HC Deb 02 December 1968 vol 774 cc1011-4
12. Mr. Eadie

asked the Secretary of State for Social Services what advice his Department issue to mothers of still-born children regarding prescription charges.

The Minister of State, Department of Health and Social Security (Mr. David Ennals)

A note on the exemption certificate asks that it should be returned in the event of miscarriage or the death of the child.

Mr. Eadie

Is my hon. Friend aware that many pharmacists are finding difficulty in understanding precisely what this means and that there is great confusion in this matter? Would he try to do something about this with a view to trying to make clear the rights which mothers of still-born children have in this matter?

Mr. Ennals

The fact that my hon. Friend has asked this Question may help to clarify the matter. The advice is certainly regarded as applicable in the case of the stillborn child and I think the majority of pharmacists know this to be so.

Mr. Dean

Does not this show that there are still many rough edges on the prescription charges scheme with the exemption, and can the hon. Gentleman give an assurance that he will look at this in order to try to smooth them away?

Mr. Ennals

I think initially we recognised that there were one or two areas which needed to be improved. We have already improved them. Of course if any further changes are required we will seriously look at them. However, I am satisfied that the system is working satisfactorily.

Mr. Cronin

Would not the most helpful action be to abolish prescription charges as rapidly as possible?

Mr. Ennals

I think my hon. Friend knows that if we were to do this we would from some other source have to find £25 million of very valuable revenue.

43. Mr. Pavitt

asked the Secretary of State for Social Services if general practitioners in rural areas who dispense medicines for their own patients will receive additional remuneration for the collection and other arrangements involved in prescription charges.

Mr. Ennals

No, Sir.

Mr. Pavitt

Is my hon. Friend aware that this is causing considerable difficulty for rural practitioners, who feel that they are being paid half a crown for their services—about one-tenth of what a plumber gets? If my hon. Friend cannot provide extra pay for them will he consider some kind of propaganda campaign, so that patients will be aware of the situation?

Mr. Ennals

No undertaking was given, nor was the matter raised when the scheme was initiated. The rural doctor has much less of a job to do than the chemist. He is not required to secure a written declaration of entitlement to exemption. He does not have to give a receipt and collect the refund. He knows his patients in a way that the chemist does not. Therefore, the problems for him are very much less onerous than they are for the chemist.

Mr. Eldon Griffiths

Does the hon. Gentleman accept that this matter is causing considerable concern among rural practitioners, who find that their costs are rising? There is also the fact that it is becoming increasingly difficult for patients to get to their places of business. This is a matter of importance. I hope that the hon. Gentleman will reconsider his answer.

Mr. Ennals

I will bear in mind the points that have been raised by hon. Gentlemen, but it is my present conclusion that there is no need for a change.

33. Mr. Pavitt

asked the Secretary of State for Social Services how he intends to check the veracity of persons who claim to be exempt from prescription charges because they hold a season exemption certificate; and what is his estimate of the cost of this check.

Mr. Ennals

Comprehensive records maintained by executive councils and social security offices, including records of the issue or prepayment certificates, enable them to determine whether or not patients are entitled to exemption and systematic sample checking is already in progress. I would expect the total additional cost to be of the order of £50,000 a year, only a small part of which would relate to declarations concerning prepayment certificates.

Mr. Pavitt

Does that £50,000 include any legal prosecutions that may arise?

Mr. Ennals

It does not include them, and one naturally hopes that they will not arise. My present impression is that there is likely to be very little misappropriation or failure to carry out the regulations. I hope that it will not be necessary for any prosecutions to be instituted.

Sir B. Rhys Williams

Would it not be a tremendous saving if Income Tax were used as the means test to end all means tests, and all these investigations of people's circumstances were dropped?

Mr. Ennals

The hon. Member is doing his best, but that is another question.

49. Mr. Lomas

asked the Secretary of State for Social Services if he will take steps to designate all patients who need hospital treatment as chronic sick and exempt them from prescription charges.

Mr. Ennals

No, Sir. No charges are made to in-patients, but we do not think there are grounds for any general differentiation between hospital out-patients and the patients of general practitioners.

Mr. Lomas

Does the Minister not appreciate that prescription charges are completely against the principle of a health service free for all in time of need, in which we believe? Does he realise that hon. Members on this side of the House believe that people who need hospital treatment are being penalised—especially those on low wages? Cannot something be done about this?

Mr. Ennals

Those who have very small incomes are exempted. I told the House in answer to earlier questions, that approximately 50 per cent. of the general public is exempted. I am certain that the proposal put forward by my hon. Friend would lead to a great deal of difficulty.

50. Mr. Lomas

asked the Secretary of State for Social Services what estimate he has made of the cost of additional staff in hospitals needed for the collection of prescription charges and of the cost of the additional clerical and bookkeeping work involved; and if this sum will be taken into consideration when he assesses the benefit to the Exchequer accruing from these charges.

Mr. Ennals

About £75,000; this has already been taken into consideration.

Mr. Lomas

Is the Minister aware that early this afternoon he gave a figure of savings amounting to £25 million through the imposition of prescription charges? Does not he now agree that with the additional cost involved it is not worth the candle to do this kind of thing to people who are in need? Will he seriously consider abolishing the whole scheme?

Mr. Ennals

I am afraid that I do not for a moment accept my hon. Friend's conclusions.

Mr. Russell Kerr

Why not?

Mr. Ennals

Because when the estimate of the £25 million saving was made the figure I have given and other figures were taken into consideration. The amount of money involved is very important in terms of the expansion of the hospital services.

Mr. Lubbock

Is the Minister aware that this £25 million saving is not a real one but is only a saving in terms of the transfer payments involved, whereas the waste of manpower involved in clerical operations such as he has mentioned represents the true cost to the nation, since the people concerned could be employed on more useful duties?

Mr. Ennals

The hon. Member has referred to clerical workers. Only about 100 clerical staff are concerned. In the majority of cases the work is done by other persons doing tasks additional to those that they were already doing.