Drugs

HC Deb 14 May 1962 vol 659 cc902-7

4. Mr. Pavitt

asked the Minister of Health how many new drugs have been prescribed to National Health Service patients before adequate clinical trials have taken place in the last three years; how many of such drugs have been withdrawn; and what steps he is taking to protect patients in this matter.

The Parliamentary Secretary to the Ministry of Health (Miss Edith Pitt)

It is not for my right hon. Friend to judge when adequate clinical trials of drugs have taken place. It is the doctor's responsibility to decide whether he is justified in prescribing a particular drug for a particular patient.

Mr. Pavitt

Is the hon. Lady aware of the concern expressed by Lord Cohen at a recent seminar and the statement by Professor Graham Wilson that, in the last year, more than half the drugs which had been issued had not been correctly clinically tested? Further, is she aware of the position in regard to the drug thalidomide which has been used for three years but has had harmful effects upon pregnant women? Is it not the Minister's duty to protect the patients in this respect?

Miss Pitt

I am aware of the symposium which was held and of the comments which were made. The drug to which the hon. Gentleman refers is the subject of a later Question, and I shall not anticipate the Answer. In fact, the British pharmaceutical industry and the medical profession both maintain a very high sense of responsibility in this matter.

Mrs. Slater

Does not the hon. Lady think that there ought to be some control by the Ministry and clinical testing of drugs before they are put on the market with the high-pressure salesmanship and intensive advertising which goes on? Are the patients to go on suffering because doctors just have not the time or are not supplied with knowledge of whether certain drugs are clinically safe or not?

Miss Pitt

This is not the responsibility of the Minister of Health. It is the responsibility of the drug manufacturers and the doctors, and I have no reason to believe that the information is not available.

Mr. Pavitt

But is not a doctor able to prescribe only that which he is permitted to prescribe and which is paid for under the National Health Service? How can the hon. Lady shelve responsibility in this way, in view of the fact that these statements have been made by very responsible people, professors of pharmacology, and that of 56 drugs tested by Professor Wilson only 25 were found to have been adequately tested by clinical means?

Miss Pitt

It still is not the responsibility of the Minister of Health to tell the doctors which drugs they shall prescribe. It is the responsibility of the Minister to see that a service is available to patients.

5. Mr. Pavitt

asked the Minister of Health if he will establish a central body independent of the drug industry and responsible to him charged with the duty of approving all drugs to be prescribed to National Health Service patients.

Mr. Powell

I have no powers to do this.

Mr. Pavitt

Is not this totally unsatisfactory? If the responsibility rests on the doctor, is it not possible to ensure that he has in his possession clear unbiassed opinions telling him the qualities of drugs and what the side-effects are likely to be? Is it not inherent in the booklet prepared by the manufacturers that they must be able to be selective in the information they give? Should not the prescriber be in full possession of all the facts? I recognise that the pharmacological and drug houses have a high measure of responsibility and in the main are responsible, but in cases where there is doubt ought not the prescriber to have that knowledge put into his hands and should not a central body be responsible for that decision?

Mr. Powell

The National Health Service Acts quite rightly, in my opinion, gave me no powers to limit the drugs that a doctor may prescribe, but the Cohen Committee, that considers new preparations, and indicates those of no proved therapeutic value, and the grounds for doing so, may include the fact that adequate clinical trials have not been carried out.

Sir H. Linstead

My right hon. Friend will be aware that in his Department a working party has been dealing with this type of problem for about two years. Is he able to say whether he has yet received a report from that working party and, if so, whether it makes any recommendations on the subject matter of this question?

Mr. Powell

Not without notice.

23. Mr. Dance

asked the Minister of Health whether he will give wide publicity to the dangers to pregnant women of the drug called thalidomide to ensure that people who have supplies of this drug in their home will destroy them.

Miss Pitt

My right hon. Friend and the Secretary of State for Scotland are taking steps to give warning through the Press and otherwise of the risk of taking hypnotics in circumstances for which they have not been prescribed.

Mr. Dance

While thanking my hon. Friend for that reply, may I ask whether she is aware that at the same time there is a drug marketed in this country known as Distaval which has ghastly effects? Does she not agree that the widest publicity should be given to what this drug can do—the ghastly effect it can have on unborn children? While I realise, from an Answer to a previous Question, that this is not her responsibility, would not my hon. Friend agree that before any new drugs are put on the market the widest possible investigation should be made of any adverse effects they might have?

Miss Pitt

I think that we should all have in mind the necessity of not worrying pregnant women unduly. Nevertheless, this particular drug has been withdrawn and the medical profession has been warned by manufacturers and by articles in the medical Press. We in the Department are prepared to add to that very quickly by issuing a Press statement and by writing to general practitioners, medical officers of health and to hospitals asking them to warn women patients of the dangers which they might incur during the pregnant stage if they use drugs which are not specifically prescribed at that time.

Mr. Dance

Will my hon. Friend also bear in mind the fact that this drug is available to women who are not pregnant? They may have some in their medicine chests at home and if they have discovered them to be effective as tranquilisers they might take them again when they are pregnant. I want all of this drug destroyed in people's homes.

Miss Pitt

That is why I put particular emphasis on women not using drugs prescribed for a condition other than that for which they were prescribed.

Mr. Pavitt

Is the hon. Lady aware that this drug was available for three years before this kind of information was available? We do not wish to worry pregnant ladies unduly, but it should be stressed that it should be the Minister's responsibility to see that protection is given.

Miss Pitt

That is really a separate question, but, in fact, the drug had extensive tests, in Germany first and then in this country. The side-effects which showed later could not possibly have been foreseen.

27. Mr. Holt

asked the Minister of Health to what extent there has been increased prescribing by doctors of standard drugs from the British National Formulary in preference to identical pro- prietary brands; and what is the estimated saving to the Exchequer in a full year.

Miss Pitt

It is still too early to judge.

Mr. Holt

Will the hon. Lady consider some way of helping doctors to write out their prescriptions when prescribing drugs from the British National Formulary? The branded description is often much more simple than the chemical one. Would not the provision of a rubber stamp which impressed the words "British National Formulary", Which doctors could stamp on their prescriptions, assist them?

Miss Pitt

I will consider that point. At first blush, it does not seem to me to be very practicable. I may also add that the Cohen Committee recently approved lists of proprietary preparations and branded preparations whose active therapeutic constituents are identical or differ only in physical form. My right hon. Friend is considering at the moment how the information in these lists can be presented.

Mr. K. Robinson

I appreciate that it may be too early to estimate annual savings, but can the hon. Lady say whether the returns coming into her Department show any marked improvement since the new policy was adopted?

Miss Pitt

Our experience is still not really sufficient to give any indication. It will mean considerable analysis of all the returns over a twelve-month period.

37. Mr. Longden

asked the Minister of Health if he will now state how his negotiations with firms in the pharmaceutical industry under the voluntary price regulation scheme are progressing.

Mr. Powell

Most prices have now been reviewed and a number of substantial reductions in the prices of patented drugs have been agreed. Negotiations continue.

Mr. Longden

I thank my right hon. Friend for that Answer. Can he tell the House how much this element of the National Health Service is now costing? Last July he said that it was costing £100 million a year, Secondly, is he satisfied that the patient is getting the maximum benefit from these drugs? Thirdly, in view of certain earlier Questions this afternoon, will he again confirm that all those in genuine need can get a refund of the prescription charge?

Mr. Powell

I cannot, offhand, give my hon. Friend the total cost of the pharmaceutical service on an annual basis at this moment, but reductions in the prices made since the new scheme came into effect total about £4 million a year. I can assure him that none of these reductions in price has operated to the disadvantage of any paient; in fact, the contrary is probably the case.