HC Deb 26 January 1959 vol 598 cc699-701
52. Mr. Blenkinsop

asked the Minister of Health, what proposals he has for introducing amending legislation to enable patients who choose private medical treatment to have the cost of prescriptions charged against the National Health Service.

Mr. Walker-Smith

None at the moment; but the British Medical Association have asked for an early discussion on this matter and I shall, of course, give careful consideration to what they say.

Mr. Blenkinsop

Will the Minister give an assurance that there will be no suggestion of trying to introduce what amounts to levels and standards of service in the National Health Service? This would be damaging and would destroy the whole meaning of the National Health Service itself.

Mr. Walker-Smith

I think the hon. Gentleman put the supplementary question in such general terms as not to be capable of a very precise answer. What I would say is that in considering the advice that I receive from the British Medical Association I shall, of course, bear the matter in mind in the context of the whole public interest.

Dr. Summerskill

Will the right hon. and learned Gentleman tell the House when this meeting is to take place, because it may be necessary for us as the Opposition to make representations to him on this matter?

Mr. Walker-Smith

The date for the meeting has not yet been fixed. I will, of course, bear in mind that the right hon. Lady may wish to make her views known.

53. Mr. Blenkinsop

asked the Minister of Health whether he will now make a statement regarding the continued imposition of charges for prescriptions under the National Health Service.

55. Mr. Prentice

asked the Minister of Health whether he is aware that the system of charging Is. for each item on a doctor's prescription has led to an increase in the cost of the prescription service, owing to the tendency of the doctors to prescribe larger quantities in order to reduce the burden on poorer patients; and whether he will consider the abolition of these charges.

Mr. Walker-Smith

These charges are being continued at present. I, of course, always keep under consideration all relevant circumstances relating to the financing of the National Health Service. In this context the additional cost due to the prescribing of larger quantities for chronic conditions must be set against the saving resulting from the substantial reduction in the number of prescriptions and the additional receipts from charges. I am satisfied that, as a result of the change in the basis of patients' charges, the burden on the Exchequer was less than it would otherwise have been.

Mr. Blenkinsop

Is the right hon. and learned Gentleman not now convinced after the report published in the Lancet, to which I am sure his attention has been directed, that this new charge is, in fact, a waste and medically it can be dangerous?

Mr. Walker-Smith

I have, of course, studied the article in the Lancet to which the hon. Gentleman refers but I think there is some misconception in that. What the article in the Lancet shows is that the drug bill for 1957 was larger than the drug bill for 1956. But that is not the material question. The material question is whether the drug bill for 1957 was as large as it would have been had we continued the old basis, and it is on that that I say a saving has been made.

Mr. Prentice

Did not the Minister see that the statistical analysis in the Lancet indicated that something like 40 per cent, of the increase in the average prescription was due to the tendency of doctors to prescribe larger quantities because they wanted to avoid putting on to their poorer patients a higher bill? Does not this show that the whole policy was misconceived?

Mr. Walker-Smith

No, I do not think so. It is appropriate for doctors to prescribe large quantities in chronic cases and that is not necessarily a wasteful procedure. To meet cases of actual hardship there is, of course, a system of refund in connection with the National Assistance Board.

Dr. Summerskill

Besides reading the article in the Lancet, has the right hon. and learned Gentleman examined closely the analysis made by the research workers appointed by the London School of Economics?

Mr. Walker-Smith

I have not got that presently in mind, but I will refresh my memory about it.