§ 5. Mr. Jesselasked the Secretary of State for Social Services what is the annual cost of medicines provided on prescription.
§ The Minister of State, Department of Health and Social Security (Dr. David Owen)The cost of medicines only is not available but the total cost in 1975 of drugs, dressings and appliances dispensed under the pharmaceutical services in England was £379 million.
§ Mr. JesselAs that figure of £379 million means that the cost to taxpayers is rising rapidly, will the Minister say what proportion of medicines and appliances is actually consumed or used and what proportion, especially of medicines, is wasted? Would not less medicine be wasted if people were taxed less and had to pay more for their medicines?
§ Dr. OwenIt is very hard to determine—I have no accurate figure—the amount of medicine wasted, but whenever unused medicines are returned, one finds that a considerable amount is turned out of people's medicine cupboards. What is needed is better prescribing overall and a recognition by patients that not every ailment is cured with pills.
§ Mr. WardWhen does my right hon. Friend propose to review the Regulations governing the dispensing of medicines, bearing in mind the numerous anomalies in the Regulations that he inherited and particularly the effect on migraine sufferers of the dual charge for drugs like Migraleve, in which two drugs are combined in one treatment?
§ Dr. OwenIt has always been the policy of the various specialist groups advising the Government not to encourage the prescribing of two separate ingredients simultaneously, on overall medical grounds, but the Regulations are open to certain problems, not least those that arise in the case of chronic sufferers having to pay prescription charges.
§ Dr. VaughanIn view of his recent statement, will the Minister reassure the medical profession that he has no intention of introducing legislation that would restrict their right to prescribe that which they think best for their patients?
§ Dr. OwenThe medical profession must recognise that it has to make economic decisions. At present the prescription bill has no cash limit and is open-ended, but if the medical profession were not able to show some form of economic restraint in its budget any Government would be forced to look at other measures. At the moment we prefer to rely on education and we hope to keep the drugs bill within reasonable bounds by that method.
Dr. M. S. MillerDoes my right hon. Friend agree that £7 a year per head of population is a relatively modest sum of money for all the benefits that come from the drugs section of the National Health service?
§ Dr. OwenOne can compare our costs with those of other countries, and we come out favourably. We must recognise that the continued existence of the voluntary price restraint has meant that the excess profits in the industry that appeared in the late 1950s and early 1960s, have been largely eradicated. We have a thriving and effective drugs industry, with a good export record.
§ Mrs. ChalkerWill the Minister look into over-prescribing by quantity of medicines within the health service, particularly in hospitals? Does he agree that there is now evidence that over-prescribing is rife in hospitals?
§ Dr. OwenI shall look at any evidence that the hon. Lady may have. On this subject one comes up against the problem of clinical freedom. In this case also one should try education. Hospital doctors are in much the same situation 178 as independent contractors in that respect. It is interesting that many hospitals require the signature of a consultant on prescriptions for the more expensive drugs, and junior doctors are allowed to prescribe only the less expensive drugs. They have not felt that to be an infringement of their clinical freedom. But it is a matter that we can examine.