HC Deb 04 May 1971 vol 816 cc1146-50
7. Dr. Summerskill

asked the Secretary of State for Social Services what plans he now has for further increases in prescription charges or for charging the patient a proportion of the cost of a drug.

25. Mrs. Doris Fisher

asked the Secretary of State for Social Services if he intends to introduce a cost-related system for prescriptions under the National Health Service.

28. Mr. John D. Grant

asked the Secretary of State for Social Services what representations he has received from the Pharmaceutical Society and/or other interested organisations concerning the introduction of cost-related prescription charges; and if he will make a statement.

36. Mr. Eadie

asked the Secretary of State for Social Services if he is now in a position to make a statement arising from representations made to him by the pharmaceutical industry arising out of proposed changes in prescription charges.

Sir K. Joseph

Preliminary proposals have been put to the medical and pharmaceutical professions as a basis for discussion, and I propose to discuss with their representatives the objections which they see. The pharmaceutical industry has been assured that I will inform it of any firm proposals which emerge.

Dr. Summerskill

Will the right hon. Gentleman in his discussions bear in mind that the professional bodies of the doctors and the pharmacists have strongly and publicly expressed their opposition to cost-related charges, in view of the fact that such charges would mean that the amount a person had to pay would depend on the nature of his illness and might affect the doctor's prescription.

Sir K. Joseph

It is because I want to understand fully their objections that I am seeking meetings with both professions.

Mrs. Fisher

Under the cost-related system the chemist must assess the price of the prescription before he dispenses it. Has the Minister considered the ethical question that will arise if a patient is short of money? When the patient is told what the charge will be he will ask the chemist which part of the prescription he ought to take. Thus an ethical question will arise between the medical profession and the chemist who dispenses the prescription.

Sir K. Joseph

The House will be aware that all those who suffer from pressure of finance should be relieved by the exemptions provided by the Government, but it is because I want to hear the chemists that I have sought a meeting with them.

Mr. Grant

Does not independent examination show that the administrative costs of introducing the new system would wipe out any savings? If the Minister will not take back his iniquitous proposals on the basis of ethics or principle, will he take them back on the grounds of efficiency?

Sir K. Joseph

No, Sir. The net saving of £15 million which my right hon. Friend the Chancellor of the Exchequer estimated is a saving after allowing for costs.

Mr. Eadie

Will the right hon. Gentleman tell us whether he will consult his right hon. Friend the Secretary of State for Scotland? Although there is a split of departmental responsibility, the right hon. Gentleman must know that Scottish pharmacists are indignant at this proposal and have said that it will eventually mean many people not being able to get the medicines they need because they will not be able to pay for them.

Sir K. Joseph

My right hon. Friends the Secretaries of State for Scotland and Wales and I will study the objections together very carefully.

Mr. Heffer

Is the right hon. Gentleman aware that there are working people who, because of the increased prescription charges, are not taking up their prescriptions, and that what was described by my hon. Friend the Member for Birmingham, Ladywood (Mrs. Doris Fisher) is already happening? Is it not an absolute disgrace that working people should be put in this position by the policy of the Government?

Sir K. Joseph

If the hon. Gentleman knows of such cases, I hope he will advise the people concerned of the immunities available and the help available by means of prepayment certificates.

Mrs. Shirley Williams

I ask the right hon. Gentleman seriously to reconsider this scheme. He will know that those who are suffering, for example, from chronic mental illness may face additional charges of as much as £1 to 30s. a week. He will also know that doctors are concerned about the "blunderbuss" principle—that is to say, putting several medicines together into one—and about the cost of a prescription for what might be described as black market, low-quality medicines. In the interests of the National Health Service I ask him to take back what seems to be an utterly destructive and misconceived scheme.

Sir K. Joseph

I must explain to the House that the scheme which my right hon. Friend and I propose to discuss with the professions is parallel with schemes already in operation in such countries as Sweden. It is not identical but it is parallel. The hon. Lady is quite wrong to talk of people having to pay £1 or more a week. A prepayment certificate limits the cost of all drugs that may be prescribed to 1p a day, and for that figure any citizen can get complete exemption from all future drug charges.

18. Mr. Pavitt

asked the Secretary of State for Social Services why the total cost of National Health Service prescriptions has more than doubled in the last 10 years.

Sir K. Joseph

Factors include the changed value of money; an increase in the number of prescriptions; and changes in the pattern of treatment involving the use of more effective and more costly drugs.

Mr. Pavitt

Is the right hon. Gentleman aware that we are still spending only 8 per cent. of our total budget on our general practitioner service, whereas we are spending 12 per cent. on pharmaceutical products? Is he also aware that for every eight general practitioners there is one commercial traveller from drug firms calling upon them? Is he further aware that each time the Government have put a charge on prescriptions, in 1956, 1961 and 1966, the drugs bill has risen? Last time it rose by £7 million. Will the right hon. Gentleman undertake a complete overhaul of his voluntary price regulation?

Sir K. Joseph

No, Sir. The country has benefited from the increased range and effectiveness of drugs, and this has contributed enormously to the relief of suffering.

Mr. Jessel

Does my right hon. Friend agree that a great deal of medicine is wasted and that we are a nation whose bedroom and bathroom cupboards bulge with half-used bottles of medicine? Would not it be a good idea if people were encouraged more to use the medicine that they are prescribed?

Sir K. Joseph

Yes, Sir. I agree with each of those propositions. But what a Government should do about it defeats me.

Dr. Summerskill

In view of the escalation in drug prices, will the right hon. Gentleman discuss with the medical profession the advantage of prescribing national formulary drugs, which are often just as effective as proprietary ones and a good deal cheaper?

Sir K. Joseph

I do not accept that the price of drugs in real terms has moved faster than the price of other commodities; on the contrary. As for the hon. Lady's suggestion, that should be addressed to her own profession as much as to the Government. Certainly I shall consider whether anything more can be done.