HC Deb 28 January 1957 vol 563 cc658-63
22. Mr. Blenkinsop

asked the Minister of Health what arrangements he has made to overcome the hardship caused to diabetics and to others suffering from chronic illness by the existing prescription charges.

Mr. Vosper

It is open to the doctor to prescribe in quantities sufficient to last a reasonable time according to his assessment of medical need. Anyone who, on paying the ensuing charges, shows that he will suffer financial hardship in accordance with the National Assistance Board's standards can obtain a refund.

Mr. Blenkinsop

The right hon. Gentleman has given a formal Answer, but is he aware that we are hoping, now that we are glad to see a new face at the Ministry, that he is taking a different view of the matter? Does he realise that very great hardship is imposed in many cases where application cannot be made to the Assistance Board, and that there is great anxiety whether individual cases will get the amount of treatment they ought to have?

Mr. Vosper

I am aware of the arguments about the chronic sick. My predecessor took certain measures to relieve their problems. At the moment, I am not convinced that there are individual cases of hardship which need further action.

Air Commodore Harvey

Will my right hon. Friend say what he considers to be a reasonable period? Would he be a little more explicit and say three or four months, which is generally thought to be a reasonable period?

Mr. Vosper

I had in mind a period of three months.

28. Mr. Dye

asked the Minister of Health what reply he has sent to the Norfolk Executive Council in reply to their resolution expressing disapproval of the increase in charges on doctors' prescription forms from 1s. a form to 1s. an item.

Mr. Vosper

I am informing the Executive Council that the Government decided that the revised charges were necessary because of the present financial and economic situation, but that every effort is being and will be made to avoid hardship, and the working of the new arrangements will be closely watched with this in view.

Mr. Dye

In view of the fact that those who are responsible for the administration of the Health Service seem to feel that this new imposition is against the well-being of the service to the people, will not the Minister see whether he can find other ways and means of economy in prescriptions, if that is necessary, particularly in the prescribing of drugs?

Mr. Vosper

I have already said that I will watch the situation and review any individual case of hardship, but at the moment I am not convinced that there is any need to adopt a new approach.

33. Mr. S. O. Davies

asked the Minister of Health if he is aware that doctors are now being urged by many of their patients to strike off prescription items because the latter cannot pay the extra charge of 1s. per item, with the result that chemists in industrial areas have reported a slump of up to 60 per cent. in prescriptions since 1st December; and if he will therefore amend the new system so as to mitigate this hardship.

Mr. Vosper

The information at present before me does not confirm the statements made, and I see no reason to alter the basis on which prescription charges are now payable.

Mr. Davies

Would the right hon. Gentleman be frank with the House? Since he has received thousands of protests about the increased prescription charges, will he tell us whether he is determined to resist dealing with this awful scandal amongst the sick and poor of this country, whatever the consequences?

Mr. Vosper

I have already said that, from the advice which I have received, both officially and in a private capacity, I do not believe there are thousands of cases of real hardship; but I am prepared to examine any individual case which may be brought to me.

Dame Irene Ward

In view of the very satisfactory assurances which the Minister has given, may I ask my right hon. Friend this question: if anybody who is outside the scope of the National Assistance Board can produce proof of hardship, has my right hon. Friend powers so to alter the Regulations that that particular case of hardship can be dealt with? Is my right hon. Friend aware that if he can satisfy us on that point, there will be many very pleased people in this country and in the House?

Mr. Vosper

I should love to please my hon. Friend, but this is a rather hypothetical question. I ought to see the case itself.

40. Mr. Awbery

asked the Minister of Health if he is aware that many chronic sick, cancer patients, diabetics, those suffering from ulcers, and others with long-standing complaints are not receiving the treatment they need and which was intended by the National Health Act, 1948; that chemists are reporting a reduction of 50 per cent. in the prescriptions since the new charges were made on 1st December; how many doctors' and chemists' professional organisations have reported these facts to him; and what steps are being taken to assist these people.

Mr. Vosper

I have no evidence from professional organisations or elsewhere that patients are not receiving the treatment they need, or that there has been such a reduction in prescriptions dispensed. Where medicines are regularly needed, it is within a doctor's discretion to prescribe reasonable quantities. The National Assistance Board will refund the charges, on application, to persons who cannot pay them without hardship, on the Board's standards.

Mr. Awbery

From the Questions which have been put to him this afternoon, and the number of people who have drawn the attention of their Members to these cases, is not the Minister satisfied that there is hardship among these people; that they are failing to go to the doctors because they have not the money to pay for the prescriptions, and will he take steps to see that the medical need of the patients, and not their pockets, is the criterion?

Mr. Vosper

I do not think I can add anything to my original replies, when I said that at present I have little evidence to indicate cases of hardship.

Mr. Gower

Will my right hon. Friend give an assurance that he will pay particular attention to the position of diabetics and those in similar categories who, although not on the National Assistance scale, may find it difficult regularly to pay the charges for numbers of drugs; and can he say whether he has had any report about these classes so far?

Mr. Vosper

The next Question on the Order Paper relates to diabetics.

Mr. Blenkinsop

Does not the Minister realise also the great danger of prescribing too large quantities of drugs?

Mr. Vosper

Yes, I am aware of that.

41. Mr. Awbery

asked the Minister of Health if he is aware that diabetic patients have now to pay in some cases five times as much for a prescription as formerly; that some of these are old-age pensioners or people with a small fixed income, unable to meet the extra charges and who consequently reduce the number of their visits to the doctor below those essential for effective treatment; and if he will now take steps to abolish such charges.

Mr. Vosper

I am aware that in some cases items prescribed for a diabetic may involve charges of several shillings, but it is open to the doctor to prescribe quantities sufficient to last for a considerable period. Persons who cannot pay the charges without hardship in accordance with the standards laid down by the National Assistance Board can obtain refund from the Board. I have no evidence that patients are being deprived of effective treatment. I see no reason to abolish the charges, the need for which has been explained to the House.

Mr. Awbery

Is the Minister aware that, among the cases which have been brought to my attention, is that of a lady who previously got all she needed on one prescription at the old price and now has to pay 5s. for the same prescription because of the number of items it contains? Is he aware that the National Health Service Act was made for the sick and not the sick for the National Health Service Act? Will he take steps, in future, not to vivisect this Act so that he can find places where he can charge these poor people more than they ought to pay?

Mr. Vosper

With regard to the first part of the hon. Member's Question, the annual charge for stabilised diabetics should be in the neighbourhood of from 17s. to 27s., which is an increase, but not a very large one, over the previous charge.

Mr. John Hynd

Will the right hon. Gentleman make clear to the House whether or not it is in his power to consider such cases of hardship which are not covered by the existing standards of the National Assistance Board? We have had several Answers today suggesting, in some cases, that he has such powers and in others that he has not—as in his last Answer. In other cases, he has said that the Question was hypothetical.

Mr. Vosper

What I had in mind was that my predecessor said that certain arrangements, such as prescribing for longer periods and in packs, would receive consideration. This is being done, but I cannot go further than that until I have further evidence.

Dr. Summerskill

As the Minister has devoted himself to the question of diabetics, will he reconsider this one case, for this reason? A diabetic has to have two kinds of insulin, needles, spirit and cotton wool. If the right hon. Gentleman grants an exception in this case, he will be helping a section of the public who have a very miserable life, apart altogether from the economic factors.

Mr. Vosper

I think it has been possible to provide one small pack for diabetics, but I cannot hold out much hope of going beyond that.

47. Dr. Stross

asked the Minister of Health whether the prescription charge must be repeated for each prescription where the medicine prescribed is for internal medication and will not keep for more than a few days, but prolonged treatment is necessary.

Mr. Vosper

I am not aware what medicine the hon. Member has in mind for use in the circumstances mentioned, but I will look into the matter if he will give me details. In general, a charge is payable for each repeated supply of medicine, except for certain specified preparations ordered for immediate and continuous treatment, which, owing to their pharmaceutical nature, need to be freshly prepared and supplied in separate containers on successive days.

Dr. Stross

May I thank the Minister for that reply and assure him that I will gladly send him specific examples? May I ask him this? Is he not aware that many medical men when prescribing for inoperable cancer cases use prescriptions such as mixtures of opium and aspirin, and that these keep for only a few days and must be made up afresh? Is it not unfair that such sufferers should be worse off than the class of people to whom he has referred when he said that he hopes that medical men will prescribe for three months?

Mr. Vosper

Some advice has been issued on this point, but I will gladly examine any evidence that the hon. Member may send to me.