HC Deb 16 July 1968 vol 768 cc1239-43
12. Mr. Murton

asked the Minister of Health why he has not excluded from the imposition of the prescription charge drugs supplied by hospital authorities to out-patients, and drugs supplied to other persons under the pharmaceutical services of the National Health Service, which are required for the treatment of chronic psychiatric disorders.

Mr. K. Robinson

I would refer the hon. Member to my reply to my hon. Friend the Member for Wandsworth, Central (Dr. David Kerr) and other hon. Members on 30th April.—[Vol. 763, c. 973–6.]

Mr. Murton

Will the right hon. Gentleman not agree that if patients suffering from these chronic illnesses are able to live full and normal lives in the community when supported by certain drugs, it is wrong that they should have to pay for these drugs?

Mr. Robinson

Those patients will be helped by the arrangements for single payment exemptions which I announced in the House recently. We discussed with the doctors the question of psychiatric illnesses, for which the need for medication is bound to vary with the nature, severity and duration of the condition, but we were not able to reach agreement to include them in the list of chronic diseases.

Mr. Pavitt

If my right hon. Friend cannot do that, will he take a special look at those undergoing intermittent dialysis on what are commonly known as kidney machines with a view to classifying them as in-patients?

Mr. Robinson

I will consider what my hon. Friend says, but they, too, will be helped by the arrangements that I have mentioned.

Mr. Dean

When does the Minister expect the single payment exemption scheme to come into operation?

Mr. Robinson

I have already said that I hope before the winter. I should not like to be more precise than that at the moment.

13. Mr. G. Campbell

asked the Minister of Health if he will make a statement on the latest position concerning exemptions from prescription charges.

20. Mr. Eadie

asked the Minister of Health if he is satisfied with the administrative arrangements involved in dealing with exemption of prescription charges; and if he will make a statement.

60. Mr. Cronin

asked the Minister of Health if he will make a statement on the latest position concerning exemption from prescription charges.

Mr. K. Robinson

The regulations providing for the reintroduction of prescription charges and the exemption of wide categories of patients came into operation on 10th June. It is as yet too early to reach firm conclusions about the operation of the arrangements.

Mr. Campbell

With reference to the Minister's replies to the last Question, will he reconsider the position of those suffering from chronic mental illnesses, because long-term medication can keep them out of hospital and thus be less expensive for the Exchequer?

Mr. Robinson

I am aware of this, and I have nothing to add to the reply that I gave just now to the hon. Member for Poole (Mr. Murton).

Mr. Eadie

Would my right hon. Friend not agree that the form filling part of the administration is regarded as complicated? Is he aware that my mail bag seems to demonstrate this fact?

Mr. Robinson

Despite the wide publicity before the charges were reintroduced, I expected that it would be a little while before the public at large became familiar with the arrangements. Preliminary information suggests that this has been so and that additional burdens have, as a consequence, fallen upon chemists, whose co-operation I appreciate. But, progressively, I expect the position to improve.

Sir J. Vaughan-Morgan

Will the right hon. Gentleman bear in mind the great cost of administration falling upon hospitals, chemists and others in administering these very complicated exemption arrangements?

Mr. Robinson

This has been taken into account.

Dr. Summerskill

Can my right hon. Friend say whether the total number of prescriptions issued has fallen since the imposition of charges? If so, does he agree that the interpretation is that people are not seeking medical advice because of this?

Mr. Robinson

I have no evidence yet one way or the other. As soon as I have evidence, I shall keep the House informed.

Lord Balniel

Does the right hon. Gentleman agree that in the opinion of many chemists, doctors and the chronic sick the present arrangements are illogical, unfair and in many ways very muddled? Will he re-examine the whole position?

Mr. Robinson

It will not be possible to take a proper conspectus of the present arrangements until they are completed by the arrangements which I hope to introduce before the winter.

14. Mrs. Renée Short

asked the Minister of Health what steps he intends to take to remove anomalies in legislation concerning prescription charges affecting women pensioners and school children over the age of 15 years.

Mr. K. Robinson

I would refer my hon. Friend to my replies of 2nd February to my hon. Friend the Member for Cardigan (Mr. Elystan Morgan), and 1st July to my hon. Friend the Member for Huddersfield, West (Mr. Lomas).— [Vol. 757, c. 429; Vol. 767, c. 182.]

Mrs. Short

Has not my right hon. Friend changed his mind since he gave those replies? If not, does not he think that it is time he did? How does he justify the fact that women old-age pensioners cannot claim exemption while their husbands can if they are a certain age, and that children staying on at school until the age of 18 must presumably pay for their prescriptions? It is a nonsensical situation.

Mr. Robinson

The answer to my hon. Friend's first two supplementary questions is "No," Sir. As I told the House before, there is some misunderstanding about this. It is an age exemption, and women pensioners aged between 60 and 64 who are in need are dealt with under separate arrangements through exemption or refunds arranged through the Ministry of Social Security. The arrangements in force are precisely those on age grounds announced by my right hon. Friend the Prime Minister initially.

19. Mr. Eadie

asked the Minister of Health how many organisations have written to him protesting against the fact that women over 60 years of age and retired may be required to pay prescription charges.

Mr. K. Robinson

In addition to the pensioners' organisations I referred to in my Answer to my hon. Friend yesterday, representations have also been made by about half a dozen local organisations. —[Vol. 768, c. 164.]

Mr. Eadie

Does my right hon. Friend agree that many women feel that there is an active discrimination here? I am glad to say that because of this there will be a building up of resentment against the imposition of prescription charges.

Mr. Robinson

There probably is a feeling of discrimination amongst some women, but, as I have tried to explain to the House, it is based on misunderstanding. There would be anomalies whatever one did. If I adopted my hon. Friends suggestion there would be anomalies as between the woman of 63 who was a pensioner and the one who was not a pensioner.

Mr. Will Griffiths

When my right hon. Friend is grappling with the distasteful consequences of the reimposition of charges, does he ever reflect on his speeches in a happier period when he forecast exactly this consequence?

Mr. Robinson

I often reflect on my earlier speeches and on my future speeches.

Mr. Maurice Macmillan

Why is the age criterion for men linked to the age of retirement, but not for women?

Mr. Robinson

One might say that it was fortuitous that it is 65, which happens to be the age of patient at which general practitioners get a supplementary allowance for all the patients on their list.

25. Mr. Fortescue

asked the Minister of Health what steps he proposes to take to overcome the problem caused by the fact that many elderly people experience difficulty in signing the forms entitling them to exemption from prescription charges.

Mr. K. Robinson

I would refer the hon. Member to my reply to my hon. Friend the Member for Willesden, West (Mr. Pavitt) on 9th July.—[Vol. 768, c. 40.]

Mr. Fortescue

Is the right hon. Gentleman aware that a great many elderly people, because of failing eyesight, or rheumatic or arthritic fingers, or even because of sheer illiteracy, are embarrassed by the fact that they have to go to a shop in a public place and sign a form? Will he consider the possibility of their being allowed to produce their pension books instead of having to sign the forms?

Mr. Robinson

I am aware that some problems have arisen from the design and layout of the declaration on the back of the form. My Department is considering possible improvements in the design of the back of the prescription form.

Dr. John Dunwoody

Would not my right hon. Friend agree that many old folk find extreme difficulty in reading this form, rather than signing it, because the print is so small? Can he explain why the forms are now printed in blue?

Mr. Robinson

I cannot answer my hon. Friend's last supplementary question. I can only suggest that the obvious explanation is the unlikely one in this case. As to the first part of his question, as I have already told the House, I am considering improvements in the design of the form.