HC Deb 30 November 1959 vol 614 cc862-5
35. Mr. John Hall

asked the Minister of Health what representations he has received from the British Medical Association in connection with the provision of drugs for private patients under the National Health Service; and what his reply has been to these representations.

39. Dr. D. Johnson

asked the Minister of Health what is the nature of the administrative difficulties that prevent the provision of drugs to private patients under the National Health Service; and if he will make a statement.

The Minister of Health (Mr. Derek Walker-Smith)

The British Medical Association has represented that drugs should be supplied to private patients on the same terms as to National Health Service patients. This raises considerations wider than those of administration and I have conveyed to the Association the substance of my reply of 4th November to my hon. and gallant Friend the Member for Arundel and Shoreham (Captain Kerby), to which I would refer my hon. Friends.

Mr. Hall

Is my right hon. and learned Friend aware that his reply to my hon. and gallant Friend was extremely unsatisfactory? His predecessors in office stonewalled on this question for a number of years, first on the ground of cost, then on the ground that certain safeguards were necessary. Now that the profession has agreed to all the safeguards required, my right hon. and learned Friend finds another reason for doing nothing. If he has no intention at all of allowing private patients to obtain drugs under the National Health Service, would it not be much more honest of him to say so, rather than to find one fresh excuse after another?

Mr. Walker-Smith

The implications of my hon. Friend's somewhat lengthy supplementary question fall below his usual standard of accuracy in these matters. Is it not a fact that excuses are being found in this context. Discussions on administrative procedures were quite clearly made without commitment on the question of principle. On the question of principle, our position is that people have a right to resort to private practice if they so desire and, therefore, the preservation of private practice is a matter of concern to the Government. If the present position endangers the existence of private practice or prevents any substantial number of people availing themselves of it who would otherwise do so, we shall certainly consider the question of drugs. At the moment we have no evidence of that.

Dr. Summerskill

Is the right hon. and learned Gentleman aware that his attitude is approved by many doctors in this country and also by the whole of the public?

Mr. Partridge

Is it approved in Norway?

Dr. Summerskill

If the hon. Member is so interested in the question of heredity, I suggest that he reads Darwin's Origin of Species, which should interest him. I will send him a copy.

The right hon. and learned Gentleman's attitude is entirely correct, for these reasons. If he gives way to the pressure that is continually applied to him, he will in fact be establishing two classes of sick people in this country and he will undermine the National Health Service. Does he recognise that if he accepts the suggestions of the hon. Member for Wycombe (Mr. John Hall) the drug bill will be increased tremendously?

Mr. Walker-Smith

I do not think that the word "pressure" is particularly felicitous to describe the conscientious efforts of some of my hon. Friends to put forward considerations in the public interest. I think that the principle is quite clear. People are entitled to resort to the National Health Service and all that goes with it. They are also entitled, if they so prefer, to go to private practice. It does not necessarily and logically follow that if they do the second they should have drugs on the same terms as the first. It is important to preserve the right of private practice and, therefore, if the evidence is forthcoming we shall certainly consider it, but so far the evidence has not been forthcoming.

Dr. D. Johnson

Is my right hon. and learned Friend aware that the opinion of many of those in private practice is as he stated? They fear that their position as private practitioners is endangered by this. May I ask my right hon. and learned Friend if he is also aware that at the outset of the National Health Service it was clearly stated then, by no less a person than the right hon. Member for Ebbw Vale (Mr. Bevan), that all the service or any part of it is to be available to anyone in England and Wales, and does he not think that his present statement is contrary to the expression of intention?

Mr. Walker-Smith

I think not, because the provision of drugs is not a separate element but an ancillary part of the general practitioner service. As to the first part of my hon. Friend's supplementary question, there is, of course, a wealth of assertion to the effect that private practice is endangered and people are debarred from entering into it who would otherwise do so, but, as he knows, there is a difference between assertion and evidence and it is the evidence for which we look to be supplied. The British Medical Association has ample opportunities to supply that evidence if it is available and I shall certainly consider it most carefully and sympathetically.

Mr. Hall

In view of the extremely unsatisfactory nature of the reply, I beg to give notice that I will raise the question again at the earliest opportunity.