HC Deb 16 April 1985 vol 77 cc129-31
11. Mr. Beith

asked the Secretary of State for Social Services what further discussions he has had with representatives of the medical profession about a scheme for prescribing unlisted medicines in exceptional circumstances.

Mr. Fowler

We have had several meetings with representatives of the medical profession to discuss a mechanism which would allow drugs not generally available at National Health Service expense to be prescribed in exceptional circumstances. Those discussions are making good progress and I hope that we can soon reach agreement.

Mr. Beith

Ought not the scheme to have been in place from the beginning of the operation of the limited list, and is it not wrong for the Minister to put the onus on the BMA when the state of his relations with that body are of no interest whatsoever to that minority of patients who may need drugs that are not on the list?

Mr. Fowler

I think that it was up to the BMA to start the talks. There is no way that I can start discussions with the medical profession unless it is prepared to have them. Even the Liberal party must accept that. We started discussions on the appeal mechanism as soon as was possible after the regulation was passed by the House. Progress is being made and I am optimistic that we shall soon have an agreement.

Mr. McCrindle

Is it correct to say that some doctors appear to be going out of their way to circumvent the provisions of the scheme? Will my right hon. Friend give an undertaking that he will do all that he can to ensure that, consistent with patients continuing to receive the drugs that they require, the anticipated savings will be achieved?

Mr. Fowler

Yes, I can give my hon. Friend an assurance on the last point. There is very little evidence that any abuses are taking place, but clearly we shall keep the position under review.

Mr. Loyden

Is the Secretary of State aware that serious concern and distress are being experienced by many patients because of the limited list? Would it not have been far better for him to await the outcome of his discussions and the establishment of an appeals machinery before taking the action that is now causing concern among doctors and patients?

Mr. Fowler

I do not accept that. We announced the proposals in November. That gave time for discussions and consultation with the public. It was entirely the responsibility and decision of the medical profession not to start those talks. As I have said, those talks have now taken place and I am optimistic that they will have a successful outcome very quickly.

Sir Bernard Braine

Is my right hon. Friend aware that not all doctors are going out of their way to frustrate these arrangements and that, in the case of the chronically sick, those who are permanently ill and need pain-killing drugs, many doctors are complaining—certainly to me in my constituency — that they are precluded from prescribing what they believe to be clinically necessary?

An Hon. Member

Nonsense.

Sir Bernard Braine

It is not nonsense in south-east Essex. What arrangements is my right hon. Friend making for greater flexibility in this matter so that patients' needs can be met?

Mr. Fowler

I agree entirely with my right hon. Friend that there is no evidence that doctors are seeking to abuse this system. The whole purpose of the talks that we are having is to meet any legitimate concerns that there may be. I think my right hon. Friend will accept and agree with me that in the first stages this new system has gone remarkably well.

Dr. Roger Thomas

Can the Minister inform us whether it is now legal and legitimate for general practitioners to provide patients with medications on the so-called blacklist if they put down on the prescription form a list of the generic contents of that particular medication?

Mr. Fowler

In one or two cases that is clearly the case, as with the ingredients of a distalgesic. That is the case and always has been.