HC Deb 20 March 1967 vol 743 cc1044-6
21. Mr. Fisher

asked the Minister of Health, in view of the fact that it is his policy to allow doctors freedom to prescribe what they believe to be in the best interests of individual patients, if he will give an assurance that he will not erode this right by limiting prescribing to a list of products approved by a central committee.

Mr. Snow

This is not my right hon. Friend's intention, but he hopes doctors will heed advice sent to them by such a committee.

Mr. Fisher

I am grateful for that reassurance, because all patients do not respond in exactly the same way to the same medicine. Will the hon. Gentleman bear in mind that a committee's simple mandatory recommendation, although no doubt perfectly all right for most people, would be undesirable if it proved the wrong drug for a minority of patients who perhaps are allergic to it?

Mr. Snow

The operation of this committee is to some extent, if not predominantly, concerned with differentiating between what I would describe loosely as generic drugs which may be combined one with the other and therefore reduce the flexibility available to the doctor for a particular treatment, and which incidentally are sometimes very expensive, and drugs which are unacceptable due, for instance, to an unacceptably lesser degree of efficacy or unacceptable because of greater toxicity than the alternative monograph preparations.

Dr. David Kerr

Would my hon. Friend accept it from me that nobody is trying to push doctors into prescribing according to a list supplied by a committee? Would he please take note that it is now possible for instructions to be given to chemists to dispense official preparations which are exactly analogous to prescription for proprietary preparations? If chemists were to do this, it could conceivably save the National Health Service a great deal of money.

Mr. Snow

I should like those words to be written above the door of every chemist in the land.

Mr. Braine

Will the Parliamentary Secretary confirm that it is no part of the Minister's function to interfere with the doctor's right to prescribe for his patient whatever drugs he thinks fit, irrespective of cost?

Mr. Snow

I should have thought that that observation needed some qualification, but there is no question of doctors being forbidden to prescribe the so-called category B preparations. I am sure that before prescribing them doctors will take into account the views of this very eminent professional body.

Dr. Summerskill

Will my hon. Friend bear in mind that many family doctors are far too busy to compare the relative merits and prices of a host of drugs all of which claim to treat the same condition and that they would appreciate guidance in this matter?

Mr. Snow

I think that guidance is given, but the doctor always has the final sanction of not receiving salesmen.

Dr. Winstanley

Is the Parliamentary Secretary aware, first, that many practitioners welcome advice on the value of individual drugs from central sources, and, secondly, that they would welcome any steps taken centrally to reduce the multiplicity of drugs which are virtually of an identical nature?

Mr. Snow

Yes. We have taken note of that.