§ 4. Mr. Easthamasked the Secretary of State for Social Services what has been the percentage increase in expenditure on family practitioner committees during the past five years; and how this compares with the increase in expenditure in the National Health Service as a whole over the same period.
§ Mr. Kenneth ClarkeExpenditure on family practitioner committees cannot be wholly identified in the accounts of health authorities, and valid comparison with total NHS expenditure cannot, therefore, be made.
§ Mr. EasthamIs the Minister aware that there is growing, grave disgust at the Government's motives in their operation of the family practitioner committees? There is a feeling now that extra growth will be allowed only through increased charges. Will the Minister assure us that that will not be the case?
§ Mr. ClarkeI can give an assurance on the last point. We are proposing to reduce bureaucracy and administration and release resources for service development. At the moment FPCs are responsible direct to the Secretary of State for the administration of the services. Our legislation will enable them to employ their own staff direct and be responsible for their own management. We believe that that will lead to more efficient administration, which will release yet more money for an improvement in service.
§ Dr. MawhinneyWill my hon. and learned Friend get to grips with the over-extensive and over-expensive drug prescribing habits of general and family practitioners?
§ Mr. ClarkeWe continue to exhort doctors to be more careful in their prescribing of drugs. The recent report, although it contains one or two controversial proposals upon which comments have been made, contains some substantial backing for the advice that has been given to the medical profession on better and more cost-effective prescribing. I agree that we need to make savings in that area in order once more to release resources for patients' services.
§ Dr. M. S. MillerI agree with the Minister that it might not be possible to identify the increase in family practitioner committee expenditure within the National Health Service as a whole, but does he agree that there is an area in which he could identify a large increase? By how much has the drug bill increased over the past five years?
§ Mr. ClarkeThe hon. Gentleman is correct. The answer referred to committee expenditure, which cannot be identified separately. The cost of the family practitioner service is increasing somewhat faster than the costs of the hospital and community services. Some of that is accounted for by the increased drug bill, part of which is the cost of new advances in drugs. However, we must ensure, as I have just said to my hon. Friend the Member for Peterborough (Dr. Mawhinney), that that drugs bill is not pushed up too far by wasteful over-prescribing or other wasteful policies.
§ Mrs. DunwoodyDoes the Minister admit that the change that will allow family practitioner committees to be even more independent will make it virtually impossible for him to impose sensible standards upon them? They will be far more independent. Will he admit now that he intends to do little to implement the Greenfield report on effective prescribing?
§ Mr. ClarkeI await with great interest to discover precisely on what grounds the hon. Lady will oppose that proposal for FPCs when we debate them on Thursday. I understood that she was complaining that we were putting them too much under the direct control of my right hon. Friend the Secretary of State. She is now complaining that we are making them too independent. She will find that we are merely reducing bureaucracy and ensuring that money is not wasted on administration.