§ 43. Mr. Abseasked the Minister of Health whether he is aware that the new right granted to the family doctor to make charges to a patient for prescribing oral contraceptives and for prescribing or fitting of contraceptive appliances is a discouragement to family planning and in conflict with the recommendation of the Royal Commission on Population that general facilities for family planning advice and treatment should be available under the National Health Service; whether he is aware that this new right will fall more onerously upon parents with large families and low incomes; and what are the reasons that have prompted him at this time to permit doctors to charge these fees.
§ Mr. K. RobinsonNo, Sir. The Royal Commission said that advice on contraception should be given under the National Health Service, and no charge is proposed for this. The prescribing or fitting of contraceptives on social as opposed to medical grounds is not, however, part of medical care under the Health Service, and a small charge in such cases is therefore reasonable. I do not believe this will discourage family planning, but the arrangement is subject to review.
§ Mr. AbseIs it not a most retrogressive step, and in complete breach of our election pledges, that prescriptions 14 should be charged? Is it not, indeed, quite in conflict with all the urging the Minister has done through the local authorities to get on with family planning when we are creating a system under which the more people are in need but least able to afford this attention, the less opportunity they will have for it? Why has my right hon. Friend capitulated to the doctors, who have already had this large increase?
§ Mr. RobinsonThere is no question of any capitulation here. My hon. Friend must have misunderstood, because in such circumstances a doctor may already issue—indeed, always has issued—a private prescription. The only difference here is that for issuing a private prescription the doctor is entitled to make a small charge. This seems to be reasonable and logical. I do not for one moment believe that it will discourage family planning. Indeed, I think that it will encourage people to go to the family doctor on this matter, which I want them to do.
§ Mr. DeanCan the Minister say how he reconciles the introduction of this new charge with his declared policy to abolish all charges within the Health Service?
§ Mr. RobinsonIt seems that the hon. Gentleman, too, does not appreciate the distinction between the private prescription and a National Health Service prescription.
§ Mr. PagetMay not this provision of a premium from the doctors' point of view—to make it more profitable to prescribe this form of treatment—have some distorting effect?
§ Mr. RobinsonI do not honestly think that doctors will be guided in the kind of advice they give to their patients by whether they get a fee of half a crown or so for writing out a prescription—[Interruption.] If I do not know the doctors, I do not know who does. I can assure my hon. and learned Friend that I have made it quite clear to the doctors that this move is experimental, and that if it were to act to the disadvantage of a patient who required the service on medical grounds it would be subject to review in the light of experience, and the doctors have accepted that.
§ Mr. AbseIn view of the unsatisfactory nature of the reply, I beg to give notice 15 that I will seek to raise the matter on the Adjournment at the earliest opportunity.