§ 6. Mr. Cronin
asked the Secretary of State for Social Services if he will give estimates of the amounts of expenditure for which the average general practitioner and the average consultant with his team are responsible, respectively, in making clinical decisions in the course of a year in the National Health Service.
§ Mr. Ennals
Detailed estimates cannot be made but, if the cost of the pharmaceutical and of the general medical services were broadly attributed to clinical decisions by general practitioners and the running costs of the hospital service to consultant teams' decisions, estimated averages for England in 1976–77 would be £36,000 and £290,000.
§ Mr. Cronin
Is it not the case that, for the sake of the principle of clinical freedom, there is hardly any effective control of this expenditure? Bearing in mind the intense pressures to which doctors are subjected by the pharmaceutical industry, would it not be possible for the Government, in consultation with the profession, to achieve some useful economies in this direction without prejudicing in any way the interests of patients?
§ Mr. Ennals
There is a major problem of escalating costs in the pharmaceutical industry. There are two aspects of the matter. One aspect concerns the cost of the pharmaceutical industry to the National Health Service, and I have been able to take action to limit the extent to which expenses can be set against costs charged. I am reducing the figure of spending from 14 to 10 per cent., and that will represent a saving. The other aspect relates to prescribing by general practitioners and hospitals. These are matters which can be dealt with only in consultation with the medical profession, but since this is 259 a part of the NHS over which there is no control whatever it should properly be discussed with the profession.
§ Mr. Speaker
Order. May I appeal to right hon. and hon. Members to ask shorter supplementary questions and to give shorter answers?
Dr. M. S. Miller
Does my right hon. Friend appreciate that those figures will be of great interest to general practitioners? Since the family doctor service is a sector of the National Health Service which attracts only 8 per cent, of the total cost of the service, and is the point at which most people have contact with the service, does not my right hon. Friend agree that if more money was spent on that aspect of the service it would be well spent and also cost effective?
§ Mr. Ennals
I shall be very brief, Mr. Speaker. This is the area with the greatest growth rate of expenditure in the National Health Service, and intentionally so. Primary care is an extremely important matter. There is a substantial growth rate in the amount of funds available for primary care as well as in the number of nurses working in the community.
§ Mrs. Chalker
Will the Minister publish a list of medical journals which will be threatened if he does not give more consideration to the speech which he delivered on 24th September?