Hynd

When the right hon. Gentleman said that the House would be aware that applicants for National Assistance would be entitled to a refund, did he mean that he has gone back on his previous statement that there would be an extension of that provision to others?

Mr. Turton

There are some Questions to be answered later on the National Assistance provision and, perhaps, the hon. Member will await the Answers to them.

15. Mrs. L. Jeger

asked the Minister of Health if he will arrange for colostomy patients to receive the four items permanently essential to their hygiene as one prescription for the purpose of payment under the new scheme.

Mr. Turton

Colostomy belts are supplied initially by the hospital where the patient has been treated. Replacements of the whole belt or parts thereof may be prescribed by a general practitioner and supplied through a chemist. Any number of parts prescribed at one time will count as one item only for charge.

Mrs. Jeger

Is the Minister aware that he has completely missed the point of the Question, which is that people suffering from this degree of hardship constantly need cotton wool, cellulose wadding, gauze and vaseline? Is he aware that it is not in their interest, nor in the interest of the community, that they should be forced to economise in anyway on these items? Does he realise that this will mean a 4s. payment every time these people have to buy those urgent necessities?

Mr. Turton

That is the type of case which will be dealt with in the way I suggested in an earlier reply. Where someone is chronically ill and periodically requires those four items it will be open to the prescribing doctor, if he thinks fit, to prescribe for a long period in advance.

Mrs. Jeger

Is not the right hon. Gentleman aware that doctors already prescribe for cases of this kind over a long period and that that does not alter the fact that prescription charges will be multiplied by four? Can he not do that piece of arithmetic?

Mr. Turton

In that case, the hardship will be spread over a very long period of three months.

16. Mrs. L. Jeger

asked the Minister of Health if he will arrange for distilled water, which is prescribed for use for injections of penicillin crystals or similar substances, to be regarded as part of the main prescription and not separately charged for.

Mr. Turton

Yes, Sir. Only one charge will be payable in these circumstances.

17. Mrs. L. Jeger

asked the Minister of Health what representations he has received from the British Medical Association about the proposed changes in prescription charges.

Mr. Turton

I have received representations against any prescription charges from the General Medical Services Committee and from the Chairman of Council of the Association.

Mrs. Jeger

Is the right hon. Gentleman not going to take any cognisance of those representations? Is he to ignore completely the views of the British Medical Association and other professional bodies in this matter?

Mr. Turton

Certainly I am going to take full cognisance of ail representations. The representative of the Association emphasised that the Association was opposed to prescription charges. He represented that the proposed method of extending the charges would result in hardship and asked for a reconsideration of the proposals of the Government. What the British Medical Association is opposed to is any prescription charge.

Dr. Summerskill

Can the right hon. Gentleman say why on a matter of this kind he did not consult the organisations which represent the doctors, which I think he will agree are in a position to advise him on this matter?

Mr. Turton

On a question of charges—which is, as it were, a Budget question—they have never been consulted before a decision of the Government has been made—never in previous history.

Viscount Hinchingbrooke

Is my right hon. Friend aware that a large section of opinion in this House and in the country thinks he is making a correct and necessary attempt to save waste in public expenditure?

Mr. Turton

In 1949, when the Socialist Government first introduced this charge, the drug bill was £30 million and the average cost per form was 4s. 6d. Today, I regret to say, I estimate the gross cost of drugs at twice that amount, and the average cost per form is 8s. 9d.

Mr. Marquand

May I ask the right hon. Gentleman to correct his statement that the Socialist Government introduced the prescription charge? Those were his words.

Mr. Turton

I said when they first introduced it. [HON. MEMBERS: "No."] It was introduced with the power in the Act—

Mr. Marquand

No.

Mr. Turton

I beg pardon; when powers were taken by the Socialist Government—and justified—to introduce a prescription charge.

30. Mr. Hastings

asked the Minister of Health whether he will arrange that old-age and other pensioners, when making payment for their medicines, may, on presentation of their pension books, receive a receipt for the sum paid, which they can present to the National Assistance Board so that the charge may be refunded if their circumstances are found to warrant this.

Mr. Turton

Receipts are already issued on request for this purpose under existing arrangements. The Postmaster-General and the Minister of Labour and National Service are making arrangements under which, from 1st December next, refunds will be made, on request, to anyone receiving National Assistance on any day and not necessarily the day on which the assistance is paid.

Mr. Hastings

What about old-age pensioners who are not receiving National Assistance and who can just manage on their pensions in ordinary circumstances but who, when they receive a bill for three or four shillings extra, find themselves in real difficulty? Ought not something to be done for such people so that, without loss of face and real difficulty, they can get that money back?

Mr. Turton

A new leaflet explaining the refund arrangements and including the form of application for persons not receiving National Assistance, which would be suitable for old-age pensioners whom the hon. Member has in mind and for others, is being supplied to chemists and dispensing doctors to be given to all persons who inquire.

Dr. Summerskill

That will involve a great deal of clerical work. Has the Minister estimated what the cost will be?

Mr. Turton

I thought that the right hon. Lady was putting down a Question about administrative expenses.

Dr. Summerskill

The Minister will recall that, when I put this question to him earlier, he said that there was a later Question dealing with the point, and I thought that this was it.

Mr. Turton

That is not very fair. The right hon. Lady asked me what the financial and administrative costs were, and I said that if she would put down a Question I would do my best to answer it.

Mr. J. Griffiths

Will not the hardship caused by these regulations and the general interference with the work of doctors be infinitely greater than the trivial saving which the Minister will make? Will he not reconsider the matter?

Mr. Turton

I very much hope not, but it is most important that I should do all I can to remove all sources of hardship.